Surgical Abortion

you will need to come back for a preparation stage before the actual abortion is performed on a separate sitting. After 10 weeks of pregnancy, you will need to have medicine inserted into the vagina to make the termination of pregnancy safer for you. This medicine costs $250, and it increases in price to above $1,000. The exact cost is roughly equivalent to the size of the pregnancy. 11 weeks would cost $3,000 whilst 14 weeks or more would cost $4,500, or more. This is not inclusive of the first consultation, ultrasound and anaesthetic fees. The exact amount can only be properly determined on a ‘case by case’ basis after a complete examination of each patient by Dr Jen.

depends on whether you need to be fully counseled. This will be explained to you during the consultation. If you have already been counseled and can prove it then there is no need to repeat it.

The operation is painless and very fast. It takes only 20-30 minutes, but because the patient is put to sleep, you will need about one hour or more for the sedative drugs given to wear off. Therefore, you will need to be fully prepared before the abortion surgery. This means you need to fast for 4 hours (no food or drink - even water) before seeing the doctor. Also be prepared to spend about 2 to 3 hours in the clinic. The operation is performed during sleep - so it is painless.

you can go home as if nothing happened. At most you will feel like having had menstrual cramps. The surgery is therefore fast and convenient and no one will find out unless you tell them.

For early termination of pregnancies, most recover quickly. Some can get more severe bleeding or cramps, just as this can complicate normal periods for many women.

As for the recovery after an abortion after 10 weeks, it is also quick. There is occasionally mild bleeding that is prolonged, with some menstrual cramps. This varies with each individual. Mild transient fever may occur and if it persists, you should contact Dr Jen. It is important for you to keep the review date which is given to you. This is normally one week after the operation.

As for the recovery after a 9 to 15 week abortion - it is quick fast. There is usually only mild bleeding for the first few days associated with mild menstrual-like cramps. About 3 to 7 days after the abortion surgery, there may be more bleeding and cramps, depending on each individual. A mild fever may occur during the first 12 hours after the procedure, but if it is any longer, you will need to contact Dr Jen.

The effects of pregnancy like morning sickness, palpitations, giddiness and other common feelings associated with early pregnancy will take one to two weeks to slowly taper away after the abortion, and does not disappear instantly. Even the urinary pregnancy test may take about two weeks to entirely disappear.

The risks and possible complications are listed below, but the risks in my hands are very rare.

I have been performing abortions for about 30 years and the main worry that I have for my patients is not whether they become infertile, but whether they will quickly get pregnant and come for another abortion.

Prevention is better than cure, so it is better to use condoms or other methods of contraception, than to use abortion as a method of family planning.

What complications may arise from a termination?

Fewer complications arise if the pregnancy is terminated early. There is no such thing as an operation or procedure that is completely risk-free. Termination of pregnancy is a safe procedure but complications are possible.

The use of flexible soft instruments instead of sharp steel instruments would lessen any trauma to the womb and endometrium.

The use of ultrasound in the Operation Theatre like what I normally have and use will lessen any risk of incomplete evacuation.

The most common complications are described below:

• Bleeding

  After the abortion it is normal to bleed for a couple of days. After that, the bleeding will decrease for a couple of weeks. This is not the menses, but post pregnancy recovery bleeding. A normal period or menstruation will, in most cases, occur after five to six weeks. If the woman bleeds more heavily than she would normally, it could be because her uterus has not been emptied completely. If this is the case she should ask an abortion doctor to examine her. This complication applies to both medical and surgical terminations. More commonly, this excessive bleeding is due to a persistence of the hormones of pregnancy which causes the womb to be filled with or engorged with blood.

• Incomplete Evacuation of the Womb

  The vacuum aspiration of the womb is much less traumatic to the womb and it’s lining than the scrapping of the womb by a sharp metal instrument, which is traditionally used to ensure that all the parts of the pregnancy are removed. However, this gentler procedure also means that the bleeding after the abortion is longer than usual. Also, in some cases, the usual shape of the womb or its usual position may make it impossible to aspirate all parts of the womb. The use of ultrasound during the procedure and in the Operation Theatre reduces this risk.

• Pelvic inflammatory disease

  This can happen when there is already pre-existing infection in the womb before the abortion procedure, or if the patient engages in sexual activity before the full healing of the womb aftrer the abortion. If a woman has an unpleasant vaginal discharge, a temperature and abdominal pains, she should contact her doctor. Inflammation can occur if the uterus has not been emptied properly, or if bacteria have got into the uterus during the operation. The inflammation is treated with antibiotics. If some tissue still remains in the uterus, it may be necessary to remove it with a new evacuation of the womb. Baths, swimming pools and unprotected sexual intercourse should all be avoided until any bleeding has stopped.

• Pain

  It is normal to have mild pain across the lower abdomen for the first couple of days after a termination. If the pain is not reduced by normal pain killers the woman should contact her doctor. Sometimes the pain can be more severe due to the spasm of expelling a large blood clot.

• Puncture of the uterus

  During a surgical termination, inserting the suction device may risk puncturing a hole in the uterus. If the doctor suspects this, the operation will be stopped and the patient will be kept in hospital for observation. This complication is rare.

• Thinning of the Endometrium

  If the doctor was too enthusiastic in scrapping the lining of the womb, then it would result in excessive thinning of the endometrium and her period may not return causing a condition known as Asherman’s Syndrome. This needs to be treated with an Intra-Uterine Device to help regenerate the endometrium.

Can abortion lead to infertility?

This is possible but rare, and is usually caused when the woman is already harboring a Chlamydia infection prior to the abortion procedure. Inflammation of the Fallopian tubes and ovaries caused by the Chlamydia organism is the most common cause of infertility following an abortion. Examination for Chlamydia is now routine in most hospitals and clinics and, if necessary, the patient will be treated before the abortion is carried out.