Choosing a procedure
There are different options for terminating a pregnancy. Which do you choose?
Abortion pill
- This medical abortion can be done up to 9 weeks of pregnancy
- After the first pill at the doctor’s practice or abortion clinic, you take the other pills at home
- It is like a natural miscarriage
- You could have painful stomach cramps and more bleeding than with a vacuum aspiration or a period
- Your partner, or someone giving you support, can be there
- There is no doctor with you, but you can always call a doctor if you’re worried about anything
- You are conscious during the abortion
- The lower part of your body can stay covered for the procedure
- You don’t know beforehand when the termination will start and how long it will take
- You do not need an antibiotic afterwards
- You can have a coil fitted 3-4 weeks later. A contraceptive implant can be placed straightaway
Vacuum aspiration
- This surgical abortion can be done up to 13 weeks of pregnancy
- A doctor carries out the procedure at an abortion clinic
- You don’t see the embryo or foetus after the abortion (unless you want to)
- With a local anaesthetic, you do have pain
- If you have sedation, you won’t feel anything. You will be attached to a drip through one of your veins
- Usually, no one is allowed to be with you during the procedure
- You have the support of the medical team
- With sedation, you’re not aware of the abortion itself, which you are with a local anaesthetic
- The lower part of your body does have to be uncovered for the procedure
- You know when the procedure will be done and how long it will take
- You will be given an antibiotic to prevent infection
- You can have a coil or contraceptive implant placed straightaway
Abortion pill
The ‘abortion pill’ is a combination of different tablets:
You take the first tablet at the abortion clinic or doctor’s practice. This tablet (mifepristone) blocks the pregnancy hormones. You’ll hardly notice anything after taking this first tablet, possibly some bleeding or stomach ache.
You are given 4 tablets (misoprostol) to take at home 1 or 2 days later. Usually the doctor advises you to insert the 4 tablets into your vagina. But you can also let the tablets melt in your mouth. This medication makes the uterus contract, and the pregnancy passes through the vagina, with some bleeding. It looks like a heavy period. You can compare it to a natural miscarriage.
Is it painful?
You may feel a short, sharp pain as the local anaesthetic is given. You may also feel some cramps during the procedure. These cramps are similar to bad period pains. Some clinics offer sedation. Then you are asleep during the procedure and don’t feel anything.
How long does the bleeding last?
The bleeding usually lasts for about 2 to 3 weeks, but sometimes for a shorter or longer period. How much you bleed also varies per person. Depending on how long you’ve been pregnant, you may see the pregnancy sac in the blood. It is a transparent ball with a tiny embryo in it. But sometimes you won’t see it between the blood clots.
An abortion pill is not a morning after pill
An abortion pill is different to a morning after pill. You take a morning after pill soon after having unprotected sex. A morning after pill can prevent pregnancy. You take an abortion pill when you’re already pregnant. The abortion pill ends the pregnancy.
Does an ‘abortion reversal pill’ exist?
You might have heard about a pill that will stop a medical abortion tablet working if you regret having taken it. This information comes from organisations who are against abortion. There is no evidence of a medication working like that. Nor any proof that this would be safe for your health.
Vacuum aspiration
During a vacuum aspiration, the uterus is emptied through the vagina using a thin tube. Usually you are given medication beforehand to gently open the cervix (entrance to the uterus), and also some pain relief. Then the abortion doctor puts a special instrument into your vagina, which keeps it open. The cervix is given a local anaesthetic, so you won’t feel anything. The doctor removes the pregnancy from the uterus through a thin tube. The procedure takes about 10 minutes.
Is it painful?
You may feel a short, sharp pain as the local anaesthetic is given. You may also feel some cramps during the procedure. These cramps are similar to bad period pains. Some clinics offer sedation. Then you are asleep during the procedure and don’t feel anything.
After the abortion
After the procedure, you are advised to stay at the abortion clinic for a while to recover. If you had sedation, you cannot drive yourself. Usually the cramping goes away after the procedure, but you may have some stomach cramps for a couple of days afterwards. You’ll be given an antibiotic to prevent infection and some advice about pain relief. There is usually some bleeding, something like a normal period.
How long does the bleeding last?
The bleeding often stops within 2 weeks. But it might last longer than that, or stop soon after the procedure.
What is more effective: an abortion pill or a vacuum aspiration?
Both an abortion pill and a vacuum aspiration are effective in terminating a pregnancy and they are both safe. With either procedure, there is a slight chance that the pregnancy hasn’t ended. That’s why it’s important to do a pregnancy test after 3 to 4 weeks.
Could you become infertile?
No, your fertility doesn’t change after an abortion. Fertility does decrease as you get older. Usually from the age of 35. Your doctor can tell you more about possible complications after an abortion.
Having a coil put in
Would you have like to use a hormonal or copper coil after the abortion? If you have a vacuum aspiration, the coil can be placed immediately. If you decide to have the abortion pill, a coil can be fitted 3 to 4 weeks later. A contraceptive implant can be placed in your arm straightaway.
Abortion after 13 weeks
It is possible to have an abortion after 13 weeks. But this isn’t offered by all abortion clinics. During the procedure, the uterus is emptied using a suction tube and special instruments. Ask your doctor or an abortion clinic about the options.
More than 22 weeks pregnant?
If you are more than 22 weeks pregnant, you can no longer have the pregnancy terminated at an abortion clinic. If there is a serious defect in the foetus, you can have a pregnancy termination carried out in a hospital. That is possible up to 24 weeks.