"No counselling for termination of pregnancy"

In March 2022 I discovered I was 4 weeks pregnant. I’d been using non-hormonal contraception for some time but it had failed. My partner and I have two children at the time, weren’t planning on having more children (hence using contraception) and felt very sad this has happened.

I didn’t want to have another baby, but didn’t want to have a termination either. I felt very conflicted about what I wanted on one hand and what I felt I should do on the other.

My husband didn’t want us to go ahead with the pregnancy and told me I didn’t have to. He has struggled with parenting two young children and I had struggled with post-natal depression and anxiety after the birth of my two children.

There’s also a bigger dependency on my job financially and we knew we wouldn’t have been able to provide the life we had wanted for us and our two children if I had another period of maternity leave and part time working. 

We agreed to look at our options and after googling NHS websites for termination, I called the Sandyford clinic’s number to ask to speak to someone about having a termination. I was told I would be given a telephone consultation the following week. I had thought about speaking to my GP practice however at the time they had a sign on the door stating that at least one of their practitioners endorsed natural family planning only and would not discuss contraception or termination. Using the practice therefore didn’t feel like an option for me. 

I received a phone call the next week from a single doctor. They ran through a 10 minute questionnaire about my medical history - previous pregnancies, ectopic pregnancies, blood clots, etc. I realise now that they did not ask about my mental health history, where I would have said that I’d been prescribed anti depressants and also propanol and diazepam for anxiety and panic attacks. 

They then explained that given my early gestation and medical history I qualified for at home termination. They explained this would involve being sent tablets and pessaries by courier to my address and gave instructions on what I needed to take and when. I asked if I needed to be seen in person (I assumed the NHS would at least perform a scan to determine how far along I was - I could have been making 4 weeks up after all) but they said no. 

The only contact I had with a medical practitioner during the whole process was that one, ten minute phone call . Pills were then posted out and sat in our house for a week while we continued to weigh up our decision and I decided whether or not I could pluck up the courage to self administer the tablets and pessaries. In the end I did; never sure if I was doing the right thing. 

During the telephone consultation, I was asked the reason for the termination. I said we have two young children already and don’t think we’d cope very well. No other follow up questions were asked and, crucially, I was neither asked: 

- are you sure about your decision? (I would have said I was undecided) and 

- do you want to speak to a counsellor to help with your decision making? 

Counselling is not offered, or mentioned, anywhere in the process (though I see NHS Scotland’s webpage on termination of pregnancy has since been updated to tell women that counselling is something they can ask for).

At the time I was accessing the Sandyford’s services, counselling is not something I knew was offered pre-termination. I didn’t know to ask for it. This is why it feels so fundamentally important that if tele-abortions continue, women are at least asked over the phone if they are sure about their decision (as they are in England) and offered counselling beforehand to help them to arrive at a decision (as they are in England). 

Since the termination, I have struggled with depression and suspect this is something I will now always struggle and have to deal with. At the suggestion of a family member I called Sandyford 3 months afterwards to ask if counselling was available. The waiting time is 12 months. I burst into tears on hearing that and that week, called Samaritans and ended up speaking with a volunteer there. I have felt utterly helpless and hopeless.

We tried to conceive again and had a miscarriage, which only compounded the feelings of sadness, loss and disenfranchised grief. I feel like the safeguards which should have been in place for women in my situation who are torn on their decision weren’t there. 

I have and always will defend a woman’s right to choose. What I now see is how important it is for women to be supported through the decision making process and the aftermath. I am not suggesting a trained counsellor can make a decision for you, however, had me and my partner had the opportunity to talk with someone about our situation, we might have reached a different decision. Or we might have made the same decision and been able to feel more at peace with it. Our peace of mind is gone. 

Had I known that women who have suffered from anxiety and depression in the past are more likely to see these conditions resurface after a termination, I wouldn’t have gone ahead. I had a termination to try to avoid going back to those dark times and to be the best Mum I can be to my two children. Instead, the experience has left me a distant, sad and even more anxious parent. 

Had I known there were maternal mental health interventions (eg perinatal psychologists) which could have supported me through an unplanned pregnancy, I wouldn’t have gone ahead with a termination. Knowledge is power and more needs to be shared with women to support them.