Pregnancy advisory service at Cardiff and Vale Hospitals

What is a pregnancy advisory service?

A pregnancy advisory service supports people dealing with an unplanned pregnancy, offering confidential advice, counselling and, for those who choose it, abortion care. Abortion is a recognised, medically safe method for ending a pregnancy.

Who is this service for?

Unplanned pregnancy happens often, and working out what to do next isn't always a simple decision. Around 1 in 3 women in the UK will have an abortion at some point in their life, so anyone weighing up this choice is far from alone in facing it.

Across England, Scotland and Wales, abortion sits within the law under the 1967 Abortion Act, provided certain conditions are met. Two doctors need to agree the legal grounds apply, with the doctor making the referral and the one carrying out treatment both signing to confirm this.

What are the benefits of using a pregnancy advisory service?

These services offer confidential, non-judgemental support to help you reach the decision that's right for you, together with safe, legal treatment should you decide to go ahead. Most abortion care across the UK is funded through the NHS.

Are there different treatment options?

• Medical abortion: Sometimes called the abortion pill, using two medicines taken a day or two apart to end the pregnancy and bring on bleeding and cramping similar to a miscarriage – this is suitable for early pregnancies, and sometimes available to take at home
• Surgical abortion: A short clinic procedure to remove the pregnancy, carried out under local anaesthetic for earlier gestations or general anaesthetic for slightly later ones
• For later pregnancies, an extra step called feticide may come first: This involves an injection to stop the pregnancy ahead of the main treatment.

Which option suits you depends on the stage your pregnancy has reached, your medical history, and your own preference.

Abortion is generally an option up until 24 weeks of pregnancy, and beyond that point only where there's a substantial risk to your life or a significant abnormality affecting the pregnancy.

What happens before treatment?

Things usually begin with a phone consultation, where you'll be asked about your medical and personal circumstances and given the chance to talk through your decision and any concerns. Many services let you refer yourself directly, without needing to see your GP first.

You may need an ultrasound scan to confirm how many weeks pregnant you are, along with blood tests, both helping determine which treatments are suitable for you.

What happens during treatment?

• For a medical abortion: You take one medicine first, then a second roughly a day or two afterward, either at the clinic or at home – this triggers cramping and blood loss as the pregnancy ends, similar to a heavy period
• For a surgical abortion: The pregnancy is removed during a brief operation, with local or general anaesthetic used depending on your circumstances, usually taking under an hour
• For later pregnancies needing feticide beforehand: A thin needle stops the pregnancy first, done in 10 to 15 minutes with you awake, before the main treatment follows.

What does recovery look like?

Recovery varies from person to person, so it's worth listening to your body and taking things easy for a few days. Some bleeding and cramping is normal, generally easing gradually across the following week or so.

Fertility can return almost immediately, so it's worth starting contraception straightaway if you'd rather not become pregnant again soon. Most methods can begin the same day or the day after treatment, and a coil can usually go in right away once things are done.

Emotional responses vary too. Many feel mostly relief, others notice a more complicated mix of feelings – there's no single right way to feel. Free counselling is available afterwards if you'd find it helpful to talk things through.

What are the risks and complications?

Possible risks include:

• bleeding, which is expected, though occasionally heavy bleeding needs further treatment
• infection, which is uncommon and usually treatable with antibiotics
• the pregnancy not being fully ended, or some tissue remaining, sometimes needing further treatment
• for surgical procedures specifically, a small risk of injury to the womb.

Evidence doesn't support a link between abortion and later fertility problems, nor between abortion and breast cancer. Someone from your care team will run through the specific risks tied to your chosen treatment before anything goes ahead.

Contact your service, or NHS 111 in an emergency, if you experience heavy bleeding, severe pain, a high temperature, or feel unwell after treatment.