Preparing for your appointment depends on the type of anaesthetic option you choose. If you are not sure about anything please do not hesitate to ask.

a. Conscious IV Sedation or General Anaesthetic

When having conscious sedation or a general anaesthetic, it is essential that you:

• do not eat anything (including lollies or gum), or smoke for 6 hours prior to your appointment (please inform us when making your appointment if you are diabetic)
• do not drink anything (including water) 3 hours prior to your appointment
• inform us if you are taking any other medication
• not drive a motor vehicle for 24 hours after the procedure
• have someone accompany you home

b. Local Anaesthetic:

If you are having a local anaesthetic you may have a light breakfast of tea/coffee, toast or cereal.

You have three anaesthetic options. All options will be fully explained during your consultation enabling you to make an informed choice:

Local Anaesthetic:

Depending on your stage of pregnancy you can choose to have your procedure under local anaesthetic. You may wish to consider this as an option as recovery is quicker and safer than a general anaesthetic.

Conscious Sedation:

The advantage of conscious sedation as an alternative to a general anaesthetic is that you will be awake during the procedure and your recovery time will be speedier. You will feel drowsy and relaxed during the procedure.

General Anaesthetic:

During a general anaesthetic you will be under unconscious sedation and completely asleep.

It is essential that you bring with you:

• your Medicare card
• your current concession, healthcare or pension card if applicable
• personal identification (this can be items such as your drivers licence or two credit or bank cards)
• any notes you were given by your GP (a doctor’s letter stating you have discussed your decision to have a termination of pregnancy is required in the state of WA)
• any medication you are currently taking (including inhalers)
• any reports or ultrasound scans of this pregnancy
• cash, credit or eftpos card for payment on the day

It will make your stay more comfortable if you bring with you:

• sanitary pads (not tampons)
• comfortable two piece clothing (ie: not a dress), preferably with a short sleeve top
• a spare pair of underwear
• a book or magazine to read while you are waiting

Counselling is available to any woman who feels they need to discuss their situation or who may be unsure about their decision.

If you would like to speak to an experienced counsellor prior to your consultation, please phone us on Freecall 1800 003 707 and we can give you the details of counselling agencies to contact. If you feel comfortable with your decision you may not feel you need counselling. It is entirely your choice.

Once you have completed the necessary administration requirements, you will have a consultation with a nurse or doctor. When you are sure of your decision, the nurse/doctor will provide you with information regarding the procedure, including your anaesthetic options. They will discuss with you your medical history and will also discuss various contraceptive methods available for future use.

Either as part of your consultation or on the day of your procedure, an ultrasound scan will be performed. This is to assess how many weeks the pregnancy has progressed (the gestation period) and to ensure that it is situated in the womb. It is not intended for diagnostic purposes and you will be advised to see your doctor if any abnormalities are discovered.

An ectopic pregnancy is a pregnancy that is situated somewhere other than in the uterus, most commonly the fallopian tubes. An ectopic pregnancy cannot develop normally and may cause a rupture. If there is a chance that your pregnancy may be ectopic you will be referred to a hospital for further treatment.

There are several blood groups including A, B, AB, O and some others which are rarer. Blood is also either rhesus positive or rhesus negative. The rhesus type you have is dependant on the blood group of your parents.

When a woman who has rhesus negative blood carries a rhesus positive pregnancy in her uterus, the blood cells from her pregnancy can enter her blood stream. Her immune system will treat the blood from the foetus as foreign and will respond by making antibodies, which will destroy the blood cells of the foetus.

By giving an injection of rhesus antibodies known as Anti-D, the woman’s immune system is prevented from making antibodies against future pregnancies. Only women who are a rhesus negative group will receive an Anti-D injection, this is given straight after an abortion or after a full term pregnancy.

Here is a brief guide on how a termination of pregnancy is performed:

Surgical abortion up to 12 weeks:

At this stage gentle suction is used to remove the contents of the uterus. As the procedure takes less than 5 minutes you may choose to have a local anaesthetic or you may select to go under general anaesthetic or conscious sedation.

From 13 weeks onwards:

The procedure at this stage of the pregnancy will take slightly longer as the doctor needs to dilate the cervix in order to remove the contents of the uterus. Please call our National Support Centre for more information on the abortion services provided at each centre.

A doctor who has been fully trained and experienced in performing these procedures will perform your termination of pregnancy.

Most women who choose not to have a general anaesthetic report that the discomfort is bearable and lasts only for a short time. Some women can experience more severe discomfort, but again this is only brief. Even with a general anaesthetic there will be some cramping pain following the procedure. Painkillers are available if they are required.

Following treatment you will spend a short time recovering in a reclining chair or bed. Unless you have any unusual pain or discomfort, you will not be examined before leaving as it is both unnecessary and uncomfortable to do so after treatment.

This depends on your anaesthetic choice – it may be longer if you have a general anaesthetic. You may leave as soon as you feel well enough, and it is advised that you have someone to accompany you home. Although the procedure itself only takes a few minutes, please plan to stay at the centre for around three hours.

Early abortion is one of the safest procedures carried out in hospitals and clinics throughout the world. There is very little risk associated with abortion, particularly in early pregnancy. There is no evidence to suggest a straight forward abortion has any affect on future fertility or any other aspect of general health. There are however a small number of possible complications which you should to be aware of.

The most common risk associated with abortion is infection after the procedure. This can be reduced by following the aftercare instructions you will be given when you attend for treatment, including not using tampons or having vaginal intercourse for about two weeks after your termination. If your procedure is performed at Marie Stopes International, we will also offer you a test for a common cause of infection, Chlamydia. If you decide to have this simple test and the result is positive, you will be prescribed appropriate antibiotics.

The most serious risk is that damage may be caused to your uterus during the course of the procedure, a risk which is greater in later pregnancy. Although the risk is extremely small, you need to be aware of it. Your treatment will be carried out by an experienced doctor and every effort is made to minimise risks.

In early pregnancy (usually 6 weeks and under), there is a risk that the pregnancy may be missed completely because it is so small. If you have a termination at this stage you may be recommended to have a repeat pregnancy test 2 to 3 weeks after your appointment to ensure all is well. A pregnancy test carried out less than 2 weeks after your treatment is not reliable.

If your procedure is performed at Marie Stopes International and you experience any of the above, we are always available to provide follow-up care.

There is also a small risk of incomplete abortion at any stage of the gestation. This is where a tiny piece of tissue has not been removed and causes prolonged bleeding and pain. If this happens it is important to seek help as quickly as possible to decrease the risk of an infection developing.

You may experience some period-pain like symptoms which are best treated with painkillers.

You may have a shower as soon as you feel well enough. However for the two weeks following the procedure it is important that you:

• Do not insert anything into your vagina including fingers or tampons (do not use tampons until your next period)
• Do not have vaginal intercourse
• Do not perform any strenuous activity, including sport or heavy physical work

For many women, making the decision to seek help regarding abortion is relatively straightforward. However, for others abortion is an issue that is fraught with complexities and the decision to undergo the procedure causes much anxiety.

While most women feel relief following an abortion and are able to move forward, some may feel a sense of loss or sadness and can experience the following:

• numbness and emptiness
• false euphoria
• the need to keep excessively busy
• general depression
• sudden bouts of crying
• anger and/or guilt
• sexual or relationship difficulties

The majority of women feel that talking through their feelings with their partner, friends, family or doctor is usually all that is needed. However, some women may not have anyone they can easily talk to, or they may think that others will pass judgment, and therefore feel very isolated, right at the time support from others is needed.

By acknowledging and accepting unexpected reactions and unresolved feelings towards the abortion, most women find they are able to work through these in a positive way. This is where post-abortion counselling can help.

If you want to talk to someone about your experience and how you are feeling, there are experienced post-abortion counselling agencies available. A Marie Stopes International team member can refer you to an experienced counsellor, or phone Freecall 1800 003 707 and we can give you the details.

The cost of post-abortion counselling varies. Some agencies are government funded with no fee and some charge a minimal cost for post-abortion counselling.

This is entirely up to you. If you have a physically demanding job you may want to take a few days off. A lot of women return to work on the day following an early termination.

It is very important that you are aware you could conceive as early as 2 weeks after your abortion. We therefore strongly advise that you decide on a suitable contraceptive method as quickly as possible.

The following is a brief guide of the methods that can be started immediately following treatment.

The Pill

The Pill is a daily oral contraceptive that contains hormones which prevent the release of an egg from the ovaries each month. This should be started on the first day after your treatment.

An Injection (Depo-Provera®)

Depo-Provera® is a synthetic hormone that is given by injection every three months and is slowly released into the body. It stops the release of an egg, changes the lining of the uterus and thickens the mucous in the cervix. A Depo-Provera® injection can be administered at the time of your treatment.

The IUD (Multiload®) or IUS (Mirena®)

An intra-uterine device (IUD) is a small plastic and copper intrauterine device. It is placed in the uterus and left there for 5 to 8 years. The IUD works by preventing sperm from meeting an egg, or by preventing an egg settling in the uterus. The Intra-uterine system (IUS) is a small, plastic, T-shaped device with a cylinder around its stem that releases the hormone levonorgestrel to prevent pregnancy. As with the IUD, the IUS is placed inside the uterus by a doctor and can stay in place for up to 5 years. Depending on your stage of pregnancy, either method can be put in at the time of your treatment.

Implanon®

Implanon® is a contraceptive implant that slowly releases the hormone progestogen into the body over a period of 3 years. This can be inserted under the skin of the upper arm during treatment.