Legal Abortion – Termination of Pregnancy at the Woman’s Request Before the 12th Week of Pregnancy

Necessary examinations and referrals for an abortion (Cabinet Regulation No. 590):

• the patient must have been referred by a gynaecologist;
• vaginal microflora smear;
• RPR
• blood group and rhesus (Rh) factor (Rh-negative patients should receive anti-Rh(D) immunoglobulin after abortion;
• We recommend that patients undergo chlamydia and gonorrhoea testing before abortion.
• In the case of surgical abortion, the patient should arrive at the clinic on an empty stomach – no food for at least six hours and no fluids for at least four hours before surgery.

What are the possible types of abortion?

Depending on the patient’s wishes, the surgical or medical termination of pregnancy is possible.

Medical Abortion

Medical abortion can be performed in the first 49 days of pregnancy. The effectiveness of this method is 95–98% by the aforementioned time of pregnancy. A medical abortion is carried out using medication prescribed for the procedure. At the first visit to the clinic, the patient takes the initial tablet after receiving detailed counselling and reviewing the principles of the chosen method. During the visit, the patient is given four more tablets to take 48–72 hours after taking the first tablet. Depending on the patient’s preference, the four tablets may be taken either at home or in the clinic, with pain relief provided if necessary. Pain relief can also be taken at home. Two weeks after a medical abortion, a follow-up ultrasound is required. In the event of an incomplete or failed medical abortion, a second dose of four tablets may be administered, or surgical abortion may be required. Surgical intervention may also be necessary in the case of heavy bleeding.

The main contraindications to medical abortion are:

• suspected ectopic pregnancy;
• the patient has a low haemoglobin level;
• the patient has a medical condition that may lead to increased bleeding;
• a known allergy to any of the medicines used.

The main risks of medical abortion are:

• heavy bleeding from the genital tract;
• severe pain with bleeding.

Surgical Abortion

Surgical abortion is performed under short-term intravenous anaesthesia. The surgery takes place in a day hospital, and the patient can go home a few hours after the procedure. In our clinic, we perform surgical abortions under ultrasound control to make sure that the tissue has been completely evacuated. After surgery, the patient receives a prophylactic dose of antibiotics.

The main risks of surgical abortion and possible complications:

• heavy bleeding from the genital tract;
• perforation of the uterine wall, trauma;
• development of uterine adhesions;
• inflammation of the uterus.

Postoperative Period

After the abortion, the patient can resume her daily activities and sports after 24–48 hours. Abstain from intercourse, swimming, taking a bath and using a sauna, as well as using tampons for 2 weeks. Further recommendations are made before the patient is discharged home.