Introduction

Abortion (termination of pregnancy) services in Wales are provided by Local Health Boards. Clinics offer a range of methods and services depending on gestational period (how many weeks pregnant you are). Each Health Board may differ in process so it is important to check with the clinic to find out what method is available, how to go about accessing the service and whether or not there are any exclusions.

The Law:

The law states that a doctor can refuse to certify a woman for an abortion if they have a moral objection to abortion. If this is the case, they must recommend another doctor who will be willing to help.

Before an abortion can proceed, two doctors must ensure that the requirements of the Abortion Act are fulfilled;

  • Abortions must be carried out in a hospital or specialised licenced clinic
  • Women who are normally resident in Wales and meet certain requirements may be offered the option of taking the second medication in an early medical abortion at home.
  • Two doctors must agree that an abortion would cause less damage to a women’s physical or mental health than continuing with the pregnancy

Under UK law, an abortion can usually only be carried out during the first 24 weeks of pregnancy. After 24 weeks, abortion can be carried out if;

  • It is necessary to the woman’s life
  • It is to prevent permanent injury, physically or mentally, to the woman
  • There is a substantial risk that the child would have serious medical/physical disabilities

Accessing abortion services:

If you have a pre-existing medical condition, it is important that you discuss this with  clinic staff in advance of any treatment.. 

Please contact the clinics below for information on abortion services in Wales, based on the Health Board area.  Sexual Health Clinics will be able to signpost you effectively to the most appropriate service.  There may be the need for patients to visit a Sexual Health Clinic initially to be referred into the abortion service.

Health Boards, contact information and clinic information:

  • Abertawe Bro Morgannwg University Health Board (ABM UHB). Abortion services Telephone line 01792 200303 (Monday to Thursday 8:00am to 3:00pm, Friday 8:00am to 12:00pm). Helpline 0300 555 0279. Up to 18 weeks gestation period – will refer onto appropriate service if over 18 weeks.
  • Aneurin Bevan University Health Board (AB UHB). BETH Clinic - Unplanned Pregnancy Service 01633 431743 (Monday to Friday 8:30am to 4:30pm). Up to 12 weeks gestation – will refer onto appropriate service if over 12 weeks
  • Betsi Cadwaladr University Health Board (BC UHB). Sexual Health Helpline 01475 443301 or referral through Sexual Health Clinic. Up to 9 weeks gestation and only RU486 method
  • Cardiff and Vale University Health Board (C&V UHB). Referred into via Sexual Health Clinic. Up to 14 weeks gestation – will refer onto appropriate service
  • Cwm Taf University Health Board (CT UHB). Termination Services 01685 728721. Body Wise (need to be referred into via a Sexual Health Clinic)  Body Wise will signpost onto appropriate hospital depending on scans and surgical procedures. Up to 16 weeks gestation – will refer onto appropriate service. All Sexual Health Clinics will refer into abortion services. Please see local services
  • Hywel Dda University Health Board (HD UHB). Pond Street Sexual Health Clinic 01267 248674 (Monday to Friday 9.15am to 4.30pm) to be referred into termination service. Up to 12 weeks gestation, between 12 to 18 weeks please see ABM UHB
  • Powys Teaching Health Board (PTHB). Sexual Health Services are available through GP practices. You may need to register as a temporary patient to access Sexual Health Services in Powys

Frequently Asked Questions (FAQs)

Do I need someone to come with me?

You can bring someone with you to make you feel comfortable but this is your decision.  If you are under 16, it is advised that a parent or guardian accompanies you however, if the doctors believe it is in your best interest and you fully understand what is involved, you can attend alone if you wish to do so.

What kind of treatment is available?

Late abortion is not available in Wales (20 to 24 weeks), however the medical and surgical method are available.  Your clinician will discuss the most appropriate method, and alternative methods if applicable, with you to help you decide the best option for you. 

What is a medical abortion?

A medical abortion does not involve surgery or anaesthetic.  It is the process of taking medication to induce contractions and thins the lining of the uterus.  This process involves two doses of medication.  The first does will block the hormone that allows pregnancy to continue, also thinning the lining of the uterus.  This medication is called Mifepristone and is taken orally.  The second dose is taken between 24 to 48 hours after the first dose and is called Misoprostol.  This will induce the contractions, and is taken either orally, allowed to dissolve under the tongue or in the cheek, or is put inside the vagina.  Within 4 to 6 hours, the lining of the womb breaks down causing bleeding, and the loss of the pregnancy.  You will have to stay at the clinic while this happens to determine whether it is best for you to go home.  The dosage depends on the duration of the pregnancy, and there may be a need for a small surgical procedure to be performed if the pregnancy does not pass.  This method procedure differs depending on the length of pregnancy – it is important to discuss with the clinician the options and methods.

What is a surgical method?

This procedure involves local anaesthetic (where the area is numbed), conscious sedation (you will be awake but relaxed), or general anaesthetic (where you will be asleep).  The surgical method can be performed by vacuum or suction aspiration or by dilation and evacuation. 

The vacuum or suction aspiration method can be used up to 15 weeks of pregnancy.  This involves inserting a tube through the cervix into the womb.  The cervix will be gently widened first, and a tablet may be placed inside the vagina or taken orally a few hours before the surgery to make it easier to open.  This method usually involves local anaesthetic or common sedation so there is little pain.  This method usually takes between 5 to 10 minutes.

The dilation and evacuation method is usually used around 15 weeks of pregnancy and involves inserting forceps (a surgical instrument used to grasping) into the cervix and womb to remove the pregnancy.  The cervix is dilated several hours or up to a day before the procedure.  This is usually carried out with conscious sedation or general anaesthetic and normally takes between 10 to 20 minutes.

Do you offer 1 day abortion in Wales?

No, the surgical method will be scheduled after a referral from the Sexual Health Clinic, which may be a few days after the assessment.  The medical method involves taking oral medication on different days.  For Welsh residents, if certain criteria is met, women may be offered the option to take the second medication, in a medical abortion, at home.  This will be agreed by your clinician.     

How do I make an appointment?

Most Health Boards will need you to be referred by a Sexual Health Clinic, you can search for these here.  Please see the table to understand the different processes for each Health Board. 

What is the maximum gestation period (number of weeks pregnant) that I can be seen in Wales for an abortion?

In Wales, the longest gestation period that will be seen is up to 18 weeks.  Women who are over 18 weeks pregnant will be referred onto the British Pregnancy Advisory Service (BPAS) for alternative services in England.     

What can I expect?

You will contact the appropriate service, depending on where you would like to go.  You can either contact the  appointment line, or access the service through a Sexual Health Clinic depending on where you live.  An initial assessment will be arranged for you to attend.  In this assessment appointment, you will have the opportunity to ask the clinician any questions you may have.  The clinician will assess your need and situation to determine what they can do – this will include discussions around methods, procedures, and risks.  Here is the opportunity to provide any information about existing medical conditions.  This is very important.  Typically, the assessment appointment will include;

  • An ultrasound scan (abdominally or internally/vaginal) to check how many weeks you are pregnant
  • A blood test to check your blood group or for anaemia
  • An STI (Sexually Transmitted Infection) test
  • A chance to discuss any concerns or questions – where information will be given to support you and forms of contraception discussions

Is the service confidential?

The service is confidential and communication is not made with any person that you do not consent to being sent information or contacted.  This applies if you are under 16.  If you are under 16, understand the process, and doctors believe it is within your best interest, it is fully confidential.  Doctors will encourage under 16 year olds to involve a parent or guardian as they will provide a level of support for you. 

 

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Women who live in Northern Ireland

Abortion services in Wales are provided by the NHS Local Health boards.  Due to Welsh Government Legislation, women from Northern Ireland are able to travel to Wales to access abortion services, receiving the same treatment and care of those who are resident in Wales.

In Wales, clinics will offer a range methods, and services depending on the gestational period (how many weeks pregnant you are).  Each Health Board may differ in process so it is important to check with the clinic to find out what method is available, how to go about accessing the service and whether or not there are any exclusions.

The Law:

The law states that a doctor can refuse to certify a woman for an abortion if they have a moral objection to abortion. If this is the case, they must recommend another doctor who will be willing to help.

Before an abortion can proceed, two doctors must ensure that the requirements of the Abortion Act are fulfilled;

  • Abortions must be carried out in a hospital or specialised licenced clinic
  • Women who are normally resident in Wales and meet certain requirements may be offered the option of taking the second medication in an early medical abortion at home.
  • Two doctors must agree that an abortion would cause less damage to a women’s physical or mental health than continuing with the pregnancy

Under UK law, an abortion can usually only be carried out during the first 24 weeks of pregnancy. After 24 weeks, abortion can be carried out if;

  • It is necessary to the woman’s life
  • It is to prevent permanent injury, physically or mentally, to the woman
  • There is a substantial risk that the child would have serious medical/physical disabilities

Accessing abortion services:

If you have a pre-existing medical condition, it is important that you discuss this with clinic staff in advance of any treatment.

Please contact the clinics below for information on abortion services in Wales, based on the Health Board area.  Sexual Health Clinics will be able to signpost you effectively to the most appropriate service.  There may be the need for patients to visit a Sexual Health Clinic initially to be referred into the abortion service.

Clinics

Health Board, contact information and clinic information

  • Abertawe Bro Morgannwg University Health Board (ABM UHB). Abortion services Telephone line 01792 200303 (Monday to Thursday 8:00am to 3:00pm, Friday 8:00am to 12:00pm). Helpline 0300 555 0279. Up to 18 weeks gestation period – will refer onto appropriate service if over 18 weeks.
  • Aneurin Bevan University Health Board (AB UHB). BETH Clinic - Unplanned Pregnancy Service 01633 431743 (Monday to Friday 8:30am to 4:30pm). Up to 12 weeks gestation – will refer onto appropriate service if over 12 weeks
  • Betsi Cadwaladr University Health Board (BC UHB). Sexual Health Helpline 01475 443301 or referral through Sexual Health Clinic. Up to 9 weeks gestation and only RU486 method
  • Cardiff and Vale University Health Board (C&V UHB). Referred into via Sexual Health Clinic. Up to 14 weeks gestation – will refer onto appropriate service
  • Cwm Taf University Health Board (CT UHB). Termination Services 01685 728721. Body Wise (need to be referred into via a Sexual Health Clinic)  Body Wise will signpost onto appropriate hospital depending on scans and surgical procedures. Up to 16 weeks gestation – will refer onto appropriate service. All Sexual Health Clinics will refer into abortion services. Please see local services
  • Hywel Dda University Health Board (HD UHB). Pond Street Sexual Health Clinic 01267 248674 (Monday to Friday 9.15am to 4.30pm) to be referred into termination service. Up to 12 weeks gestation, between 12 to 18 weeks please see ABM UHB
  • Powys Teaching Health Board (PTHB). Sexual Health Services are available through GP practices. You may need to register as a temporary patient to access Sexual Health Services in Powys

Frequently Asked Questions (FAQs)

Can I travel to Wales for an abortion?

Yes, women living in Northern Ireland are able to travel to Wales for an abortion (termination of pregnancy).

Will I need to pay for an abortion?

NHS abortions for women travelling to Wales from Northern Ireland will be free of charge.

Where in Wales can I access abortion services?

Any Health Board’s Sexual Health service in Wales can be contacted for referral to an abortion clinic.  There are abortion services in all 7 of the Health Boards in Wales, however, there may be different processes and referral criteria (e.g. gestation period).  This would need to be discussed with the clinic.

Do I need proof that I am a Northern Ireland resident?

NHS clinics in Wales provide free abortion care to women who live in Northern Ireland however, it is recommended that you bring proof of address (e.g. Passport) in case you are asked to provide evidence that you live in Northern Ireland. 

Do I need someone to come with me?

You can bring someone with you to make you feel comfortable but this is your decision.  If you are under 16, it is advised that a parent or guardian accompanies you however, if the doctors believe it is in your best interest and you fully understand what is involved, you can attend alone if you wish to do so.

What kind of treatment is available?

Late abortion is not available in Wales (20 to 24 weeks), however the medical and surgical methods are available.  During your assessment a clinician will discuss the most appropriate method, and any alternative methods if applicable with you to help you decide the best option. 

What is a medical abortion?

A medical abortion does not involve surgery or anaesthetic.  It is the process of taking medication to induce contractions and thins the lining of the uterus.  This process involves two doses of medication.  The first dose will block the hormone that allows pregnancy to continue, also thinning the lining of the uterus.  This medication is called Mifepristone and is taken orally.  The second dose is taken between 24 to 48 hours after the first dose and is called Misoprostol.  This will induce the contractions, and is taken either orally, allowed to dissolve under the tongue or in the cheek, or is put inside the vagina.  Within 4 to 6 hours, the lining of the womb breaks down causing bleeding, and the loss of the pregnancy.  You will have to stay at the clinic while this happens to determine whether it is best for you to go home.  The dosage depends on the duration of the pregnancy, and there may be a need for a small surgical procedure to be performed if the pregnancy does not pass.

This procedure differs depending on the length of pregnancy – it is important to discuss with the clinician the options and methods.

What is a surgical method?

This involves a procedure involving local anaesthetic (where the area is numbed), conscious sedation (you will be awake but relaxed), or general anaesthetic (where you will be asleep).  The surgical method can be performed by vacuum or suction aspiration or by dilation and evacuation. 

The vacuum or suction aspiration method can be used up to 15 weeks of pregnancy.  This involves inserting a tube through the cervix into the womb.  The cervix will be gently widened first, and a tablet may be placed inside the vagina or taken orally a few hours before the surgery to make it easier to open.  This method usually involves local anaesthetic or common sedation so there is little pain.  This method usually takes between 5 to 10 minutes.

The dilation and evacuation method is usually used around 15 weeks of pregnancy and involves inserting forceps (a surgical instrument used to grasping) into the cervix and womb to remove the pregnancy.  The cervix is dilated several hours or up to a day before the procedure.  This is usually carried out with conscious sedation or general anaesthetic and normally takes between 10 to 20 minutes.

Do you offer 1 day abortion in Wales?

No, the surgical method will be scheduled after a referral from the Sexual Health Clinic, which may be a few days after the assessment.  The medical method involves taking oral medication on different days. 

How do I make an appointment?

Most Health Boards will require you to be referred by a Sexual Health Clinic, you can search for these here.  Please see the table to understand the different processes for each Health Board. 

What is the maximum gestation period (number of weeks pregnant) that I can be seen in Wales for an abortion?

In Wales, the longest gestation period that will be seen is up to 18 weeks.  Women who are over 18 weeks pregnant will be referred onto the British Pregnancy Advisory Service (BPAS) for alternative services in England.     

What can I expect?

You will contact the appropriate service, depending on where you would like to be treated.  This will either be through an appointment telephone line, or through a sexual health clinic.  An initial assessment will be arranged for you to attend, during which   you will have the opportunity to ask the clinician any questions you may have.  The clinician will assess your need and situation to determine what they can do – this will include discussions around methods, procedures, and risks.  This is your opportunity to provide any information about existing medical conditions.

This is very important. Typically, the assessment appointment will include;

  • An ultrasound scan (abdominally or internally/vaginal) to check how many weeks you are pregnant
  • A blood test to check your blood group or for anaemia
  • An STI (Sexually Transmitted Infection) test
  • A chance to discuss any concerns or questions – where information will be given to support you and forms of contraception discussions.

How long will I be in Wales?

This all depends on the type of procedure, the Health Board area, the time from the first appointment to the procedure, how long the treatment takes, and if there are any complications.  You may need to wait a few days before the procedure.  This can be discussed with the clinics.

Is there any aftercare support?

The Sexual Health Clinics will have a helpline number for you to contact should you need to. The Family Planning Association (FPA) also provide support for women living in Northern Ireland.  Their helpline 0345 122 8687 is available Monday to Friday 9:00am to 5:00pm, and they will provide non-judgemental and non-directive counselling to support you following an abortion.

Is the service confidential?

The service is confidential and communication is not made with any person that you do not consent to being sent information or contacted.  This applies if you are under 16.  If you are under 16, understand the process, and doctors believe it is within your best interest, it is fully confidential.  Doctors will encourage under 16 year olds to involve a parent or guardian as they will provide a level of support for you. 

If you need  more information:

If you need more information, you can contact us via our “Ask Us Your Health Question” online enquiry service.  This service is not suitable if you are feeling ill or have symptoms.  If you (or the person you are asking about) are feeling ill please call your doctor (GP). 
  
We will reply within three working days (working days do not include Saturdays, Sundays and Bank Holidays).

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How is it performed?

Abortions can only be carried out in hospital or licensed clinics.

You won't usually need to stay in the clinic or hospital overnight, but you may need to attend several appointments on different days.

Before the abortion

Before having an abortion, you'll need to attend an assessment appointment at the hospital or clinic.

During this assessment, you may:

  • discuss your reasons for considering an abortion and whether you're sure about your decision
  • be offered the chance to talk things over with a trained counsellor if you think it might help
  • talk to a nurse or doctor about the abortion methods available, including any associated risks and complications
  • do a pregnancy test to confirm you're pregnant – an ultrasound scan may be done to check how many weeks pregnant you are
  • be tested for sexually transmitted infections (STIs), your blood type and low iron levels (anaemia)
  • be given antibiotics to reduce the risk of an infection developing after the abortion

When you're sure you want to go ahead with the abortion, you'll be asked to sign a consent form and a date for the abortion will be arranged. You can change your mind at any point up to the start of the procedure.

Methods of abortion

There are two main types of abortion:

  • medical abortion (the "abortion pill") - taking medication to end the pregnancy
  • surgical abortion - a minor procedure to remove the pregnancy.

Medical and surgical abortions can generally only be carried out up to 24 weeks of pregnancy.

But in exceptional circumstances an abortion can take place after 24 weeks – for example, if there's a risk to life or there are problems with the baby's development.

You will be offered a choice of which method you would prefer whenever possible.

Medical abortion

A medical abortion involves taking medication to end the pregnancy. It doesn't require surgery or an anaesthetic, and can be used at any stage of pregnancy.

It involves the following steps:

  • you first take a medicine called mifepristone – this stops the hormone that allows the pregnancy to continue working; you'll be able to go home afterwards and continue your normal activities
  • usually 24 to 48 hours later, you have another appointment where you take a second medicine called misoprostol – this will either be a tablet that you may swallow, let dissolve under your tongue or between your cheek and gum, or put inside your vagina
  • within about four to six hours, the lining of the womb breaks down, causing bleeding and loss of the pregnancy – you may have to stay at the clinic while this happens or you may be able to go home

If a medical abortion is carried out after nine weeks, you may need more doses of misoprostol and you're more likely to need to stay in the clinic or hospital. Occasionally, the pregnancy doesn't pass and a small operation is needed to remove it.

Surgical abortion

Surgical abortion involves having a procedure with local anaesthetic (where the area is numbed), conscious sedation (where you're relaxed but awake), or general anaesthetic (where you're asleep).

There are two methods.

Vacuum or suction aspiration

Can be used up to 15 weeks of pregnancy. It involves inserting a tube through the entrance to the womb (the cervix) and into your womb. The pregnancy is then removed using suction.

Your cervix will be gently widened (dilated) first. A tablet may be placed inside your vagina or taken by mouth a few hours beforehand to soften your cervix and make it easier to open.

Pain relief is usually given using medicines that you take by mouth, and local anaesthetic, which is numbing medicine injected into the cervix. You may also be offered some sedation, which is given by injection. A general anaesthetic isn't usually needed.

Vacuum aspiration takes about 5 to 10 minutes and most women go home a few hours later.

Dilation and evacuation (D&E)

Used from around 15 weeks of pregnancy. It involves inserting special instruments called forceps through the cervix and into the womb to remove the pregnancy.

The cervix is gently dilated for several hours or up to a day before the surgery to allow the forceps to be inserted.

D&E is carried out with conscious sedation or general anaesthetic. It normally takes between 10-20 minutes and you may be able to return home the same day.

Afterwards

If you have a medical abortion, you may experience shortlived side effects from the medications, such as nausea and diarrhoea. General anaesthetic and conscious sedation medication can also have side effects.

For all types of abortion, it's likely you will experience some stomach cramps and vaginal bleeding, too. These usually last a week or two. Sometimes light vaginal bleeding after a medical abortion can last up to a month.

After an abortion, you can:

  • take ibuprofen to help with any pain or discomfort
  • use sanitary towels or pads rather than tampons until the bleeding has stopped
  • have sex as soon as you feel ready, but use contraception if you want to avoid getting pregnant again as you'll usually be fertile immediately after an abortion

Get advice if you experience heavy bleeding, severe pain, smelly vaginal discharge, a fever or ongoing signs of pregnancy, such as nausea and sore breasts. The clinic will give you the number of a 24-hour helpline to call if you have concerns.

You may experience a range of emotions after an abortion. If you need to discuss how you're feeling, contact the abortion service or ask your GP about post-abortion counselling.

Buying abortion pills online

It's against the law to try to cause your own abortion. It is possible to buy abortion pills online, but you will not know if these are genuine and they could be harmful.

Before doing anything, contact an abortion advice service such as the British Pregnancy Advisory Service (BPAS), who can help you find appropriate care for free and in confidence.

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Risks

Abortions are generally very safe and most women won't experience any problems.

But like any medical treatment, there is a small risk that something could go wrong. The risk of complications increases the later in pregnancy an abortion is carried out.

Possible complications

The main risks associated with abortions are:

  • infection of the womb – occurs in up to 1 in every 10 abortions; it can usually be treated with antibiotics
  • some of the pregnancy remaining in the womb – occurs in up to 1 in every 20 abortions; further treatment may be required if this happens
  • continuation of the pregnancy – occurs in less than 1 in every 100 abortions; further treatment will be needed if this happens
  • excessive bleeding - occurs in about 1 in every 100 surgical abortions
  • damage to the entrance to the womb(cervix) - occurs in up to 1 in every 100 surgical abortions
  • damage to the womb - occurs in up to 4 in every 1,000 surgical abortions, and less than one in 1,000 medical abortions carried out at 12-24 weeks 

Women who have an abortion are no more likely to experience mental health problems than those who continue with their pregnancy.

There is also no link between having an abortion and an increased risk of breast cancer.

When to get medical advice

After having an abortion, you'll probably experience some period-type pains and some vaginal bleeding, which should gradually improve after a few days, but can last for one to two weeks. It's normal and is usually nothing to worry about.

But you should get advice if you experience any signs of a possible problem, such as:

  • excessive bleeding – for example, if you pass large clots or go through two or more sanitary pads an hour for more than two hours in a row
  • severe pain that can't be controlled with painkillers such as ibuprofen
  • a high temperature (fever)
  • smelly vaginal discharge
  • continuing pregnancy symptoms, such as nausea and sore breasts

The clinic will provide you with the number of a 24-hour helpline to call if you experience any problems after an abortion.

Effect on fertility and future pregnancies

Having an abortion won't affect your chances of becoming pregnant and having normal pregnancies in the future.

Many women are able to get pregnant immediately afterwards, so you should start using contraception right away if you don't want this to happen. You should be advised about this at the time you have the abortion.

However, there's a very small risk to your fertility and future pregnancies if you develop a womb infection that isn't treated promptly. The infection could spread to your fallopian tubes and ovaries – known as pelvic inflammatory disease (PID).

PID can increase the risk of infertility or ectopic pregnancy, where an egg implants itself outside of the womb.

But most infections are treated before they reach this stage and you'll often be given antibiotics before an abortion to reduce the risk of infection.

Having several abortions is associated with a slightly increased risk of giving birth prematurely, before the 37th week of pregnancy, in future pregnancies.

Talk to your doctor or an abortion advice service for more information if you're concerned about the possible risks of an abortion.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 08/11/2018 11:02:08