Pregnancy Termination Procedures

Current figures indicate that in Australia, one in every three women will have an abortion at some time in their lives. This procedure is possibly the most commonly performed procedure and is one of the safest, however all procedures carry risks, even if they are rare. Most women find that their recovery following a surgical abortion is quick and uneventful with most women returning to work or school the following day.

First trimester abortion (5 – 12 weeks)

The medical name of the procedure during the first trimester is called “suction curettage”. This is a simple and safe procedure in which a thin plastic tube is inserted through your cervix and into your uterus. The pregnancy is then removed by applying a gentle suction. This suction removes the embryonic sac and the soft, thickened lining of the uterus which surrounds the sac. The procedure only takes about 10 minutes.

At the Private Clinic, we routinely perform an ultrasound scan to verify the presence and location of the embryonic sac before the operation, and also to verify that all tissue has been removed at the completion of the operation. This post-procedure scan is performed while you are asleep.

This protocol offers our patients several benefits;

You have a high degree of certainty that the termination procedure was completed successfully.
It allows us to maintain a very low complication rate by virtually eliminating complications caused by retained tissue.
It allows us to perform “early” terminations from approximately one to two weeks after a missed period.
We are able to identify women who are at risk of having an ectopic pregnancy and we will arrange for follow-up treatment. This is a potentially life threatening condition where your pregnancy has lodged within a fallopian tube and it will rupture if it is not detected and treated early.
There is no additional fee for this ultrasound.

Is it possible to be too early to have an abortion?

Regardless of whether you are having a surgical abortion or a medical abortion (with pills), it is necessary to confirm with an ultrasound scan that there is a pregnancy sac located within your uterus before a termination can be commenced.

The reason for this is that as many as 1 – 2% of women will have a pregnancy which develops in one of the fallopian tubes. This is known as an ectopic pregnancy and it is a very serious complication if it is not diagnosed and treated early. An ectopic pregnancy will eventually become too large and will rupture the tube, causing pain and internal bleeding. Hospital treatment must be provided immediately in these cases.

Neither a medical nor a surgical abortion should be performed until the doctor has ruled out the possibility of an ectopic pregnancy. This is done by performing an ultrasound scan at the clinic which can detect pregnancies within your uterus from 5 to 6 weeks after your last period.

A medical abortion is particularly dangerous when performed without verifying that an intra-uterine pregnancy exists because the bleeding and cramping which occur as a part of the medical abortion process would mask the symptoms of an ectopic pregnancy, leading to a delay in seeking emergency treatment.

When can I schedule an appointment?

In order to reduce any uncertainty, it is advisable to aim to schedule your appointment for approximately 6 weeks after the first day of your last period. If you have a 28 day menstrual cycle and your period is two weeks late, this would make you approximately 6 weeks pregnant.

If you are unsure of the date of your last period, your GP might choose to perform a blood test. If your pregnancy hormone (BHCG) levels are above 1700, you would normally be OK to attend the clinic for a termination, either surgical or medical.

You should also be aware that most urine pregnancy tests are not particularly suitable for dating pregnancies, however if your test shows a very faint second line, this is a clue that you might be too early to have a termination.

Second trimester abortion (13 weeks or more)

The Private Clinic only offers a limited number of surgical abortion appointments from 13 to 15 weeks. As these appointments are in high demand, we have additional requirments prior to booking an appointment. If you suspect that you might be around 13 weeks or more, you must;

See your GP urgently to arrange a referral for a ultrasound scan to establish the exact gestational age and to identify any potential risk factors that the clinic would need to be aware of.
If you already had an ultrasound scan done during the first trimester, you may need to arrange for a more recent scan to be arranged. Call the clinic to discuss if this is required.
We suggest that you call several clinics to determine booking requirements, cost, and availability. You will not be able to book an appointment with any clinic ultil you have a recent ultrasound report, but this step will provide you with some guidance as to where and when you may be able to make an appointment.

You should be aware that despite abortion being legal up to 22 weeks, there are very few doctors who perform pregnancy terminations over 13 weeks so appointments are becoming increasingly difficult to obtain. Please act early to give yourself the best chance that a termination of pregnancy is possible.

If you find yourself unable to secure an appointment for a second trimester abortion at a private facility, your GP should provide you with a written referral to a specialist obstetrician and gynecologist. There are a small number of specialist O&G’s who can perform late term abortions in the private hospital system.

Anaesthesia for abortion

Many women are anxious about experiencing pain during their procedure. This is a common fear which we fully appreciate and we undertake to ensure that your visit is as stress free and pain free as possible. Prior to the start of the procedure, the anaesthetist will give you an intravenous anaesthetic. We use a combination of anaesthetic medications which provide a combination of analgesia (strong pain relief), sedation and also an amnesic effect so that little or no memory of the procedure remains afterwards. This type of anaesthesia is fast acting, is very effective, allows you to sleep through this short 5 – 10 minute procedure and is considerably safer than general anaesthesia. Your recovery time will be more rapid. Approximately one hour.

Some people have an extreme fear of injections. If you are worried about this aspect of the procedure, please advise the doctor during your counselling discussion as we have options available to relieve your anxiety.

A few patients may experience some mild cramping, similar to period pain, after the Procedure. This will settle within about one hour and if necessary, you will be given some pain relief medication.