The female reproductive system and surgical abortion
Surgical Abortion-The female reproductiveis made up of the:
- vagina – a muscular canal that leads to the entrance (neck) of the uterus, known as the cervix
- uterus (womb)
- fallopian tubes – tubes that extend from the uterus, one on each side. They both open near an ovary, and carry the eggs (ova) from the ovaries to the uterus
- ovaries – two small glands that contain your eggs (ova).
When you become pregnant, a fertilised egg lodges in the lining of the uterus (the endometrium).
A surgical abortion involves the removal of the pregnancy (sometimes known as the ‘contents of the uterus’) via the vagina by surgical means. To have a surgical abortion, the cervix must be opened wide enough to allow the surgical instruments into the uterus.
Preparing for a surgical abortion
Always check with your clinic, but general instructions before undergoing an abortion include:
- Don’t smoke, eat or drink (not even water) for about six hours before the operation.
- Expect to be at the clinic for at least two hours.
- Bring sanitary pads, your referral letter, your blood group card, your Medicare card and any health care card you have.
- Arrange for someone to drive you home.
Anaesthetic for a surgical abortion
The clinic you go to for an abortion will tell you about what type of anaesthetic it can offer you, and how you should prepare for it.
Anaesthetic choices may include:
- general anaesthetic – this makes you completely unconscious. Any operation involving a general anaesthetic carries risk. There is a danger of choking if fasting isn’t properly undertaken beforehand
- nitrous oxide gas – or a similar gas. This puts you in a state of ‘twilight sleep’. You are awake, but sedated and calm
- local anaesthetic – anaesthetic is injected into your cervix to make the area numb, so that you don’t feel anything during the operation (this is known as a paracervical block)
- local anaesthetic with intravenous sedation – a combination of intravenous sedation (sedative medication is put into your vein using an intravenous line) and local anaesthetic injected directly into your cervix.
Method of surgical abortion
Most abortions are performed using ‘suction (vacuum) aspiration’. To have this procedure you need to be in your first trimester (first three months) of pregnancy. (This means you are 12 weeks pregnant or less.)
Your cervix opening is gradually widened with rods of increasing size and a slim tube is then inserted into your uterus. The pregnancy (the fetus and the placenta) is withdrawn with gentle suction. Another instrument called a curette is used to check the uterus is empty.
This operation takes less than 15 minutes.
Surgical abortion after 12 weeks gestation
For a termination of a pregnancy after 12 weeks gestation, for instance in the second trimester, the procedure is similar to that of a first trimester abortion, but your cervix is prepared differently. This can involve:
- Hormone-blocking tablets may be used to help soften your cervix. These tablets may be taken by mouth or inserted into your vagina. They take about two hours to take effect. The abortion is then performed using suction and instruments to remove the pregnancy.
- Your cervix opening may be widened a little, and then have a special device inserted. This device swells over several hours until the cervix is opened wide enough to allow the abortion to occur. Medications may also be used. The abortion is usually performed one or two days later.
After a surgical abortion
Be guided by your clinic as to how to care for yourself and reduce your risk of infection after a surgical abortion. Generally, the following suggestions apply (for two weeks after your procedure, or a few days after bleeding has stopped):
- Shower instead of taking a bath.
- Avoid sexual intercourse.
- Use sanitary pads instead of tampons.
- Avoid going swimming.
When to seek medical advice after a surgical abortion
See your clinic, GP or a hospital emergency department immediately if:
- your bleeding becomes heavy
- you develop a fever
- you experience severe cramping or abdominal (tummy) pain.
These symptoms could indicate an infection.