What kind of abortion is safe
The operative (instrumental) termination of pregnancy
Surgical termination of pregnancy is usually carried out on an outpatient basis in a clinic or doctor's office. After the procedure and a short rest period, the woman can go home. The surgical termination can be performed under a brief general or local anesthetic.
Surgical termination of pregnancy (also colloquially known as “abortion”) is also referred to as instrumental or surgical termination. The standard procedure is vacuum aspiration, also called suction or suction curettage. A narrow tube is inserted through the vagina into the uterine cavity under general or local anesthesia. The embryo and the lining of the uterus are suctioned through this tube. Curettage, which used to be a common practice, in which the uterus is scraped off with a spoon-like instrument, is no longer recommended due to a higher rate of complications.
The operative termination usually takes place on an outpatient basis in clinics, day clinics or in appropriately equipped medical practices.
How does the surgical abortion work?
Surgical termination of pregnancy usually takes place in three steps:
- Advice and preliminary examination
Bring the counseling certificate with you to your appointment in the practice or clinic. The other required documents (e.g. blood group ID, health insurance card, etc.) are best requested when making an appointment. The doctor will use an ultrasound scan to check the position of the uterus and the age of the pregnancy. You may be given a tablet to take a few hours before the abortion to make the cervix softer and easier to stretch for the procedure. During the preliminary examination, you will also be informed about the advantages and disadvantages of general anesthesia and local anesthesia so that you can decide which method to use, provided that both are available.
If the procedure is performed under general anesthesia, as with any anesthetic, you must not eat, drink, chew gum or smoke a few hours beforehand.
- Surgery and anesthesia
With general anesthesia, you will receive the anesthetic through a needle placed in the arm vein. If you have decided on local anesthesia, you will receive a pain reliever and sedative in advance if you wish. Then the cervix and the cervix are anesthetized. Then the cervix is carefully expanded a few millimeters with metal rods so that a suction tube can be inserted through which the embryo and the uterine lining are sucked off. After the suction, the uterus contracts to its original size with labor-like contractions. The doctor will then check whether the mucous membrane and embryo have been completely removed. The actual procedure is over after about ten to 15 minutes.
Women with a rhesus-negative blood group are given anti-D immunoglobulins after the termination to prevent the formation of antibodies during a later pregnancy.
- After the procedure
After general anesthesia, you will be a little light-headed. You can rest in a relaxation room in the practice or clinic until your circulation has recovered. If you have the impression that an additional pain reliever is necessary, discuss with your doctor which one is suitable for you.
You are not roadworthy after the surgical termination and should not drive a car or bike. If you have had general anesthesia, it is necessary for someone to pick you up and escort you home.
Before you go home, you will be given information on what to look out for over the next few days, as well as a phone number to call in an emergency.
It is usually recommended that you see your gynecologist two to three weeks after the procedure.
What to watch out for after the procedure
After the termination, bleeding begins, which is usually less than normal menstruation. It can last up to two weeks. Until the bleeding stops, you should not go swimming, take full baths, use tampons, or avoid sexual intercourse.
In the days after the abortion, the body changes hormones, so that the breasts and abdomen may feel different again. Sometimes a mental depression is also noticeable.
It can be helpful to organize practical and emotional support from friends or family for the first few days. It is advisable to take a little rest after the procedure and, if necessary, to be unable to work. The reason for the incapacity for work is not stated on the certificate of incapacity for work for the employer.
Complications are rare
Surgical termination of pregnancy is a very safe procedure. Injuries to the uterus, tears in the cervix, incidents of anesthesia or high blood loss are very rare.
If you have a fever, heavy bleeding or persistent pelvic pain, you should contact your doctor immediately to rule out complications such as inflammation or remaining tissue in the uterus. These complications are also very rare; they occur in up to two percent of the procedures.
If the termination of pregnancy proceeds without complications, it usually has no effect on fertility or subsequent pregnancies.
Don't forget about contraception
With the cancellation, a new menstrual cycle begins. There is also the possibility of a new pregnancy. You can discuss with your doctor which contraception method is best for you in the information meeting before you cancel.
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