Methods of abortion
In the case of elective abortion before the end of the 12th week of pregnancy, two methods for terminating the pregnancy are used: Surgical and medical abortion. Medical abortion is currently the most common method of abortion: Over 90% of abortions are currently performed as a medical abortion.
You are free to choose between surgical and medical abortion, provided the method you choose is considered to be medically justifiable.
The abortion process is started by you taking a tablet at a gynaecological outpatient clinic. The active ingredient in the tablet prevents the womb from reacting to progesterone, a hormone which is released by the body and plays a major role in maintaining the early stages of pregnancy. This prevents any further development of the pregnancy. The abortion process will start as soon as you have taken the tablet. You should then complete the abortion.
After taking the tablet, you should go home. It is recommended that you try to live as normally as possible. You may become nauseous and experience some bleeding and abdominal pain over the next few days, but not everyone experiences these symptoms. Some people may abort even after taking this initial tablet. You should contact the hospital if this happens.
After two days, you must complete the abortion. You can return to the hospital or opt to complete the abortion at home if it is safe to do so.
If you opt to have a medical abortion in hospital
Two days after taking the first tablet, you will be admitted to the day ward. You or a healthcare professional will insert some tablets in your vagina and you will then be then given painkilling tablets.
The active ingredients in the tablets will cause the womb to contract. You may experience severe menstrual pain, particularly while the body is expelling the contents of your womb. It is also normal for you to experience bleeding, with blood clots. You must also be prepared to bleed more heavily than during a normal period. You will be given painkilling medication if necessary.
It is common for it to take 4-6 hours from insertion of the tablets in your vagina until the pregnancy is terminated. You can eat and drink whatever you want and live as normally as possible. It is better to remain active, as this can speed up the process and help to reduce pain. Most people return home from the hospital on the same day. In some cases, it may be appropriate to stay overnight in hospital until the next day.
If you opt to have a medical abortion at home
If you are healthy and over 18 years of age, you can opt to complete your abortion at home if the pregnancy has lasted less than nine weeks. You must have an adult with you on the day on which your pregnancy is terminated.
The process of abortion is the same as when you are admitted to hospital (see above). You will be given tablets to insert into your vagina in the morning two days after you were given the first tablet in hospital. You must then take some painkilling tablets which you were given by the outpatient clinic. You will be told how to contact the hospital if necessary, at any time of day.
After a medical abortion
After they have had a pregnancy terminated, most women will gradually bleed less and less over a period of 2-3 weeks. As long as you continue to bleed, you should use sanitary towels, rather than tampons. You should avoid sexual intercourse during the first two weeks after your termination, or for as long as you continue to bleed. You can go on sick leave for 1-2 days from the day on which you take the last tablets.
The side effects to the procedure are normally minor. The most common problems are heavy bleeding and abdominal pain. The risk of infection is low.
There are no medical check-ups to attend after an abortion, but you should take a pregnancy test after four weeks to make sure your pregnancy has been terminated (approximately 1 in 100 women are still pregnant after a medical abortion). If your period does not return within 4-6 weeks, contact your GP to find out whether you are still pregnant.
This is a minor procedure which is normally done under sedation or general anaesthetic, but it can also be carried out under local anaesthetic in order to numb the cervix. The doctor will gently scrape the inside of your womb via the vagina.
The actual procedure takes about 10 minutes. You will then be observed in the ward for 1-2 hours before you will be allowed to go home. You will be offered painkillers if you experience any pain after the procedure.
Women who have not previously given birth will be given preparatory medical treatment on the morning of the procedure in order to soften and expand the cervix.
After a surgical abortion
After returning home from hospital, most women will gradually bleed less and less over the course of a week. You should avoid sexual intercourse during the first two weeks after your termination, or for as long as you continue to bleed.
You can take sick leave for 2-3 days if you wish. The side effects of surgical abortion are usually minor, and most procedures are straightforward. The most common side effects relate to the anaesthetic and manifest themselves in the form of nausea and vomiting. Some women may experience heavy bleeding and abdominal pain. The risk of infection is low. In rare cases, the womb, bladder or intestines can suffer damage.
It is very unusual for the procedure not to result in termination of pregnancy. If your period does not return within 4-6 weeks, contact your GP to find out whether you are still pregnant.
Check-ups following surgical abortion are not common if there are no complications such as fever, increasing pain and/or heavy bleeding. Any check-ups will be performed by your GP or regular gynaecologist. You must make an appointment yourself.
Contact the hospital if:
You should contact the hospital if, after a medical or surgical abortion, you:
- bleed so much that you fill six night/large sanitary towels in two hours
- experience heavy bleeding with clots for more than 14 days
- experience pain lasting more than 14 days
- develop a fever (temperature above 38°C)
Reactions to having an abortion
Women react in different ways to having an abortion. Most people will feel relief after the procedure, but it is not unusual to feel sad too. A mixture of different emotions is also a common reaction. Most people find it helpful to talk to close family and friends.
Do you need guidance?
Many people find deciding whether to go through with or terminate a pregnancy a difficult decision. If you need someone to talk to, call Amathea, which is a government-supported, free counselling service on 90 65 90 60.
You can call Helsenorge.no’s helpline on 23 32 70 00 and be forwarded directly to a hospital or counselling service. They will also be able to provide you with relevant information and guidance concerning the applicable regulations and your rights.
All healthcare professionals have a duty of confidentiality.
Information for anyone considering having an abortion
In Norway, women have the right to decide for themselves whether they wish to have an abortion during the first twelve weeks of their pregnancy.
Illustration: Foto: Colourbox