Medical Termination of Pregnancy in Hospital

This page provides information about the option of a medical termination of pregnancy in the hospital (up to 19+6 weeks gestation). It supports the information that is given to you over the phone or in clinic.

It is important that you arrive on the ward at the agreed time. If you are late your treatment may need to be postponed. A member of staff will start your treatment as soon as they are available.
You can have breakfast as normal before you come into hospital.
You can bring one person with you for support to the ward and they may stay with you.
Unfortunately there is no childcare at the hospital so you will need to make any arrangements for your children to enable you to come into hospital.
You will need to arrange for someone to accompany you home after the treatment and stay with you overnight.
Occasionally you may need to stay in hospital overnight so we advise that you bring an overnight bag.

The staff on Ward 6, the gynaecology ward, are here to support you through the process. If you need to contact them before or after your visit, or in between visits, the contact details are: 01324 566 390 or 01324 566 388.

How does a medication termination in hospital work?

Medical termination is a two part process in which medication is used to stop and then expel the pregnancy. A tablet called mifepristone is first used to block progesterone, a hormone needed in pregnancy. After that another tablet called misoprostol helps the pregnancy come out. This medication can be placed high in the vagina or under the tongue. In general, the further on you are in the pregnancy the more doses of the second medication you need.

What are the risks of medical termination?

The procedure is very safe but like all medical treatment there are some risks. The main risks are:

The procedure not working. About 1 in 100 people are still pregnant even after taking the treatment. If this happened we would offer you further treatment to ensure you were no longer pregnant. Or there might be small amounts of pregnancy tissue left inside. In this case we may need to give you further treatment, or in a small number of cases you may need to have a surgical operation.
Infection (about 1 in 100). You may need antibiotics if this happens.
Haemorrhage (excessive bleeding). The risk of this is only about 1 in 1000.

Having a medical termination of pregnancy does not affect your fertility in the future or your ability to have children.

What will happen on my first visit?

The nurse will check your medical details and answer any questions you have.
You will be given the first part of the treatment – the mifepristone – to swallow with some water.
You may feel a little sick. If you vomit within 2 hours of taking the tablet you will need to return to the ward to take another tablet.
You will be given a time to come back to the ward for the second part of the treatment.
This part of the treatment may also happen at home or in clinic.

You will be asked to attend the hospital twice. The first visit will take 30 minutes to an hour. If you are seen face to face for your first appointment you can usually take the tablet at this appointment or be given it to take home with you. The second visit will be two days after and will take the whole day and occasionally you may need to stay overnight.

What will happen between my visits?

Most people don’t feel any different after taking mifepristone but some might experience bleeding and pain. If you have only a small amount of bleeding and the pain eases with paracetamol then just proceed as planned and come to your second appointment.
There is a small chance that the pregnancy could be expelled before the second part of the treatment so if the bleeding is heavy, the pain severe or if you are worried then please phone the Gynaecology Ward 6 for advice. You can phone the ward at any time day or night and somebody will be there to help you.
It is important that you come for your second appointment even if you think you are no longer pregnant.

What will happen on my second visit?

You will be admitted to the gynaecology ward early in the morning on the day of treatment, or if you are further along in your pregnancy, or you live far away or can’t get there by the early morning, this may be the night before. It is usual for the procedure to take most of the day and you should expect to stay between 8 and 10 hours. For some women the procedure can take up to 24 hours.
To make your stay more comfortable you may want to bring something to read or headphones to listen to music. You will be offered meals while on the ward but may want to bring some snacks and drinks. You can eat as normal during the procedure if you wish to.
A nurse will insert 4 small misoprostol tablets into your vagina. There is also the option of putting these tablets under your tongue, holding them there for half an hour, and then swallowing any bits that are left over. You will also be given a suppository (a tablet into your back passage) of a painkiller. You will start to bleed and experience period type cramping. People vary in how they find this – some have significant bleeding and pain while some do not. If your pregnancy is more advanced (over 10 weeks) the pain and bleeding can be very significant. The nursing staff will be there to provide as strong pain relief as you need. Some people also suffer diarrhoea, nausea and hot flushes or chills. These are not something to worry about but if you tell the nursing staff they can help you relieve the symptoms.
The misoprostol tablets are repeated every 3 hours until the pregnancy has been passed. You may need up to 5 doses to expel the pregnancy.
You will be asked to use a bedpan each time you use the toilet so that the nurse can check to see if the pregnancy has been expelled. It is possible that you may see the pregnancy in the bedpan and if you are worried about this please ask the nurse for assistance. Expelling the pregnancy can be upsetting and a nurse will be available to support you through it. There will be buzzers by the bed and in the toilet for you to call a nurse for help.
After the pregnancy some people can bleed quite heavily and you may be given an injection to help slow down the bleeding. The nurse will check your bleeding regularly and you may be examined. In a very small number of cases if the bleeding isn’t settling you may need an operation to remove the rest of the pregnancy.
Once the complete pregnancy is passed the bleeding will settle and any pain should ease. When the bleeding is reduced sufficiently, and you feel well enough, you will be discharged. Usually that will be the end of the procedure, although in a small number of cases you may need to be examined, or to return 7-10 days later for an ultrasound to be sure that the pregnancy has passed completely.
If your blood group is Rhesus negative you will need an injection of anti-D before you go home.

How long will I bleed for after the procedure?

You may bleed for 2 to 3 weeks following the termination, but some women bleed less than this and some may continue to bleed up to their next period. Generally the bleeding should get lighter each day and should not smell unpleasant. Usually we advise that you use pads or period pants rather than tampons until your next period.

When can I have sex again?

You can have sex when you feel comfortable to. If you do not want to become pregnant again then using contraception will help prevent this. You will be able to discuss all forms of contraception with the clinic staff, and we can give you most methods home with you to make it easier for you to start.

How will I feel after the termination?

Most people feel relieved when the termination is over. However people experience a wide range of emotions and each person’s experience is unique. If you would like to discuss your termination further with a support service – however you are feeling – you can contact:

Abortion Talk on 0333 090 9266. Their talkline is open Monday, Tuesday, Wednesday and Thursday 7pm-10pm, Outside these hours you can leave a message or request a call back.

Further info at www.abortiontalk.com

What do I need to look out for after the procedure?

Most people are well after the procedure is completed and do not need to contact the ward again. However if you experience any of the following then contact your own doctor or the staff on Ward 6.