Surgical abortion

When a woman learns that she is pregnant, it can cause different emotions to surface: happiness, sadness, anger, even depression. For some women, the news is an emotional shock.

For most women, two options present themselves: continue or terminate the pregnancy.

Opting for an abortion is a very difficult decision to make. Some women will feel confused and ambivalent. It is important that you take the time to think this through clearly before making a final decision. You should explore all possible avenues, and even find someone – partner, friend, confidant, adviser – with whom to talk.

If you opt to terminate the pregnancy, our medical team will offer you a surgical abortion in the best possible conditions.

We will not judge the reasons on which you have based your decision. You will be treated with the utmost respect, in a warm environment, with gentleness and understanding. The entire process is strictly confidential.

Before making an appointment for a pregnancy termination, you need to take a pregnancy test, either at home, at a pharmacy or a clinic. When the pregnancy is confirmed, and you know you want to terminate it, we will be able to give you an appointment quickly.

When you call, we will ask for your name, a telephone number, the date of the first day of your last menstrual period, and your weight. We will also ask you whether you have allergies and health problems.

Pregnancy termination is offered by appointment and is accomplished in one session. You can come by yourself, but it is preferable that you be accompanied when you leave to go home.

Expect to spend two hours at the clinic. First, an adviser will spend 15 to 20 minutes to explain the procedure, the instructions to follow after the abortion, and the various contraceptive methods available. The surgery itself will take from 10 to 15 minutes. Then, expect to spend from 20 to 45 minutes in the rest area.

If you want, you can have someone accompany you during the procedure. But, to ensure objectivity, the meeting with the adviser will be done alone.

At the clinic, it is possible to get an abortion between the 5th and 12th weeks of pregnancy. If you think your pregnancy is more advanced, we can suggest an appropriate place where you can get the services you need.

To determine the number of weeks of pregnancy, start counting the weeks from the first day of your last menstrual period.

In Quebec, you can get an abortion until the 22^nd week of pregnancy.

You will feel something, but there will not be much pain since the procedure will be carried out under local anaesthetic and you will be offered pain-control medication, which will greatly contribute to your overall comfort.

If you have a health insurance card, present it at the reception. Mention that you have an appointment, and we will open a medical file for you.

You cannot eat or drink for 4 hours before your appointment. We will do a pregnancy test even though you have already had one.

You will be asked to fill out a medical history form.

The adviser will then come get you for the consultation. For the whole length of the procedure, which is set in a warm and safe environment, you will be surrounded by a surgeon, two nurses and an orderly. Each one is there to support and listen to you with the utmost respect.

As was mentioned above, the meeting with the adviser aims at supporting you in your choice, not judge the reasons that motivate your decision. The meeting is not a psychological evaluation.

It is meant to inform you on the sequence of events involved in the procedure. Each step will be explained to you. You will also be able to discuss the various contraceptive methods available to you.

To ensure you are comfortable to ask any question you might have and feel free to talk about your worries and fears, you will be alone with the adviser during the meeting. If you want to be accompanied for the procedure, please mention this to the adviser during the meeting.

There are two types of abortion methods: medical and surgical.

A nurse will bring you to the operating room where the surgeon will be waiting. She will accompany you during the length of the procedure, which should last from 10 to 15 minutes.

You will be asked whether you want your companion to be present during the procedure.

The surgeon then proceeds with the gynaecological examination, followed by an ultrasound. This is done to determine the pregnancy’s age. The examination consists in applying a probe covered in a jelly-like substance on your lower abdomen or in the vagina.

The surgeon will then screen you for chlamydia and gonorrhoea; a cotton swab is swiped inside the vagina.

The nurse will install an oximeter on one of your fingers. This device measures your pulse and your blood’s oxygen level.

The area around your cervix will be anaesthetized. This will ensure you experience maximum comfort during the surgery since the anaesthesia will help reduce pain.

You will not be asleep. This is not general anaesthesia.

The cervix will be anaesthetized with Xylocaine (the same medication used by dentists).

We will propose an intravenous painkiller (Fentanyl). The administered quantity is adapted to each patient.

To help you relax, a medical relaxant will be made available to you (Versed). If you prefer not being administered intravenous medication, laughing gas can be used. This is a mix of nitrous oxide and oxygen. The gas is absolutely harmless and its effect is short-lived. It will give you a relaxed sensation and you will feel some drowsiness, but you will not fall asleep.

The nurse will then take a blood sample to determine your blood type’s Rhesus factor (Rh). If your Rh is negative, we will administer an Rh factor antibody solution (WinRho vaccine).

Surgical abortion involves dilation, aspiration and curettage, which is accomplished with sterilized surgical instruments. This type of surgical intervention involves no incisions.

The procedure starts with a gradual dilation of the cervix with a dilator (a small metallic rod). A cannula is then inserted and used firstly for aspiration, secondly for curettage, a step in which the walls of the uterus are cleaned.

The technique is a common one and is very safe.

As soon as the procedure has been completed, the surgeon and nurse will bring you to the rest area.

You will be given the opportunity to rest comfortably in a bed for 30 to 40 minutes.

Cookies and water will be offered; this will help you recover faster.

You will feel much better after a light meal.

The nurse will check that bleeding is light. In some cases, there is no bleeding.

We will give you the necessary information on the advice to follow after the abortion. You will be given a prescription and necessary medications, if needed.

After you have rested well, we will make sure you are in good enough shape to return home.

Take note that it is forbidden to drive a car after having been administered intravenous medication (Fentanyl/Versed) for a period of 24 hours.

Following the pregnancy termination, you should take the remainder of the day to rest. If needed, the surgeon can give you a medical note for your work or school.

Some women go back to work on the same day, but it is important that you give yourself time to recover. Playing rough sports in the following week is not recommended.

Sexual activity can resume after a period of 7 full days. Avoid any penetration during the first week after the abortion.

It is possible to become pregnant from 7 to 10 days after the abortion, even if you are still bleeding. It is strongly suggested that you use a contraceptive method during sexual relations.

It is not uncommon that it take several weeks for you to feel comfortable during intercourse. Take the time you need.

Bleeding varies from one woman to another. You may experience no bleeding at all or you may start bleeding immediately after the abortion, sometimes lasting from 3 to 4 weeks.

In other cases, bleeding will be intermittent.

You may have blood clots and/or abdominal cramps in the 4 to 6 days following the pregnancy termination.

In all these cases, bleeding is normal. Abnormal bleeding is noted if you fill more than one sanitary napkin per hour for three consecutive hours. Most women will get their next menstrual period 4 to 8 weeks after the surgery. We cannot accurately predict when it will occur.

For your first post-abortion menstrual period, you may experience brownish blood loss, which is sometimes accompanied by abdominal cramps.

For 2 to 3 weeks following the pregnancy interruption, you may experience uterine cramps that may be a little more intense than menstrual cramps. These cramps may be more intense on the fourth, fifth or sixth day following the abortion.

To relieve the pain in the 24 hours following the surgery, take two 200mg tablets of ibuprofen (Advil/Motrin) with food every 4 hours.

or

take two 325mg tablets of Tylenol every 4 hours

or

take one 500mg table of Tylenol every 6 hours.

or

alternate between Advil and Tylenol every 2 to 3 hours.

You can also apply heat to the abdomen, take a bath, or lie down with knees folded up to help reduce the pain

In order to reduce the risk of infection, avoid vaginal douches, vaginal creams, tampons, and any form of penetration for a period of 7 days.

In the days following the abortion, you could experience short bouts of fever, tender breasts or milk flow from the breasts.

Most symptoms disappear in the first week following the procedure.

Risk of hemmorrhage or complications following the abortion are extremely rare.

If you suffer from fever, if you experience excessive bleeding, and if you suffer from intense pain for more than 24 hours, even though you have been taking painkillers (ibuprofen, acetaminophen), please contact us:

During the day, call 514-281-6476

Evening/night and weekend: An emergency number will be given to you during your meeting with the adviser just before the pregnancy termination.

If everything goes well, a follow-up examination is not necessary. However, if you are worried about something, it is possible to make an appointment with the clinic.

We recommend that you take a pregnancy test 4 weeks after the abortion. If you get a positive result, please call the clinic: 514-281-6476.

During your pregnancy termination appointment, you can discuss available contraceptive methods with a nurse.

If you so desire, a physician can prescribe oral contraceptives, contraceptive patches, Depo-Provera, a contraceptive ring (Nuva Ring), or an IUD.

There is absolutely no link between infertility and abortion. The pregnancy termination procedure is done by a surgeon in a safe and sterile environment, which reduces any risk of complications to a minimum.

The pregnancy termination method we practice (dilation, aspiration, curettage) does not affect women’s fertility.

If you feel the need to discuss your situation with a health professional, you can set up a consultation with a physician.
Contact us: 514-281-9848

If you want to get help from a psychologist, contact the Ordre des psychologues du Québec.
514-738-1223 

1-800-561-1223

Grossesse-secours is an organisation that can help you in evaluating your options and making a decision:
514-271-0554