Surgical Abortion

It is estimated that around a quarter of all pregnancies in Australia are unplanned. For many people abortion, also known as termination of pregnancy, is the best option in their circumstances. Abortion is a safe and common method to end a pregnancy.

There are two types of abortion: surgical and medical. Both are low-risk and have a high success rate.

Preparing for a surgical abortion

Before booking an abortion, some services will offer a clinic appointment or phone call with a nurse to discuss both medical and surgical abortion so you can decide what is the best option for you.

If you choose a surgical abortion, some services require you to attend an appointment with a doctor or nurse a few days before the procedure. Other services will offer you only one appointment for the abortion procedure.

There are some medical conditions and social circumstances that restrict the type of abortion you can have. At your first appointment the doctor or nurse usually takes a medical, social and sexual health history. You will have the opportunity to ask questions and be given any information you may need. What you discuss will be kept confidential.

Before an abortion, the doctor or nurse will confirm the pregnancy with a urine test and organise blood tests and an ultrasound to check the stage (length) of pregnancy. It may also be recommended you test for sexually transmitted infections (STIs).

You may also want to discuss contraception options with your doctor or nurse. Some contraception such as an intrauterine device (IUD) or contraceptive implant (Implanon NXT) can be inserted during a surgical abortion while you are under light sedation.

Once you have all the information you need and have consented (agreed) to a surgical abortion, you can go ahead with the procedure.

Do I have to have counselling first?

No, you do not. It is an option.

Most people do not need counselling or support from a professional to make a decision about abortion.

It is usually helpful to find someone supportive to talk to. Choose someone you trust. This may be your partner, a friend, a family member or a health professional.

For more information see Abortion and Emotional Support

Surgical abortion procedure

Surgical abortion is most commonly performed during the first trimester of pregnancy (up to 12 weeks). It may also be performed in the second trimester (12 to 24 weeks) or in rare circumstances, the third trimester (24 to 36 weeks).

First trimester surgical abortion is carried out in a medical clinic by a doctor. The procedure is usually performed under light (twilight) sedation. When you are comfortably sedated, your doctor will insert a small tube into the uterus (womb), via the vagina and apply gentle suction (known as vacuum/suction aspiration or suction curette) to remove the lining and contents of the uterus. The procedure itself takes less than 15 minutes, however with preparation and recovery, you will be in the clinic for around 4 – 5 hours. Abortions later in pregnancy might involve extra steps depending on how the length of the pregnancy.

If you have chosen to have an intrauterine device (IUD) or contraceptive implant (Implanon NXT) inserted, this will be done while you are under sedation.

What to expect after a surgical abortion

After a surgical abortion you will spend time in the medical clinic to recover. It is normal to feel tired or drowsy for several hours after light (twilight) sedation. A nurse will be there to ensure you are comfortable.

When you feel ready and you have been assessed by the nurse, someone will need to drive you home. This person should be organised by you before you attend the clinic.

In the few days after a surgical abortion, it is usual to experience light vaginal bleeding, abdominal cramps and breast tenderness.

Complications of a surgical abortion

Complications are uncommon after a surgical abortion, but may include:

• Reactions to the anaesthetic.
• Damage to the uterus or cervix caused by surgical instruments. This is very uncommon.
• Small pieces of tissue left in the uterus (womb) requiring a minor surgical follow-up procedure to clear the lining of the uterus (around 1 in 1000 cases). This procedure is done under general anaesthetic.
• The surgical abortion does not work and the pregnancy continues (around 1 in 1000 cases). If this happens another surgical abortion may be required.
• Haemorrhage – very heavy bleeding. In rare cases a blood transfusion is needed.
• Infection requiring antibiotic treatment (symptoms include persistent pain, an unusual vaginal discharge, fever and feeling generally unwell).

Contact your abortion provider, doctor or nurse if you experience:

• heavy bleeding or bleeding that is not settling
• pelvic pain that is not settling
• an unusual or smelly vaginal discharge
• unexplained fever
• feeling generally unwell.

Recommendations after a surgical abortion

After a surgical abortion it is recommended you:

• use pain medication such as ibuprofen or paracetamol to help manage any cramps (your doctor or nurse can prescribe stronger medication if needed)
• massage your abdomen and use heat packs
• rest and take time off work or study.

To lessen the risk of infection during the week after having the procedure, you should not:

• insert anything into the vagina (including tampons and menstrual cups – which should not be used until your next period)
• have vaginal sex
• perform any strenuous activity, including sport or heavy physical work, until the bleeding stops
• go swimming or have a bath (you can shower).

Follow-up after a surgical abortion

No follow up is needed after a surgical abortion if you are feeling well.

Surgical abortion may not be suitable if you:

• have had an allergic reaction to an anaesthetic
• have a uterus (womb) that is not the usual shape
• are very overweight
• cannot access a surgical abortion clinic
• do not have a support person who can drive you home after your appointment.

Where can I access surgical abortion?

Abortion service providers are located across Victoria in a range of health services and private practices. The costs, procedures and time required can vary from service to service. Having an abortion earlier in a pregnancy can minimise procedure costs and maximise your options.

To find surgical or medical abortion services in Victoria contact 1800 My Options phone line - 1800 696 784.

Where to get more information and support

• Sexual Health Victoria
• 1800 My Options phone line - 1800 696 784
• A doctor or nurse
• Your local community health service
• A public hospital (some provide a limited number of free abortions)
• A private abortion provider
• A psychologist or counsellor
• Your youth worker, social worker, support worker
• An obstetrician or gynaecologist
• Better Health Channel
• Equinox – for transgender services
• Jean Hailes
• Marie Stopes Australia
• Multicultural Centre for Women’s Health
• The Women’s (The Royal Women’s Hospital)

If you are using the internet for information, only use reliable and reputable websites, such as the ones provided above. Be aware of anti-abortion or pro-life websites containing inaccurate and harmful information and imagery.