What to Expect during Termination of Pregnancy?

Termination, also called abortion, is the process of ending a pregnancy. Abortion is a personal decision. The reasons include genetic disease, an early miscarriage, or terminating an unwanted pregnancy. Qualified doctors perform the procedure in licensed clinics or hospitals.

For abortion, there are two methods; Medical Abortion and Surgical Abortion.

1. Medical abortion: The doctor gives two medicines to the woman to consume at home, in their office, or both. The pregnancy should be nine weeks or less. The doctors also provide specific instructions about the usage of the medicines.
2. Surgical abortion: It is also called Clinical Abortion, Dilation and Curettage (D&C), and Aspiration Abortion. In this abortion, the doctor removes the embryo from the uterus under mild sedation, local or general anaesthesia. A few reasons women go for surgical abortion include:
   1. Failed medical abortion
   2. Personal preference
   3. Pregnancy of more than nine weeks
   4. genetic disorders (they are found much later in pregnancy)

Women can expect the following before the abortion procedure. The doctor will:

1. Do a physical examination and confirmation of pregnancy
2. Do blood and urine tests
3. Determine the length of pregnancy and that it is not an ectopic (the foetus develops outside the womb) pregnancy
4. Ultrasound to see the pregnancy in the womb
5. Explain to them the procedure, side effects, and risks

Women can expect the following for medical abortion or surgical abortion:

1. Medical abortion
   1. The medicines are taken orally or through the vagina for this method. There is no need for anaesthesia. 
   2. A combination of 2 medicines induces abortion when taken together. 
   3. The two medicines are Mifepristone and Misoprostol. 
   4. Mifepristone blocks the progesterone, due to which the uterine lining becomes thin, and the embryo will get detached. 
   5. Further, Misoprostol causes womb contraction, bleeding, and embryo expulsion.
   6. Oral route: the woman will take Mifepristone either in the doctor’s office or at home. Later after 24 to 48 hours, she will have to take Misoprostol at home.
   7. Oral and vaginal/buccal/sublingual route: The woman will take Mifepristone orally, and after 24 to 48 hours, she will have to take Misoprostol through the vagina or under the tongue dissolved in the cheek. 
   8. After taking the medicines, the side effects of medical abortion start shortly after taking the second medicine. The woman may notice bleeding and cramping within one to four hours after taking the second medicine, heavy bleeding with blood clots and cramping for several hours. She may also have chills or a lower fever lasting for a day. Some women may also have nausea, tiredness, and diarrhoea. 
   9. A follow-up appointment is scheduled within two or three weeks to examine the woman and check for any signs of complications.
2. Surgical abortion
   1. For this method, surgery will be done to remove the pregnancy from the uterus.
   2. Before the surgery, the woman will be given medicine to open her cervix. The medicine will be provided after 1, 2, or a few hours before the surgery, depending on the type of medicine.
   3. The woman will be given conscious sedation and local or general anaesthesia. 
   4. The type of anaesthesia to be given depends on the situation, pregnancy weeks, and preference.
   5. There are two types of methods for Surgical Abortion:
      1. Suction or Vacuum Aspiration: When the pregnancy is up to 14 weeks, the doctor can perform Suction or Vacuum Aspiration The doctor inserts a tube from the vagina to the uterus. Then the foetus is removed with the help of suction. This method takes around five to ten minutes, and the woman can go home after a few hours. Depending on the duration of the pregnancy, the doctor uses special instruments to end the pregnancy.
          
      2. Dilation and Evacuation (D and E): If the pregnancy is over 14 weeks, the doctor inserts special instruments like forceps through the vagina into the womb to remove the foetus. For this method, the woman is under sedation or general anaesthesia. The surgery takes around ten to twenty minutes, and the woman can go home the same day. 

After the abortion, a woman can expect the following things:

1. For all types of pregnancy, the woman may have vaginal bleeding and stomach pain or cramps. The bleeding will last for one or two weeks. However, light vaginal bleeding can last till a month in case of medical abortion.
2. In the case of Medical Abortion at home, the woman would need a pregnancy test or scan to ensure you are not pregnant. In addition, the woman may notice short-lived side effects like feeling sick and diarrhoea.
3. In the case of Surgical Abortion, the woman can also have side effects due to local or general anaesthesia.
4. After the abortion, the woman can take pain-relieving medicines such as paracetamol or ibuprofen to help with discomfort or pain.
5. They should use sanitary pads till the bleeding stops. Avoid tampons.
6. They can return to their usual activities (including work) as they feel comfortable within one or two days. 
7. They can take a shower or bath as usual. If the woman is showering within 24 hours, she might need someone’s help as she may feel drowsy due to general anaesthesia. 
8. Avoid using tampons and use sanitary pads till the bleeding stops.
9. The woman can have sexual intercourse as long as she feels comfortable. Use contraceptives as there are more chances of becoming pregnant because they will be most fertile after the abortion.

It is advisable to meet your doctor for the abortion procedure. Do not take self-medication without knowing your condition. After reading this blog, you will understand what to expect before, during, and after the surgery. Also, please help your loved ones in these difficult times.

If you have any doubts or queries, feel free to contact our personal care assistant, they will guide you and solve all your worries. You can also visit our HexaHealth website for more information on abortion.