Unplanned Pregnancy and Abortion - frequently asked questions

 

What questions should I ask when choosing a clinic?

1. What is the skill and experience of the operating doctor?
2. What kind of facility is it and is it built to government standards?
3. What are the clinic's infection control practices?
4. What standard of care and emotional support is provided both with the procedure and in the following weeks?
5. What is the cost? (The public health system does provide some places at no cost but these are very limited. In all private clinics there will be some out of pocket expenses. These may be covered by Private Health Insurance. If there are problems with payment it should be referred to the Practice Manager who can negotiate the costs.

How does the law relate to abortion?

In March 2008 the law was reformed so all women in Victoria could have legal access to surgical abortions under 24 weeks. This clinic operates to 18 weeks.

How is the procedure performed?

Terminations under 13 weeks gestation (from the last normal period) are carried out by dilation and suction curette. This usually takes less than 15 minutes. The patient can choose to have a local (awake) or general (asleep) anaesthetic. Adverse reactions are extremely rare.

How long will it take to recover?

The amount of time you will be expected to stay at a clinic varies and depends upon whether you have a local or general anaesthetic. It is important to rest for the remainder of the day. You can usually return to work the next day but avoid heavy lifting or strenuous activity for 2 weeks. You must not drive until the following day.

Do I need to see a counsellor?

If you choose to have counselling our aims are to provide a supportive, non directional environment in which a woman can explopre thoughts and feelings about the pregnancy and look at the outcomes of all her options.

Not all women will have serious issues in choosing to terminate a pregnancy, but the opportunity to give space to discussion, provide accurate information and affirm their decision is still a valuable first step in providing a supportive environment for those wishing to undergo a termination of pregnancy (TOP) procedure.

Do I need to see a doctor?

It is important that a full medical assessment is undertaken prior to the procedure. All patients must also sign a medical consent for a TOP procedure and other things you may wish to have done eg: PAP Smear, Blood group or Implanon.

Is the procedure safe?

Abortion is a low risk procedure if performed between 6 and 12 weeks gestation. There is however a small increase in risk with each week after the seventh week.

What are the chances of a complication / minor problem / unplanned event?

The overall risk of experiencing a complication during or soon after an abortion is estimated in 9 women in 1000 in Australia. In Australia deaths after abortion are rare (no deaths reported in Victoria in the past 25 years). The skill and experience of the operating doctor can affect the rate of complications.

The doctor in our clinic has been operating for over 20 years and has a complication rate of <1% in the 2010 / 2011 years. Complications recorded are considered to be minor problems. Major complications have not occurred occurred with surgical abortion at this clinic.

What are the possible immediate problems?

Infection,related to surgery has not been a problem at this clinic.

Is there pain afterwards?

Most women will experience a cramping pain similar to that of a period pain. This varies from woman to woman, some experiencing no pain, others more severe. Over the counter analgesia should give sufficient pain relief eg Panadeine, Nurofen or Panadol.

Is there a chance that the abortion could fail or be incomplete?

Failure of abortion is rare, particularly if performed by an experienced doctor. 1:4000 for our operating doctor. Risk is increased if the abortion is undertaken prior to 6 weeks gestation, if the uterus is an unusual shape or position, or if the doctor is less experienced. An additional curette may then be required.

Is there a risk I may not be able to bear children in the future?

In the absence of complications an early abortion carried out under proper conditions does not cause an increase risk of infertility. An untreated infection is the most likely complication to effect future fertility.

Retained Products

Retained products can cause heavy bleeding after the procedure, like a miscarriage. A recurrette is necessary. Our rate is <1%. Medical abortion pill is up to 5-10%.

Are there likely to be negative emotional consequences?

Women's reactions to having an abortion are mixed and varied. There is no one normal way to feel. If the decision has been difficult you may in fact experience a period of sadness and grief either before or following an abortion. The majority of women however will not experience serious emotional consequences. If a period of emotional upset is more intense or long term it is most important to seek professional help from a counsellor or doctor. Most women feel relieved.

How soon can I get pregnant after an abortion?

You can fall pregnant again the first time you have intercourse after having a termination. It is thus important that an appropriate form of contraception is chosen to enable it to be started immediately after the abortion. It is important you are fully aware of the correct way to use it. You can discuss this with your doctor or staff at a clinic prior to your discharge.

Is the procedure confidential?

This clinic has strict confidentiality protocols. Every medical procedure is confidential. You are under no obligation to tell anyone outside the clinic of your decision although often it helps if you have a friend you can talk to. No information should be disclosed to any other person including your regular GP without your consent. If you are under 16 years of age consent from a legal guardian is required. Our Privacy Policy is available to view on line.

What if I am under 16 years of age?

We need the involvement of a parent or guardian for anyone younger than 16 years, unless that person is independent, living away from home, or the circumstances are very unusual. In these situations the support of a regular local doctor or another adult family member is helpful.

What is an ectopic pregnancy?

An ectopic pregnancy is a pregnancy outside the uterus. It is usually less that 8 weeks and found in the tube. Women at risk can be those who have had abdominal surgery e.g. ruptured appendix, previous ectopic, positive Chlamydia tests, pelvic sepsis or having had the morning after Pill or Mini pill.

It is potentially a life-threatening condition and needs to be treated promptly. Where ectopic pregnancy cannot be excluded follow up is required.

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