Abortion

Question 1

What is an abortion?

Answer 1

It is an elective procedure to end a pregnancy

Question 2

What is another term for abortion?

Answer 2

Termination of pregnancy

Question 3

What is the legal framework for abortions?

Answer 3

1967 Abortion Act

Question 4

What is the 1967 Abortion Act?

Answer 4

It involves two registered medical practitioners supporting the woman’s request under the following circumstances…

• The pregnancy is likely to risk the life of the pregnant woman, greater than if the pregnancy is terminated
  -The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman
• There is substantial risk that if the child was born it would suffer from physical or mental abnormalities as to be seriously handicapped

Question 5

Which regions of the UK does the the 1967 Abortion Act cover?

Answer 5

Scotland

England

Wales

Question 6

What is the legal status of abortions in Northern Ireland?

Answer 6

It is permitted if under 28 weeks gestation and it is completely the women’s choice - not the doctors

Question 7

How should clinicians manage patients who wish to have an abortion - however they have a conscientious objection?

Answer 7

They don’t need to provide this treatment - instead they refer the patient onto another colleague

However, this does not include provided care who are currently undergoing abortion (post-operative complications - bleeding) or pregnant women who are considering abortion

Question 8

How do we manage the confidentiality of patients under the age of 16, who have an abortion?

Answer 8

If they have capacity the clinicians will not tell their parents or carers

Question 9

Are GPs informed if individuals have an abortion?

Answer 9

No, individuals can refer themselves to an abortion clinic

Question 10

What are the four main arguments for abortion (pro-choice)?

Answer 10

It acknowledges the sexual and reproductive rights of the women

An unwanted pregnancy can harm physical and mental health

A safe abortion saves lives globally

A potential human does not have the same rights as a child

Question 11

What are the three main arguments against abortion (pro-life)?

Answer 11

It denies the rights of the embryo/foetus

It eliminates potential for life

There is contraception that can be sued as an alternative

Question 12

When can individuals take a pregnancy test after sexual intercourse?

Answer 12

A pregnancy test may not be accurate until they have missed a period or three weeks after unprotected sex

Question 13

When should abortion ideally take place?

Answer 13

Before 24 weeks gestation

Question 14

When can surgical abortion be conducted?

Answer 14

Between 5 to 24 weeks gestation

Question 15

What do we induce before surgical abortions?

Answer 15

Cervical priming

Question 16

How do we induce cervical priming before conducting a surgical abortion?

Answer 16

We misoprostol three hours prior to surgery

Question 17

Why do we induce cervical priming before surgical abortion?

Answer 17

It reduces the risk of perforation and haemorrhage

Question 18

What surgical procedure is conducted in pregnancies under 14 weeks gestation?

Answer 18

Cervical dilatation and suction of the uterus contents

Question 19

What surgical procedure is conducted in pregnancies between 14 and 24 weeks gestation?

Answer 19

Cervical dilatation and evacuation using forceps

Question 20

What are the three advantages of surgical abortion over medical abortion?

Answer 20

There is less risk of retained tissue

There is shorter post-procedure bleeding

They can fit intrauterine contraception immediately

Question 21

What is the disadvantage of surgical abortion over medical abortion?

Answer 21

There is a risk of uterine perforation and cervical damage

Question 22

What is the most common complication following surgical abortion?

Answer 22

Infection

Question 23

What is the follow up treatment provided after surgical abortions?

Answer 23

24 hour access to advice and emergency admission

Question 24

When do we generally conduct medical abortions?

Answer 24

Earlier in pregnancy

Question 25

When can we conduct medical abortions?

Answer 25

It can be used at any time from a positive pregnancy test to 23+5 weeks gestation

Question 26

What are two abortion drugs?

Answer 26

Mifepristone

Misoprostol

Question 27

What is the class of the mifepristone drug?

Answer 27

Anti-progesterone

Question 28

What is the function of mifepristone?

Answer 28

It blocks the action of progesterone, halting the pregnancy and relaxing the cervix

Question 29

What is the class of misoprostol?

Answer 29

Prostaglandin analogue

Question 30

What is the function of misoprostol?

Answer 30

It initiates uterine contractions and softens the cervix

Question 31

When is misoprostol taken? Which route is administered via?

Answer 31

One to two days after mifepristone

Vaginal route

Question 32

At what gestational age is medical abortion safe at home?

Answer 32

< 10 weeks

Question 33

How long can it take to pass the pregnancy, if it is under 12 weeks gestation?

Answer 33

4 - 6 hours

Question 34

What are the two common side effects of medical abortion?

Answer 34

Heavy bleeding

GI upset (vomiting, diarrhoea)

Question 35

What is the follow up treatment provided after medical abortions?

Answer 35

Pregnancy test

24 hour access to advice and emergency admission

Question 36

How long following abortions may a urine pregnancy test remain positive for?

Answer 36

4 weeks

Question 37

Do abortions increase the risk of infertility?

Answer 37

No