Patient information: Surgical termination of pregnancy

This booklet contains information about your surgical termination of pregnancy. Read this information carefully and keep it to look at later on. Ask us if you have any questions after reading it.

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This page is an accessible text version of the PDF Patient information: Surgical termination of pregnancy (PDF, 199Kb)
Ref: NMAC0012-STOP-V13-DEC17

Interpreter services

Please let us know if you need a telephone interpreter to help you understand any of this information. If you need one at any time before or after your procedure, you can call TIS National on 131 450 and ask to be connected to Marie Stopes Australia on 1300 003 707.

Contents

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What is a surgical termination of pregnancy?

Surgical termination of pregnancy (also known as surgical abortion) is a simple, safe day-surgery procedure in which gentle suction is used to end a pregnancy. It is one of the most common surgical procedures in Australia.

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Preparing for your appointment

If you are having IV sedation, you must follow these important fasting guidelines:

  • Do not eat anything for 6 hours before your appointment. This includes lollies and gum.
  • You may continue to drink a small glass of water each hour up to 2 hours before your appointment, but no other fluid.

If you are having IV sedation you must arrange for an appropriate support person to accompany you home. You cannot drive a motor vehicle for 24 hours following your procedure and you cannot travel home alone by taxi. Your support person must come into the clinic to collect you.
It is expected that you will spend around 4 hours at our clinic. If you are more than 12 weeks pregnant your stay will be longer.

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What happens during my appointment?

You will have a consultation with both a nurse and a doctor who will talk to you about your decision and ask about your medical history and any previous pregnancies and operations. The procedure and anaesthetic options will be explained, including any risks, and you can ask any questions you might have. You will be seen alone initially but your support person may join you part way through the consultation if you prefer. You will also have an ultrasound to check how many weeks pregnant you are. Whether you see the ultrasound or not is your choice.

We will also discuss your contraceptive options and other sexual health screening that can be done at the same time as your procedure.

Before your procedure you will be asked to give your written consent. Please make sure you have read and understood the information in this booklet, asked any questions and had them answered, and that you are not being forced or pressured to consent. If you don’t understand the information, or feel you are being pressured, please let your doctor or nurse know.

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What does the procedure involve?

You will change into a gown before entering the procedure room. Your support person will not be able to be present with you during the procedure so they may prefer to leave the clinic at this time and return in an hour or so.
Following the administration of your chosen anaesthetic, the doctor uses gentle suction to remove the pregnancy from the uterus. The procedure, in most cases, takes no more than15 minutes. If you are having IV sedation you will usually not be aware or remember anything. If you are having local anaesthetic you will be awake and experience some cramping during the procedure which may vary in intensity.
If your pregnancy is more than 12 weeks you will be provided with further information about additional steps required before your procedure. Procedures at this gestation almost always require IV sedation.

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What happens following the procedure?

You will spend a short time resting in a bed and then a reclining chair. Our recovery nurses will review you regularly and check for any unusual pain or bleeding. Once you have recovered from the anaesthetic and are feeling well enough you will be discharged into the care of your support person. This is usually within an hour of your procedure.

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What to expect after the procedure

When you go home you should rest for the remainder of the day. As soon as you feel well enough, you can return to your normal activity and resume gentle exercise. Avoid any strenuous activity for one week, including sports or heavy physical work.

Many women return to work the day after an early termination. If you have a physically demanding job you may want to take a few days off. Remember to ask for a medical certificate during your consultation, and for your support person, if required.

To reduce the risk of infection, we recommend you do not insert anything in your vagina for one week; this includes tampons, fingers or having vaginal intercourse.
You may experience any of the following post-procedure, or you may experience none:

Bleeding: This differs for each person and may last up to 2 weeks. It is not normally heavy but may be accompanied by some small blood clots. Commonly, bleeding may increase for a few days, 4 to 5 days after the procedure. Some women may have no bleeding following their procedure. This can be quite normal too. If you experience excessive bleeding, such as soaking through a maxi-pad every half hour for 2 hours, passing large clots or bleeding heavier than a period for more than a few days, or if you are at all concerned, please contact us on 1300 888 022 at any time.

Abdominal pain/cramps: If you experience abdominal pain or cramps these can be eased with uterine massage, a heat pack and/or over-the-counter pain relief, such as ibuprofen or paracetamol. Pain and cramping should not be severe and should settle in a few days. If pain is severe or persistent, changes in nature or you are at all concerned, please contact us on 1300 888 022 at any time.

Nausea: If you suffered from nausea (feeling sick) before your procedure, you will probably find that it improves within 24 hours after the procedure. However, if nausea persists more than one week, please contact us on 1300 888 022.

Breast discomfort: Breast fullness or tenderness can last for 1 to 2 weeks after your procedure. For some women, particularly those more than 12 weeks gestation, your breasts may become fuller or leak a little fluid for a few days. For relief, try wearing a support bra or taking a mild over-the-counter pain relief but do not squeeze or massage your breasts. If your breasts are still sore after 2 weeks, please contact us on 1300 888 022.

Emotional effects: How you feel after an abortion will depend on your reasons for having one and how comfortable you were about your decision. The majority of women feel relieved and that they made the right decision for them at the time. However, after the abortion, some women want to talk about their experiences and feelings. If you would like to speak to an experienced counsellor about your experience and how you are feeling, please contact us on 1300 003 707 to make a booking for this free service.

Other possible effects: If you experience any other effects such as fever, lethargy, feeling generally unwell, smelly vaginal discharge or are concerned about anything else, please contact us on 1300 888 022 at any time.

Menstruation: The first menstrual period is expected 4 to 6 weeks after your procedure; however, some contraceptive methods may affect this. If your period has not come in this time, please contact us on 1300 888 022.

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Surgical risks

Surgical termination of pregnancy is an extremely safe procedure; however, all surgical procedures have some risks. The risks mentioned below do not include all possible complications, but are the more common or major complications.

Retained pregnancy tissue or clot: Although all care is taken, in approximately 1 in 100 procedures a small amount of tissue may be left in the uterus or blood may collect and form a clot. This can cause excessive bleeding and/or pain and may require treatment or a repeat procedure. This can be provided at one of our clinics at no additional cost.

Continuing pregnancy: In around 1 in 500 procedures the pregnancy remains in place and may continue to develop. This is more likely in procedures performed very early in pregnancy. If this occurs, a repeat procedure can be provided at one of our clinics at no additional cost.

Infection: This is uncommon (less than 1%) and serious infection is rare. You will be given antibiotics at the time of your procedure to reduce the risk of infection.

Perforation of the uterus: In about 1 in 1,000 procedures the instruments used may make a small hole in the wall of the uterus. This usually heals by itself, but if we are concerned about possible injury to internal organs like the bowel, or to blood vessels, we will transfer you to a hospital for further assessment. In some cases, surgery may be necessary and very rarely a hysterectomy may be required.

Haemorrhage: Excessive bleeding severe enough to require a blood transfusion occurs in around 1 in 5,000 cases (up to 12 weeks).

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Anaesthetic risks

The type of anaesthetic used for your procedure is very safe. Please advise the anaesthetic doctor if you have experienced any problems with previous anaesthetics. Anaesthetic risks include:

Allergic reaction: This is rare (1 in 10,000). Please tell the doctor of any previous allergic reactions.

Airway spasm: Tell the doctor if you smoke, have asthma or have recently had a cold or chest infection.

Aspiration: It is very important that you follow the fasting instructions given. This will prevent contents of your stomach being inhaled into your lungs when you are under the anaesthetic.

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What does it mean if I am Rhesus Negative?

During your consultation we will test for your blood group, if it is unknown. If your blood group is a Rhesus Negative type, you will get an injection of Anti-D to prevent Rhesus sensitisation and protect future pregnancies. We will give you more information about this if you are Rhesus Negative.

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Contraception following your procedure

Having a termination of pregnancy does not affect your future fertility. In fact, an egg can be released within 2 weeks of your procedure so it is possible for you to fall pregnant again before your next period.

For this reason, we strongly advise that you start contraception as soon as possible. During your consultation, the nurse and doctor will provide you with further information to help you decide which option suits you best. Please take the time to look at our Contraception brochure, ask us for fact sheets on any of the contraceptive methods or visit out online contraception adviser at mybestfit.mariestopes.org.au.

The more effective long acting reversible contraceptive methods, such as intrauterine devices (IUD/IUS), contraceptive implants and injections can be easily inserted at the time of your procedure so you won’t need to worry about making a further appointment.

Other hormonal methods such as the contraceptive pill or vaginal ring can be started the day after your procedure and will be effective immediately but remember, you should not have vaginal intercourse for one week after your procedure.

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Do you know your Healthcare Rights?

The Australian Charter of Healthcare Rights describes the rights of patients and other people using the Australian Healthcare system. Marie Stopes Australia advocates these rights which are:

  • Access – you have a right to healthcare
  • Safety – you have a right to safe and high quality care
  • Respect – you have a right to be shown respect dignity and consideration
  • Communication – you have a right to be informed about services, treatment options and costs in a clear and open way.
  • Participation – you have a right to be included in decisions and choices about your care
  • Privacy – you have a right to privacy and confidentiality of your personal information
  • Comment – you have right to comment on your care and have your concerns addressed.

At your appointment you should also receive a copy of the Australian Charter of Healthcare Rights brochure which you can also view in English and other languages at safetyandquality.gov.au.

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24 hour aftercare

If you experience any of the following problems or have any concerns, please call our aftercare nurses directly on 1300 888 022 at any time:

  • soaking a maxi pad every half hour for 2 hours;
  • excessive or prolonged bleeding;
  • severe or persistent cramps or pain;
  • fever, lethargy or feeling generally unwell;
  • persistent pregnancy symptoms.

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