In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. Clinical Obstetrics and Gynaecology. Elsevier; chap Rivlin K, Westhoff C. Family planning. Comprehensive Gynecology. Editorial team. Abortion - surgical. Before the procedure, you may have the following tests: A urine test checks if you are pregnant. A blood test checks your blood type. Based on the test result, you may need a special shot to prevent problems if you get pregnant in the future.
An ultrasound test checks how many weeks pregnant you are. During the procedure: You will lie on an exam table. You may receive medicine sedative to help you relax and feel sleepy. Your feet will rest in supports called stirrups. These allow your legs to be positioned so that your doctor can view your vagina and cervix.
Your health care provider may numb your cervix so you feel little pain during the procedure. Small rods called dilators will be put in your cervix to gently stretch it open. Sometimes laminaria sticks of seaweed for medical use are placed in the cervix. This is done the day before the procedure to help the cervix dilate slowly.
If you are less than 12 weeks pregnant, the oral medications need 45 to 60 minutes to be most effective. You will be awake, but well relaxed. You may stay in your room or wait in the reception area. We have magazines and portable stereos; you may want to bring something to read or a CD to occupy your wait time, which will be 45 to 60 minutes.
If you are 12 to 14 weeks pregnant, the misoprostol needs two to three hours to work. We will page you when it is time for you to return to the clinic. When you return, we will give you oral medications, including Vicodin, Valium and ibuprofen, and ask you to wait an additional 30 to 60 minutes for those to fully relax you. Continue reading. Your support person can be right next to you for the whole procedure.
Use a speculum to view inside your vagina 2. Clean your vagina and cervix with gauze soaked in soap 3. Apply numbing medication to your cervix 4. Dilate your cervix, the tight opening to your uterus, with thin metal rods 5. Insert a narrow flexible tube into your uterus 6. Apply gentle suction to the other end of the tube to remove all of the pregnancy tissue. Toward the end of the procedure, you may feel a cramp that feels similar to a menstrual cramp in your uterus, as it is shrinking down to its usual size.
Most of the procedure time is spent preparing your body for the procedure. The suction portion only takes about a minute and the entire procedure takes around 15 to 20 minutes.
After the procedure, you should remain resting for a few minutes. You will probably have some cramping and spotting. We will provide you with a heat pack and a menstrual pad as well as juice and crackers. When you feel able, you may get dressed. Your health educator will then give you instructions on how to take care of your body.
For larger pregnancies tissue forceps may be used as well to lift out the pregnancy tissue. This will take a little longer. Most women feel pain similar to menstrual cramps. For others, abortion is more uncomfortable. Slow, even breathing again helps to ease the cramping. Taking the products of the pregnancy home is an option which can be discussed with your counsellor, doctor, or nurse.
This is the term often used for pregnancies over 14 weeks. The procedure is similar to the Vacuum Aspiration except that, as well as aspiration, removal of the tissue with forceps is usually routine. The cervix may require more dilatation. It can cause some cramping or bleeding, but makes the abortion procedure quicker and more comfortable. Medicines are generally registered in New Zealand for specific purposes, and misoprostol is not registered for use in abortion.
However, it has a long-established safety record when taken by mouth. Research has showed it is a sufficiently safe and effective medicine which can be used prior to a termination procedure.
This is used for medical abortion but is also registered for use prior to surgical abortions. It is more effective than misoprostol but takes longer and is much more expensive. With later pregnancies sometimes in a two-stage procedure the cervix is treated with laminaria which absorb fluid and swell over 12 to 24 hours to slowly dilate the cervix.
Other hydrophilic water absorbing material can also be used. Most early abortions in New Zealand are performed with local anaesthetic which is injected in and around the cervix neck of the womb.
For some patients this is not felt, but others feel it as a short-lasting unpleasant sensation, like local anaesthetic used by dentists. Many clinics use some form of pre-operative pain relief or sedation. This may be a mixture of tablets given in the hour before the operation or drugs given intravenously into a vein just before the procedure.
When drugs are used which alter consciousness by making the woman significantly drowsy this is called "conscious sedation". This is usually enough to make the patient feel more relaxed and experience minimal pain from the procedure.
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