The Abortion Act

• Ground A → continuance of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated.
• Ground B → termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.
• Ground C (MAJORITY) → the pregnancy has not exceeded its 24th week and that continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman.
• Ground D → the pregnancy has not exceeded its 24th week and that continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of any existing children of the family of the pregnant woman.
• Ground E → there is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.
• Ground F → to save the life of the pregnant woman.
• Ground G → to prevent grave permanent injury to the physical or mental health of the pregnant woman.

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Legal in the United Kingdom and can be performed until 24 weeks gestation. After 24 weeks, it can still be carried out only in specific circumstances where the mother’s life is at risk, or the baby will be born with severe disabilities or congenital anomalies.

• Mifepristone (to terminate pregnancy) followed 48 hrs later by misoprostol (to expel the fetus).
  • <9 Weeks → take misoprostol at home.

  • 9 weeks → do in clinical setting (extra doses, max. 5, of misoprostol may be needed).

  • 22 weeks → add feticide (KCL).

• Surgery (most common risk = infection, up to 10%)
  • <15 weeks → vacuum aspiration.

  • 15 weeks → dilatation and evacuation.

• Antibiotic Prophylaxis → PR metronidazole.
• Urine pregnancy test often remains positive for up to 4 weeks following termination. A positive test beyond 4 weeks indicates incomplete abortion or persistent trophoblast.

Imperforate Hymen → amenorrhoea, all other sexual characteristics developed, cyclical pelvic pain.

Mastits / Breast Abscess → simple analgesia, supportive care (warm compress), continue breastfeeding. Antibiotics (flucloxacilin) if infected nipple fissure, symptoms not improved after 12-24 hours of continuing to breastfeed or breast milk culture positive.