Ways of Performing Abortions

Ways of Performing Abortions
Medical abortion offers a new alternative to women in the U.S. seeking to terminate their pregnancies. Medical abortion uses drugs to stop the development of the embryo and to cause uterine cramping and bleeding that expels the pregnancy. Medical abortion is available early in pregnancy-before seven to nine weeks from a woman?s last menstrual period, depending on the method used. More than 90% of women who use medical abortion successfully terminate their pregnancies. Otherwise, a suction abortion is done. Side effects to the drugs used in a medical abortion are usually mild and may include nausea, diarrhea, vomiting, abdominal pain/cramping, dizziness, vaginal bleeding, and headache. Pregnancy termination may be completed within a few days after the administration of medications or it may take up to 1 month. The pregnancy may be passed at an unpredictable or inconvenient time. The woman may see the pregnancy tissue. She will want to consider these factors in her decision making process. What is suction abortion? Suction abortion is a technique that has been used since 1967. It is a relatively simple and safe procedure.
The physician first does a bimanual exam (using one hand on the abdomen and two fingers in the vagina) to determine how many weeks pregnant you are. ? A sterile cloth is then put over your legs and abdomen and a sterile speculum is inserted into the vagina to view your cervix. ? Next, your cervix is numbed by several small injections of local anesthetic in and around it. (Let your practitioner know if you are allergic to any medications.) The injections may cause a stinging or burning sensation. ? A clamp called a tenaculum is then used to hold the cervix steady for the duration of the procedure. The size of the uterus may be measured internally by inserting a thin probe. This may result in some cramping. The opening in the cervix is dilated which may again result in some cramping. ? A small, flexible plastic tube (about the size of a pencil) is inserted into the uterus. The contents of the uterus are gently removed by manual vacuum aspiration or by a suction machine. The suction lasts 3-5 minutes and can produce a pulling sensation and/or some cramping. The cramping is a sign that the uterus is being emptied and is returning to its normal size. How long does suction abortion take? The actual procedure takes about 15 to 20 minutes. Before you come, check with your doctor about instructions for preparing for your appointment. If you have a blood donor card or other verification of your blood type, please bring this with you to your appointment. You should plan to spend about two hours in the doctor?s office for preparation, procedure, and recovery. You may bring a supportive friend to be with you during the procedure, and you are advised to have someone with you who can drive you home. Where can suction abortion be performed? Most early suction abortions can be performed safely in a specifically equipped procedure room in a doctor?s office. Rarely, the doctor may recommend that the pregnancy be terminated in a hospital. When is the operation done? Suction abortion may be done as early as five to six weeks from the last menstrual period. Some doctors prefer to wait until seven or eight weeks. How much does it cost? An early termination, i.e. one that is done within the first 12 weeks of pregnancy, costs about $500 in a doctor?s office. Later terminations cost more. Most doctors require full payment in advance of the operation. Your insurance may cover some of the charges. Call your insurance office for information. Medical assistance may be available to eligible low- income women. Legal Considerations: In Washington State, only the patient needs to sign the consent for a pregnancy termination. How many days off work or school should the woman allow? For an early termination, allow 1-2 days (the day of the abortion and possibly the day after). As a general rule, avoid strenuous activity the day after. Are there complications with abortions? Complications are rare, but as with any medical procedure, they are possible. Nationally, the complication rate for early pregnancy termination is less than 1%. The following possible complications can occur: 1. Infection:Report to the doctor any temperature over 100? Fahrenheit. 2. Excessive Bleeding: Some menstrual-like flow or spotting is normal for a few days to a few weeks. If you are having heavier, bright red blood and using one pad an hour, call the doctor immediately. 3. Severe Pain:Menstrual-like cramps are common and normal for the first few days. Report any other abdominal pain, fever, burning with urinating, or unusual vaginal discharge to the doctor. 4. Incomplete Abortions: This is rare, but possible, and may require further care. 5. Missed Abortions: Rarely, the pregnancy may be missed entirely by the procedure. Be sure to report to the doctor any continuing signs of pregnancy. 6. Perforation:This involves the tearing or puncture of the uterine wall during the procedure. This is a very rare, but potentially serious, complication that may require hospitalization. remember: It is very important that you return to the doctor for a post-abortion exam 2-4 weeks after the procedure to insure that the abortion was complete and that there are no other complications. The fee for the abortion usually covers this exam. If you have any concerns related to your abortion, you should contact the doctor who performed the abortion promptly. He or she is responsible for your care. Will the woman be able to get pregnant in the future? Yes. It is extremely unusual for an abortion to cause infertility. One suction abortion without complications has not been shown to have any negative effect on a woman?s ability to conceive or carry a later pregnancy to term. When can the woman expect my next period? Your normal period should begin 4-6 weeks after the abortion. How soon can intercourse be resumed? Your doctor will give you specific instructions. Generally, you should avoid intercourse, swimming, deep tub baths, douching, and tampons until you have had your post-abortion exam. This is usually performed 2-4 weeks after the abortion. How can another unintended pregnancy be avoided? Any unprotected intercourse following an abortion can result in another pregnancy. To avoid pregnancy in the future, you need to choose and use a method of contraception if you decide to be sexually active. Most birth control pills are started the Sunday following the abortion. A diaphragm or cervical cap is usually fitted or checked 2-4 weeks following the abortion. If the method you choose fails or you have unprotected intercourse, you may want to discuss emergency contraception (morning after treatment) with your clinician. How will the woman feel emotionally after the abortion? The emotional effects of abortion depend in part on the meaning each woman attaches to the pregnancy and the abortion, and partly on the hormonal changes that occur with pregnancy. We recognize that these are different for every woman. The hormonal changes can accentuate mood swings in the immediate post-abortion period. We encourage women to use their own support systems both before and after the abortion. Also, Women?s Clinic staff is available to any student to discuss abortion-related questions or concerns.

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