Ending the pregnancy surgically

There are several ways of ending a pregnancy for fetal abnormality – here we discuss what is likely to happen to women who have a termination at around 13 weeks. Procedures may vary though from hospital to hospital, and some gynaecologists prefer one technique to another.

Most NHS hospitals can offer a surgical termination (also known as STOP) up to 13 weeks. Women will usually be treated in a hospital daycare unit. The procedure takes about 10 minutes and the woman will generally be offered a general anaesthetic so that she is not awake. During the procedure, the woman’s cervix will be gently stretched so that a small instrument can be passed through into the womb and the pregnancy removed by suction. The process is sometimes referred to as ‘suction evacuation’ or vacuum aspiration, though most women we talked to thought they had had a D & E (dilatation and evacuation) which is the surgical procedure that can be performed later than 13 weeks. For more detail about these processes (see Patient.co.uk).

In NHS hospitals later pregnancies are usually ended by induction, a process that involves the woman going through labour and delivering the baby naturally. This process is also referred to as a medical termination. Women’s experiences of induced labour and birth are discussed in ‘Ending the pregnancy by induction’.

The reason most NHS hospitals can only offer STOP up to 13 weeks is that there aren’t enough NHS doctors trained to perform D&E. This expertise can be found in the independent sector (where most terminations for non medical reasons are carried out).

Several women felt they couldn’t have coped with labour and a normal delivery, so were relieved to have the option of a surgical termination. Most were unsure what procedure they had gone through – all they could remember was being given the anaesthetic and then coming round again.

Though she had a surgical termination she was cared for in a maternity ward where she felt able…

Age at interview 38

Gender Female

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Because she was just under 14 weeks pregnant she chose to end her pregnancy surgically and does…

Age at interview 34

Gender Female

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Many women said they had expected the surgical termination to be straightforward physically and less upsetting than going through an induced labour and birth. However having been through the experience, several women concluded that there were good and bad things about ending a pregnancy surgically. Several felt that the procedure too clinical and wished they had had more contact with a sympathetic midwife. Some women also wondered with hindsight, if it would have been better for them emotionally to have seen and held the baby.

She was booked into a day surgery unit at the last minute because she wanted to avoid going…

Age at interview 41

Gender Female

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She was treated in a gynaecology unit and missed being cared for by a midwife or having someone…

Age at interview 36

Gender Female

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Some women wanted hospital staff to know that they were not ending the pregnancy lightly and did not want to be seen by others as having a termination for non-medical reasons.

Ending a pregnancy surgically means that the baby’s body will not remain intact, and some women regretted later that they had not seen the baby or known his/her sex. Several experienced heavy bleeding afterwards because part of the placenta had been left behind in the womb and had to go back into hospital for more treatment – usually D & Cs – when this had happened some women found the experience upsetting and unpleasant.

Parents also had to decide in advance of the procedure whether they want to keep the baby’s remains for burial or a funeral. Some hospitals now follow guidelines (see guidelines – Royal College of Nursing ‘Sensitive disposal of Fetal Remains’) about how to deal with the baby’s remains, but when arrangements went wrong and the baby was lost, parents were let down and upset.

Signing the consent form

Before a pregnancy can be ended, the hospital is required to get written consent from the woman concerned. Consent forms explain what will happen during...

Ending the pregnancy by induction

The physical and emotional demands of ending a pregnancy, which ever method was used, were usually intense and unforgettable - even for women who had...