What You Need to Know About Surgical Abortion

What Is a Surgical Abortion?

Surgical abortion is a medical procedure that is both safe and effective for terminating a pregnancy. Unlike medical abortion, which involves taking medication to end a pregnancy, surgical abortion involves a physical intervention, where the pregnancy tissue is removed vaginally using either gentle suction or specialised instruments. It is a short day procedure performed in a clinic or hospital setting.

Typically, surgical abortion is considered when medical abortion is not suitable or causes an adverse reaction (contraindication) to the patient, such as allergies or medical conditions. The abortion process is typically straightforward, with steps taken to ensure the safety and comfort of the individual undergoing the procedure.

What Are the Types of Surgical Abortion?

There are two approaches to performing surgical abortions in Singapore. The decision regarding which type of procedure to undergo depends on several factors, including gestational age, medical history, and personal preferences.

The two primary types of surgical abortion include:

Vacuum Aspiration

Vacuum aspiration, also called suction aspiration, is typically performed during the first trimester (up to 12 weeks). This procedure involves the use of gentle suction to remove pregnancy tissue from the uterus.

Dilation and Evacuation (D&E)

Typically performed in the second trimester (14-24 weeks), this method involves dilating the cervix and removing the pregnancy tissue via surgical instruments and suction. D&E is a more complex procedure than vacuum aspiration, requiring considerable skill and precision.

What to Expect Before the Procedure

Before the surgical abortion, patients must first attend an initial consultation with a doctor to discuss the surgical abortion procedure, address their concerns or questions, and review their medical history.

The doctor will also recommend the following preoperative instructions to ensure readiness on the day of the procedure:

• Physical Examination: A thorough physical examination will be conducted to identify any underlying health issues. Doctors may also order an ultrasound to accurately determine gestational age.
• Mandatory Pre-abortion Counselling: All registered abortion clinics in Singapore offer counselling services to provide emotional support for individuals seeking an abortion. For women under the age of 16, counselling will be conducted at the Health Promotion Board Counselling Centre, where a parent or guardian must accompany them for consent.
• 48-Hour Cooling-Off Period: After counselling, a mandatory 48-hour waiting period will be implemented before the procedure can be performed to help patients decide whether to have an abortion or not.
• Fasting: Patients are also advised to refrain from eating or drinking for a few hours before the procedure, particularly if anaesthesia will be used.

How Is the Procedure Performed?

Although the specifics of the surgical abortion may differ, the following is a general overview of what to expect:

• Anaesthesia: Before the procedure, general anaesthesia is administered to manage the pain throughout.
• Cervical Dilation: A device called dilators (rods) is used to expand the cervix and provide access to the uterus.
• Pregnancy Tissue Removal: Depending on the procedure type, the doctor utilises gentle suction or specialised instruments to remove the contents of the uterus.
• Completion: The procedure itself is relatively quick, often taking 15-30 minutes to complete. After the procedure, the patient will be moved to a recovery room for a short period to monitor for any immediate complications.

What to Expect After the Procedure

Surgical abortion is a day surgery procedure, which means patients can be discharged home the same day as the procedure. It is common to experience mild cramping, spotting, and bleeding that resemble a menstrual period afterwards. The healthcare team will provide detailed instructions for managing these side effects at home, such as over-the-counter pain medications and adequate rest.

Recovery time following a surgical abortion may vary in every case, but many women are able to resume daily activities within a few days. Remember to follow the doctor's advice and avoid strenuous activities until healing is complete.

What Are the Possible Risks and Complications?

Surgical abortion carries some risks, but the chances are very low when performed by a qualified abortion doctor in an accredited healthcare facility.

Seek immediate medical help if you are experiencing any of the following complications:

• Infection: This can occur if bacteria enter the uterine cavity during the procedure. Preventive antibiotics are often prescribed to mitigate this risk.
• Excessive Bleeding: The occurrence of heavy and prolonged bleeding (haemorrhage) may indicate retained pregnancy tissue, which requires medical attention.
• Incomplete Abortion: Sometimes, pregnancy tissue may not be completely expelled, which requires a follow-up procedure.
• Uterine Damage: Though uncommon, surgical instruments may cause injury to the uterine wall or surrounding organs (perforation), particularly during more complex procedures like D&E.
• Uterine Scarring: Scar tissue can form in the uterus following multiple abortions, leading to painful periods and future fertility problems.

When contemplating an abortion, it is important to have all the necessary information and reliable resources at your disposal to make a well-informed decision. To ensure safety, seek abortion care from an experienced abortion doctor at an MOH-accredited facility. Remember, you are not alone, and support is always available to guide you through this journey.

Learn more about our safe abortion options, including surgical and medical abortions, by consulting Dr Jen today. Click on the booking form here, or send us a message via WhatsApp.