Termination of Pregnancy/Abortion

It can be done before 24 weeks if continuing the pregnancy involves greater risk to the physical and mental health of the mother or existing children of the family.

It can be done at any time if:

• Continuing the pregnancy is likely to put the mother’s life at risk

• Terminating will prevent “grave permanent injury” to the mother

• There’s substantial risk that the child will suffer physical or mental disabilities

The legal requirements for a TOP are:

• 2 registered medical practitioners must sign to agree

• Must be carried out by a registered medical practitioner in a NHS hospital or approved premise

Medical TOP

• First, Mifepristone is given (anti-progesterone to discontinue pregnancy), followed by Misoprostol (prostaglandin for expulsion of uterine contents) 1/2 days later.

  • This is the most appropriate option earlier in pregnancy, but can be done at any time

N.B. In a miscarriage, only Misoprostol is needed as the pregnancy has already ended.

Surgical TOP

• Prepped by cervical ripening with medications like misoprostol, mifepristone or osmotic dilators

• Options are:

  • Suction of uterine contents (< 14 weeks)

  • Cervical dilatation and evacuation/curettage using forceps (14-24 weeks)

A pregnancy test needs to be done after 3 weeks post-TOP to confirm it’s complete.

Complications:

• Bleeding

• Pain

• Infection

• Failure of abortion

• Structural damage