Abortion

Description

Abortion may be performed using medicines or surgery.

A non-surgical, or medical, abortion can be done within 7 weeks from the first day of the woman's last menstrual period. A combination of prescription hormone medicines are used. The doctor may give you the medicines while you are in the medical office, after performing a physical exam and asking questions about your medical history.

A surgical abortion uses a vacuum to remove the fetus and related material. This is usually done after 6 weeks of pregnancy. Medicine (sedative) may be given to cause sleepiness. The doctor may numb the cervix so you have little pain during the procedure.

If the surgical abortion is done after 12 weeks of pregnancy, the doctor must first open (dilate) the cervical canal. Small sticks called laminaria are placed into the cervix to cause it to open. Sometimes, this is done a day or two before the actual abortion procedure. The doctor will insert a hollow tube into the womb before using the vacuum to remove the tissues (fetus and placenta) from the womb. You may receive medicines to make the uterine muscles contract. This reduces bleeding.

Indications

There are several reasons an abortion might be considered:

• The woman may not wish to be pregnant (elective abortion)
• The pregnancy is harmful to the woman's health (therapeutic abortion)
• There developing baby has a birth defect or genetic problem

The decision to end a pregnancy is very personal. Most health care providers recommend careful counseling before making such a decision.

Abortion is a controversial issue. A woman who chooses to end a pregnancy may feel she cannot share her decision with others. Therefore, it is important for her to identify those who may help her through what may be a difficult time.

It is also important to choose a reputable health care provider or clinic that advocates choice for women. Women who are trying to make this difficult decision should find a safe place in which they can obtain counseling regarding all options for pregnancy resolution.

If a woman chooses to have an abortion, she should find a safe place to have the procedure performed and obtain the proper support and follow-up care afterwards.

Risks

Risks of surgical abortion include:

• Excessive bleeding
• Infection of the uterus or fallopian tubes
• Damage to the uterus or cervix
• Emotional or psychological distress

The risks of surgical abortion increase as a woman gets further along in her pregnancy. That's why it's important to make a decision about abortion as early as possible, when the procedure is safest.

Risks of medical (non-surgical) abortion include:

• Prolonged bleeding
• Fetus not passing completely from body, making surgery necessary
• Nausea
• Vomiting
• Diarrhea
• Pain

The risks for any anesthesia are:

• Reactions to medications
• Problems breathing

The risks for any surgery are:

• Bleeding
• Infection

Expectations after surgery

Most women who have a surgical abortion in an appropriate medical center recover without any physical complications.

Women who have a medical (non-surgical) abortion have cramping and bleeding, and pass the pregnancy as though they were having a miscarriage.

Some women feel ambivalent about ending a pregnancy, and may need psychological and emotional support at the time of their procedure. It's important to seek counseling before making this very difficult decision.

Convalescence

Physical recovery usually occurs within a few days, depending on the stage of the pregnancy. A small amount of vaginal bleeding and mild uterine cramping should be expected for a few days.

A hot bath or use of a heating pad or hot water bottle on the abdomen may help relieve discomfort. Strenuous activity should be avoided for a few days following an abortion. Tampons may be used after 3 days. Sexual intercourse should be avoided for 2 to 3 weeks. A normal menstrual period should occur 4 to 6 weeks after the operation.

It's important to begin using birth control immediately after the abortion procedure. It is possible to get pregnant again even before having a normal menstrual period.