It happens. You forgot to take the pill, the condom broke during sex, your contraception didn’t work, or you experienced sexual violence. You did not plan this pregnancy, but it happened. So, you’re on full right to choose an abortion.
Please share this post with your friends. Each of us needs to know the truth about pregnancy termination, its complications and types.
In the modern world, you have a choice, and foremost, you are not alone. In most developed countries, including Ukraine, abortion is a legal and usually safe procedure for terminating a pregnancy. The options depend on the term, contraindications, and your choice, and together with your gynecologist, you should choose the one that is safest for you. The days when women put themselves in mortal danger trying to get rid of an unwanted pregnancy are long gone.
In this article, I have collected for you the possible options for abortion, possible complications, and prospects for future pregnancies. Spoiler alert: you will be able to give birth without any problems in most cases.
Abortion statistics
- 6 out of 10 unplanned pregnancies end in abortion;
- About 40-50 million abortions take place annually in the world. That’s almost 125,000 abortions a day. Here you can see real-time statistics on abortion in the world;
- As of February 6, 2023, more than 4.5 million abortions have already taken place in the world;
- Almost 45% of all abortions are unsafe, but 97% of them are performed in developing countries;
- More than half of all unsafe abortions take place in Asia, mainly in South and Central Asia;
- Each year, 4.7-13.2% of maternal deaths are caused by unsafe abortion;
- In developed regions, 30 women die for every 100,000 unsafe abortions. In developing regions, this number rises to 220 deaths per 100,000 unsafe abortions;
- Legalization and accessibility of abortion reduces their number;
- In Ukraine, abortion is allowed at the request of a pregnant woman up to 12 weeks, and up to 22 weeks for medical reasons.
Vacuum aspiration
Common name is “vacuum”. This is the most frequent surgical procedure for abortion. Works only up to the 12th week of pregnancy, i.e. the first trimester. The surgery can be performed under local or general anesthesia, which you can discuss with your doctor.
On the gynecological chair, the doctor inserts a mirror into your vagina, then treat the cervix and vagina with an antiseptic. A medical dilator will keep the cervix open. Then the embryo will be removed from the uterus using a special suction device. The procedure takes only a few minutes. After the surgery, you will rest from 30 minutes to several hours, depending on the type of anesthesia and your well-being, and that’s it. You can go home.
Complications
They are extremely rare, but you should see a doctor as soon as you have the following symptoms
- Heavy bleeding. Smearing bloody discharge is normal after a vacuum, but not the heavy bleeding. More than two pads per hour for two hours is a reason to seek help;
- Severe pain in the lower abdomen. It is also normal to have a little pain, but if the painkillers prescribed by your doctor do not work, go to the emergency room immediately;
- High fever. Fever above 38º for more than 24 hours indicates the onset of an infection. Seek medical attention immediately;
- Pregnancy symptoms do not disappear within a week.
You may also feel faint, but it should not lead to permanent dizziness.
Medical abortion
The procedure does not require surgery, anesthesia, or a hospital stay. You just need a visit to a doctor, a decision, and medications prescribed by a doctor. The condition for this type of abortion is a short gestational age – from 7 to 9 weeks. Other contraindications are the presence of an intrauterine device, allergies to the components of the drug, certain blood thinners, or steroid medications. Plus, medical abortion cannot be used if you have heart and vascular diseases associated with blood clotting.
The doctor prescribes medications that block the hormone progesterone, causing the lining of the uterus to thin and preventing implantation and growth of the embryo. And then drugs that cause the uterus to contract and reject the fetus. The type of medication, dosage, and timing should also be determined by a specialist. You can take the medication orally, or you can take it orally first and then take the second dose vaginally, buccally (the pill is dissolved between the cheek and teeth) or sublingually (under the tongue). This method is considered more effective and reduces possible side effects.
Side effects
- Abdominal cramps;
- Vaginal bleeding;
- Nausea;
- Vomiting or diarrhea;
- Fever;
- Headache.
Painkillers are usually prescribed, sometimes antibiotics. However, inflammation after a medical abortion is extremely rare. You even might to go through this stage without changing your usual routine. However, if you experience the symptoms listed in the previous section, consult a doctor.
Crucially, remember to visit your doctor about a week later to make sure the abortion was successful. You must do an ultrasound examination of the pelvic organs using a transvaginal probe.
Usually, ovulation occurs two weeks after a medical abortion, and the next pregnancy is possible even before the onset of menstruation.
Dilation and evacuation (D&E)
This method is a thing of the past. It is used for medical reasons if the gestation period exceeds 12–14 weeks. Yet, the World Health Organization (WHO) now also recommend medical abortion as relevant at this time. Namely, it states that health care facilities should offer at least one, and preferably both, methods if possible, depending on the experience of health care providers and the availability of training.
Legislation
In the United States, abortion is not legal in all states. In those where it is legal, it can be performed between 6 and 24 weeks, depending on the state. Abortion is not available from the third trimester onward. In Britain, abortion is allowed up to 23 weeks and 6 days. In Ukraine, it is allowed up to 12 weeks, and up to 22 weeks for medical reasons.
Procedure
Like vacuum extraction, the procedure is performed on a gynecological chair under general or partial anesthesia. However, in addition to the vacuum, the doctor uses medical instruments, including forceps and a curette, to clean the uterus. The whole procedure takes 10–20 minutes. After the surgery, the doctor will administer medications to contract the uterus and stop bleeding.
You do not need to stay in the hospital. After resting for about an hour, the doctor will make sure that everything is fine and let you go home.
Possible complications are similar to those that can occur after a vacuum. Of course, seek medical attention immediately in case of heavy bleeding, high fever, and severe pain.
After an abortion
If the procedure has been done by a professional, there are usually no complications. There are also usually no negative consequences for your reproduction system, so you should take care of quality contraception as soon as your doctor allows you to have sex. Nonetheless, after several surgical abortions, scars can form on the uterus, which prevent subsequent pregnancies.
I advise discussing with the doctor performing the vacuum aspiration the following option: install an IUD immediately after the procedure, when you are still sleeping under anesthesia.
It is a myth that the IUD cannot be inserted immediately after the evacuating pregnancy from the uterine cavity is completed. I do not recommend performing surgical techniques under local anesthesia. Why stress yourself even more? The installation of an intrauterine device immediately after vacuum aspiration helps prevent the development of adhesions in the uterine cavity and another unplanned pregnancy.
Abortion used to be associated with an increased risk of breast cancer. However, a 10-year study by American scientists has disproved this link.
You need to rest, refrain from intense training and lifting weights. Hormonal changes occur in the body, so mood and sadness are likely to change. It’s essential to allow yourself to live through these feelings and take care of yourself. Abortion is a hard decision, but it is the legal right of every woman, so all the feelings she has are right. Be sure to consult a doctor if you feel that you are not coping psychologically.
I wish you only health and happiness!
At the Lior Medical Center, we are always here to help with any of your health issues.
You can learn more about your health and body from my courses: A girl becomes a woman, All about you. What it’s like to be a Woman, All about you 35+.
I’m eager to file all of these courses in English, just send me a request to dr.silinaeducation@gmail.com.
