MAKING YOUR CHOICE

Your decision to have an abortion or continue a pregnancy is not a simple or easy one. It is important to take the time you need to make the choice that is best for you. Talking with family members, friends, and loved ones whom you trust can help. You can also seek advice from your doctor at FV Hospital, and if you wish so you can be proposed a consultation with a clinical psychologist who can help you as you make your decision.

WHAT ARE YOUR OPTIONS?

There are two types of abortion:

• A surgical procedure. A surgical procedure usually requires anaesthesia and is performed in an operating theatre room;
• A medical process where you take tablets instead of having surgery. A medical process requires you to take two types of tablets to bring on a miscarriage 24-48 hours apart. This method is suitable only for early pregnancies (<9 weeks);
• Both methods are safe and effective methods of terminating a pregnancy.

The right option for you may depend on how far your pregnancy has advanced, your general health, medical condition and your own personal preference.

Abortion is a safe medical procedure however you should be aware that there are a small number of possible complications associated with surgical or medical abortion.

All methods of early abortion carry a small risk of failure to end the pregnancy and therefore a need to have another procedure. This is uncommon, occurring in less than 1 in 100 women.

CAN A DOCTOR REFUSE TO PERFORM AN ABORTION?

A doctor has the right to refuse to perform an abortion on the grounds of conscience, but he or she must refer you to another doctor who will help.

WHAT CAN I EXPECT BEFORE I HAVE AN ABORTION?

Your obstetrician will explain the process to you and answer all your questions. The doctor will review your medical history, do a physical examination and a pregnancy test. An ultrasound may be performed to determine the date of the pregnancy and to exclude ectopic pregnancy. You will be requested to sign a consent form.

MEDICAL ABORTION

A medical abortion uses two medicines to end a pregnancy. The first one (an anti-hormone called mifepristone) weakens the attachment of the pregnancy to the uterus. A second medication (a prostaglandin called misoprostol), swallowed or put into the vagina a few days later, makes the uterus cramp and causes bleeding to expel the pregnancy, usually within 4 to 6 hours.

With a medical abortion, women often have stronger cramping and heavier bleeding than with a period. Bleeding and spotting usually last about 9-16 days. A return visit is needed to ensure the abortion is complete.

Complications are rare. A small number of women will need a vacuum aspiration because of heavy bleeding or because the medical abortion does not end the pregnancy. Very rarely a blood transfusion is needed because of excessive bleeding.

SURGICAL ABORTION

In the first 12 weeks of pregnancy surgical abortion is usually done by a method called vacuum aspiration. With a vacuum aspiration (also called suction), the cervix (opening to the uterus) is stretched open slightly. The pregnancy is then removed through a small tube using suction. Vacuum aspiration is done in the operating theatre and the procedure takes less than 15 minutes, however, from the point of arrival at the hospital, to preparation for the surgery and recovery from the anaesthetic, having a surgical abortion can take 4 to 5 hours. After the anaesthetic has worn off and you have received your aftercare advice, you will need to be driven home.

For a short time after the procedure, women may have strong cramping. Spotting or bleeding like a period may last for a few days or weeks. Complications are rare, but include infection, excessive bleeding, a tear in the cervix or uterus, incomplete abortion, or a continuing pregnancy.

Do not have intercourse or insert anything in your vagina for one week because your cervix is open and this may increase the risk of infection.

You can have a shower as soon as you wish, but we advise you not to have baths or go swimming for one week after the procedure.

Avoid any strenuous activity for at least one week, including sports or heavy physical work to allow your body time to recover.

WILL ABORTION AFFECT MY CHANCES OF HAVING A BABY IN THE FUTURE?

It is very unlikely that having an abortion will stop you becoming pregnant in the future.

If you do not have any problems or injuries with your abortion then having an abortion does not reduce your chances of getting pregnant or having a baby in the future. Problems are not common.

If your cervix has been damaged, there is some evidence that you may have a very small increased risk of miscarriage and premature birth if you get pregnant again.

WHAT IF MY BLOOD GROUP IS RhD-NEGATIVE?

If you are RhD-negative, you should usually be offered an anti-D injection after your abortion.

CONTRACEPTION

You can get pregnant within two weeks of having an abortion. You should therefore begin to use contraception immediately after your abortion.

Most contraception methods are very effective and dramatically reduce the risk of unplanned pregnancy.

EMERGENCY CONTRACEPTION

The Emergency Contraceptive Pill (ECP), also called “morning after pill” prevents a pregnancy from occurring. It does not cause an abortion.

The ECP should be taken as soon as possible after unprotected sex (though it is effective up to 3 to 4 days).

You can get the ECP on prescription by seeing a doctor, or you can buy it in a pharmacy.

ECP works around 85% of the time in preventing pregnancy.

Another emergency contraception option is the copper intrauterine device (IUD). It is more than 99% effective at preventing pregnancy. It must be inserted inside the uterus (womb) by a trained doctor and can last for up to 5-10 years.