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Abortion is a hot topic that might come up in your Medical School interview – and understanding abortion will help you when it comes to answering interview questions too.

Abortion Defined

Abortion is defined as the medical process of ending a human pregnancy so it doesn’t culminate in the birth of a baby. A pregnancy can be terminated by taking medications or having a surgical procedure.

Under the 1967 Abortion Act, abortion is legal in England, Wales and Scotland up to 24 weeks of the pregnancy in most cases. An abortion may only legally be carried out if two Doctors agree that continuation of the woman’s pregnancy will negatively impact her physical or mental health, or that of her existing children.

An abortion is legal after 24 weeks if the woman’s life is at risk due to the pregnancy, the child will be born with a severe disability or there is a risk of grave physical and mental injury to the woman – although this is generally safer if carried out earlier in the pregnancy.

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Methods of Abortion

There are two main types of abortion – surgical abortion and medical abortion (using pills).

Surgical Abortion

Surgical abortion involves an operation to remove the pregnancy from the womb. In cases up to 14 weeks of pregnancy, vacuum or suction aspiration can be used. In cases after 14 weeks, dilatation and evacuation can be used. Find out more about these methods on the NHS website.

Medical Abortion

If a woman chooses to end their pregnancy within 10-weeks of gestation and have a medical abortion, they have to take two pills 24 to 48 hours apart.

The first pill is mifepristone, which works to inhibit progesterone (the hormone that maintains pregnancy) and must be taken at a clinic. The second pill is misoprostol, which induces contractions in the womb to pass the pregnancy and can now be taken at home or at a clinic.

Medical Abortions at Home

In August 2018, the government announced that women in England would be allowed to take the second early abortion pill at home. This came into effect on 27th December 2018 and has brought England in line with Scotland and Wales.

Women are still able to choose to take the second pill in the clinic if they want, but this change prevents the risk of women miscarrying on their journey home, which was previously quite a common, painful and traumatic experience.

Legalising use of the second pill, misoprostol, at home has been well received by gynaecologists, with the president of the Royal College of Obstetricians and Gynaecologists (RCOG) describing this as a compassionate measure which symbolises “a major step forward for women’s healthcare”, as it prevents the distress and embarrassment of pain and bleeding during their journey home from taking their second pill.

However, the Society for the Protection of Unborn Children believes this move “further trivialises abortion” as it pushes women to experience the emotional and physical trauma of a miscarriage without medical supervision. Right To Life has also expressed their concern about the ability to adequately monitor who takes the pills and whether they are taken free from force or coercion.

In March 2020, the UK’s Department of Health and Social care confirmed that it would allow women in England to temporarily manage medical abortions at home in light of the lockdown imposed due to the COVID-19 pandemic. Under this policy, women in England were able to take both medications necessary for medical abortion at home during the first 10 weeks of pregnancy following a telephone or electronic medical consultation, rather than having to take the first dose at a health facility.

The Legal Debate

There is significant legal debate surrounding abortion, which centres around the point in time at which abortion is allowed.

This debate centres around beliefs about when the foetus becomes a living organism, and thus when abortion becomes murder. Some people believe that abortion at any point in the pregnancy is murder. At the other end of the spectrum, others argue that abortion is acceptable at any point during the pregnancy as, until the child is born, they do not consider it to be alive.

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Northern Ireland and Abortion Rights

Until October 2019, abortion was illegal in Northern Ireland, unless the woman’s life was at risk or if continuing with the pregnancy would cause serious physical or mental health effects to the woman.

The criminalisation of abortion in Northern Ireland dated back to 1861, although it was amended in 1945 to allow abortions under the above circumstances, and was debated several times over the years. Rape, incest and fatal foetal abnormalities were not grounds for legal abortion in Northern Ireland.

In 2017, the UK government allowed Northern Irish women to access NHS-funded abortions in Great Britain, when previously women had to pay for the procedure themselves.

In May 2018, the Republic of Ireland voted overwhelmingly to overturn their abortion ban in an abortion referendum. The Northern Ireland Human Rights Commission brought an appeal to the Supreme Court in early 2018 over the legality of the abortion law in Northern Ireland, but it was rejected.

In May 2018, Northern Ireland voted in a referendum to make abortion legal with 66.4% of voters voting to amend the constitution so that abortion could be legalised. In October 2019, abortion was decriminalised and became lawful in Northern Ireland.

The new framework for lawful abortion services – The Abortion Regulations 2020 – came into effect on 31st March 2020. Under the new regulations, termination of pregnancy is allowed:

  • unconditionally prior to 12 weeks.
  • up to 24 weeks when continuing the pregnancy would risk mental or physical injury to the woman or girl that is greater than the risk of terminating the pregnancy.
  • after 24 weeks when there is substantial impairment to the foetus, including when death is likely before, during or shortly after birth.

Termination must only be carried out by registered medical professionals – however, those using abortion pills purchased online will not be prosecuted, and health professionals are no longer under any duty to report their patients’ use of abortion pills.

Ethics: Pro-Life

It’s important to understand the arguments held by people who oppose abortion, and are described as pro-life. Some people may believe that:

  • Human life begins at the point of conception. Therefore, abortion is tantamount to murder as it is the destruction of a human life.
  • Instead of carrying out an abortion and taking an innocent human life, the child can be adopted if the parents are not able to cope with looking after them.
  • Some woman may be pregnant as a result of rape or incest. The unborn child is innocent and should not be punished for this crime through an abortion.
  • An abortion can cause psychological distress for the woman.
  • All children have great potential and a woman could possibly decide to abort a foetus that may have been extremely important to society or to the world.

Ethics: Pro-Choice

The alternative opinion is called pro-choice and describes those who support abortion. People with this ethical stance may believe that:

  • Almost all abortions are carried out in the first three months of the pregnancy, at which time the foetus cannot exist independently outside of the mother’s womb. Therefore it cannot be regarded as a living organism, and abortion is arguably not murder.
  • Fertilised eggs which are used for in vitro fertilisation (IVF) are often thrown away or destroyed if not implanted and some would argue that these fertilised eggs are human lives – but destroying them is not considered as murder.
  • In the case of rape or incest, forcing a woman to have the child is likely to be more psychologically damaging to her than having an abortion.
  • Keeping abortion legal will prevent deaths and complications from unsafe backstreet abortions that are carried out in secrecy.
  • An abortion may be necessary to save the woman’s life in certain cases and thus this option should be taken where necessary, rather than risking the mother’s life.

Abortion Questions

Abortion may come up during your interview in ethics or empathy questions. Some example questions include:

You could also talk about the recent changes to medical abortions at home to showcase your depth of knowledge.

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