In-Clinic Abortion: Overview
An in-clinic abortion refers to surgical procedures done to terminate a pregnancy. Compared to a medical abortion, an abortion surgery is proven to be safer and more effective, provided it is conducted by a qualified abortion surgeon.
Preparation: What You Need to Do Before an In-Clinic Abortion
Take note that in Singapore, before a woman can receive abortion services, she first needs to complete a mandatory counselling with an authorized professional and abortion doctor, followed by a 48-hour cool-off period. Once these have been completed, she can then set an appointment to have the procedure at an accredited abortion clinic.
Following a series of physical and lab tests, the patient will be given a list of instructions on how to prepare for the procedure, which includes:
- Abstain from eating and drinking (even water) at least 6 hours before the procedure.
- Be at the clinic two hours before the scheduled operation.
- Arrange for transportation home.
For patients who are taking certain medications, the doctor may need to adjust the prescription to prevent any complications. For instance, the use of aspirin may be discouraged because aspirin thins the blood, which may slow down recovery.
Types of Abortion
An abortion in Singapore can only be carried out if the pregnancy is below 24 weeks, unless the mother’s life is in danger. Depending on the length of gestation, the abortion procedure can be done in one of two ways:
- Medical abortion – Usually only done for pregnancies less than 10 weeks, a medical abortion involves taking medication (misoprostol) that will cause contractions in the uterus to expel pregnancy tissues.
- In-clinic abortion – For pregnancies 12 weeks or more, abortion surgery is performed. Depending on the length of pregnancy, the abortion procedure may involve only a vacuum aspiration, in which the pregnancy tissues are suctioned out of the uterus using a thin cannula, or a mid-trimester pregnancy termination (MTPT), in which the foetus is first delivered vaginally, followed by the cleaning of the womb to ensure the complete removal of all pregnancy tissues.
How the Procedure Is Done
The type of abortion procedure that will be performed will depend on how far along the pregnancy is, as follows:
- Vacuum aspiration (pregnancies < 12 to 14 weeks) – This procedure involves inserting a cannula through the vagina and into the uterus to suction out and empty the contents of the womb.
- Mid-trimester pregnancy termination (pregnancies 14 to 24 weeks) – MTPT involves first delivering the foetus, then surgically removing any remaining pregnancy tissues in the womb.
All surgical abortions are day procedures and done under general anaesthesia. They usually take only 5 to 15 minutes, and do not require hospitalization. As a side note, an abortion in Singapore is prohibited for pregnancies beyond 24 weeks unless the mother’s life is in danger.
What to Expect After an In-Clinic Abortion
Similarly, a set of instructions will be provided by the abortion doctor to help facilitate full recovery and avoid any complications:
- Avoid physically strenuous activities and exercises for at least a week after the abortion.
- Use sanitary pads instead of tampons for bleeding to prevent infections.
- Avoid sexual intercourse for 1 to 2 weeks after the procedure.
- Avoid douching or putting anything inside the vagina for 1 to 2 weeks.
- Do not take long baths or go swimming for 1 to 2 weeks.
Taking prescribed or over-the-counter medicines can also help to alleviate certain pains and discomforts that might be experienced following the procedure. Getting enough rest is necessary, though patients are usually cleared to go back to work the next day.
Common Side Effects
After an abortion procedure, the patient can experience the following:
- abdominal cramps or pain
- light bleeding or spotting
- nausea and vomiting
These are normal effects that should subside after a few days or weeks.
Possible Risks and Complications
Abortion surgery is safe, but like other surgical procedures, it carries certain risks and complications, albeit rarely in the hands of an experienced and qualified doctor.
When to See a Doctor
Some symptoms need emergency medical care, including:
- heavy bleeding (soaking 3 or more sanitary pads per hour)
- passing large blood clots for over 2 hours
- fever that lasts more than 24 hours
- foul-smelling vaginal discharge
- worsening pain and cramps (especially after 48 hours)
- persistent pregnancy symptoms after one week