Abortion means the expulsion of the foetus from the uterus (womb) before it is capable of independent life. This is about the 24th week of pregnancy. An abortion which occurs spontaneously is often called a miscarriage, and an artificial abortion is called either a termination of pregnancy or a therapeutic abortion.
Miscarriages are extremely common, perhaps occurring in as many as one in three pregnancies in the first four weeks of gestation. These miscarriages sometimes pass unnoticed, mistaken for a heavy menstrual period. Common symptoms are loss of blood from the vagina and regular cramping pains in the lower abdomen.
Therapeutic abortions are generally performed in public hospitals or private clinics which specialise in such operations. The safest time for a therapeutic abortion is between six and twelve weeks after the menstrual period. At this stage of pregnancy, it is more likely that the abortion will be completed within a few hours, and that it will not require major medical procedures.
Whether or not to have a pregnancy terminated is a difficult decision. Counselling and medical advice should be sought as early as possible. Counsellors are available at many clinics, Family Planning Associations and women’s health centres. They can provide the woman with the chance to talk out her feelings, examine the options open to her, and come to decision about her pregnancy. In addition, counsellors can provide information about what procedures are appropriate for the abortion, choice of clinics, choice of local or general anaesthetic, the cost of the procedure, length of clinic stay, recovery time, legality of the abortion, safety of the support available and what to expect on the day of the abortion.
Abortions are carried out either by vacuum aspiration or dilation and curettage (D&C) . The commonest, safest and simplest method of abortion is vacuum aspiration. The neck of the uterus is widened and a narrow tube passed into it to gently suck out the contents.
Dilation and curettage involves gently scraping the contents of the uterus with a narrow spoonlike instrument.
In pregnancies of more than fourteen weeks, the most usual method is prostaglandin induction. Prostaglandin, a natural hormone, is infused through the vagina, and labour starts soon afterwards. The procedure necessitates a hospital stay of 2-3 days. An injection of saline solution through the abdominal wall into the uterus is also sometimes used to precipitate an abortion.
If performed by skilled and sympathetic staff, it is rare that there should be any complications after the abortion. Support and counselling are available to help women adjust after the abortion, from most clinics and hospitals. It is advisable to start adequate contraception immediately after the termination.
The legal position regarding therapeutic abortions varies from state to state in Australia.
For more information on this, or other aspects of abortion, contact the Family Planning Association, a women’s health centre, abortion information service, or a social worker attached to a public hospital.
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