Surgical Abortion – For a woman 5 weeks 0 days to 20 weeks 0 days pregnant
Important Information about the Surgical Abortion:
- You can expect to be in the clinic for 2 to 3 hours although the abortion procedure may only take 10 minutes.
- You cannot drive for 24 hours after your abortion and you must have an escort home. This is a requirement of the College of Physicians and Surgeons of Alberta. If you have someone with you, you can take a taxi or the bus home.
- You CANNOT have any food or beverages (this includes candy, gum and water) 6 hours before your appointment time.
- You can bring a support person with you and your support can be with you in different parts of the clinic, including the procedure room. Your support person will need to have picture ID to enter the clinic.
- Please do not bring children to the clinic.
On the day of your appointment
When you arrive:
- The clinic is the green brick building on the southwest corner of 109A Avenue and 124 Street. There are two large trees and a picnic table in front. You can access the clinic at the main door facing 109A Avenue. The clinic is NOT the house across 109A Avenue. The house is not associated with the clinic even though it has signs that make you think it is.
- Please park on the avenue as the parking lot is for staff only. Thank you.
- When you come to the door you will have to ring the door bell and you will be asked your name to confirm you have an appointment.
- When you come into the clinic you will be asked for your picture ID and Alberta Health Care card and anyone with you will also need to have picture ID to come into the building.
In the front waiting area:
- You will also be given a chart to fill out. If you would like to fill out this chart before your appointment and bring it with you, use this link Abortion Patient Form 2016. When you print the chart, on your print screen please ensure you choose the “Reduce to Printer Margins” setting.
- Once your chart is filled out and your file created, you will see a nurse for an ultrasound and speak with a counsellor. You will not see them at the same time.
You will be weighed to ensure you receive the proper amount of medications before your abortion procedure.
The nurse will review your medical history from your chart.
The ultrasound will be done to determine the number of weeks of the pregnancy. During the ultrasound you will not see or be told anything unless you ask.
Once you have spoken with a counsellor and signed your consent form you will be given a low dose of an anti-anxiety medication called Ativan.
You will then change and have a seat in the patient only waiting area before you see the doctor.
- All women meet with a counsellor, at least briefly.
- Your support person is welcome to join you in counselling, after the counsellor has spoken with you alone first.
- Your time in counselling is an opportunity to ask questions, discuss any concerns you may or may not have and to talk about birth control. The counsellor will also review the consent forms with you and have you sign them.
- All of the counsellors at Woman’s Health Options are Social Workers registered with the Alberta College of Social Workers and are specifically trained to work in abortion care.
In the procedure room:
- A nurse will come to get you from the patient-only waiting room. If you have a support person coming with you, the nurse will get your support from the front waiting room. In the procedure room you will be lying on the bed and your support will sit beside you facing your head.
- The nurse will help you get settled and start an IV. The medications you are given through the IV will make you very drowsy, relaxed and help with pain. You will not be put all the way to sleep.
- The nurse will be beside you throughout the procedure, monitoring and supporting you.
- Prior to the abortion the doctor will do a pelvic exam (with a gloved hand and lubrication gel, the doctor will insert two fingers into your vagina) to determine the size and position of your uterus.
- Once the pelvic exam in complete the doctor will insert a speculum (the instrument used for a pap exam) into the vagina. This allows the doctor to see the cervix (the opening of the uterus). The doctor will then apply local freezing to the cervix, this may cause a small amount of cramping or pinching.
- There are different abortion procedures depending on the size of the pregnancy, however: regardless of the pregnancy size, the procedure involves gently opening (dilating) the cervix and removal of the fetal tissue and cleaning of the uterus. Cleaning the uterus is done with a small vac-curette (a hollow tube used with suction) and a curette. There is more information about this in the Surgical Abortion Procedures section below.
In the recovery area:
- After the surgical abortion you will walk with the nurse to the recovery area. You will have a seat in a comfortable reclining chair.
- You can have a support person sit with you in the recovery area if you want.
- You will be monitored by nurses for 30-60 minutes until the medications have worn off and you are well enough to be discharged.
- You will be offered something to drink but take small sips at first. It is normal to have nausea and vomiting after the abortion.
- Before you are discharged you will be given an envelope with information that includes aftercare instructions and how to reach a clinic nurse if needed.
Throughout your time in the clinic, you can expect to be treated with kindness, dignity and respect, by caring pro-choice staff.
If you have any questions or concerns please contact a clinic counsellor at email@example.com
Surgical Abortion Procedures
5 weeks to 12 weeks – The doctor will gently dilate (open) the cervix to gain access to the uterus; this may result in slight pressure and cramping. Once the cervix is open the pregnancy tissue is removed with a small suction tool. The doctor will then clean the walls of the uterus and do a final pass with the suction tool. The procedure takes 5-7 minutes. During and after the procedure women feel slight to significant cramping as the uterus contracts and returns to pre-pregnancy size.
12 weeks to 16 weeks – The abortion procedure is performed as it would be for a 5-12 week pregnancy. However, a woman will first need to insert Misoprostol (Cytotec) tablets into her vagina. These tablets will take 1-2 hours to take effect and in the process will soften the cervix making dilation easier and safer. The tablets may cause some cramping as the cervix softens.
16 to 20 weeks – In this range of pregnancy, the abortion will be a two day procedure called a D & E or Dilation and Evacuation. If a woman does not live in the city of Edmonton, it will be determined at the time of booking the appointment, if she will need to stay in Edmonton overnight on day one of the procedure.
The D & E Procedure
Day 1: A woman will follow the same initial steps as she would for a surgical abortion procedure. She will fill out her chart, have an ultrasound and speak with a counsellor. After these steps she will be given medication orally and will change and wait to see the doctor. The doctor will do a pelvic exam, insert a speculum, freeze the cervix and insert tiny sticks called laminaria into the cervix. A woman will then walk to the recovery area and have a seat. She will get something to drink and will be given verbal and written instructions for her care that night and the 24hr medical assistance information and medications to take later.
That night: The laminaria sticks will remain in the cervix overnight and will absorb moisture from the cervix and expand. Some women have cramping and nausea overnight and can use the medications they were sent with to help them feel more comfortable. A woman can eat after she leaves the clinic but must stop eating at midnight.
Day 2: A woman will return to the clinic and be taken to change and receive medications from the ultrasound nurse. She will be given Misoprostol (Cytotec) pills to insert into her vagina. These tablets will take 1-2 hours to take effect and in the process will soften the cervix making dilation easier and safer. She will be in the back patient-only waiting room. When it is time to see the doctor a nurse will bring her to into the procedure room, start an IV and the medications given through the IV will make her very drowsy, relaxed and help with pain. She will not be put all the way to sleep.
The laminaria sticks helped the cervix to dilate, but the doctor may further dilate the cervix to gain access to the uterus. This may result in pressure and cramping. Once the cervix is open the doctor will remove the pregnancy tissue. The doctor then cleans the walls of the uterus and uses suction to ensure all pregnancy tissue is removed. This procedure takes about 15 minutes. During the procedure and afterwards women feel slight to significant cramping as the uterus contracts and comes back to pre-pregnancy size.