What To Expect When You’re Expecting an Abortion

Everything you ever wanted to know about an abortion but were too afraid to ask your doctor

Abortion is a subject no one wants to talk about in public. It is legal in India till 5 months, but legal does not mean safe, readily available or without stigma (Photo: iStock)

Were you not careful enough? Were you wasted? Was there an accident with the condom? Did you not know about the morning-after pill? Is this your first pregnancy?

It does not matter. None of that matters if a woman is with child and decides to be without.

Abortion is legal in India up to 20 weeks of pregnancy, a proposed law to increase the limit to 24 weeks in ‘special cases’ has been sitting with the Parliament for a couple of years now.

Ending a pregnancy is a common, even a normal event in the reproductive cycle of a woman. So if you are wondering about an unplanned pregnancy or just curious about the technicalities of an abortion, read this handy guide with tips on a simple, safe procedure, because every two hours in India, a woman dies from an unsafe abortion.

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Know Your Options

There are two kinds of abortion procedures - medical (done by pills) and surgical (where doctors directly remove your pregnancy). Your choice of procedure depends on how long you’ve been pregnant and your personal preference.

First trimester abortions are extremely safe, one of the safest medical procedure you can undertake and generally have no long-term risks to your future fertility (Photo: iStock)

Medical Abortion

Medical abortion involves terminating the pregnancy using pills to expel the lining of your womb from the body, thereby ending the pregnancy.

This involves taking two pills, mifepristone and misoprostol, to terminate the pregnancy.

How It Works

Step 1: The hospital or the clinic will first do a vaginal ultrasound to determine the health of the uterus and the weeks of the pregnancy. At this stage, a stomach-based sonograph cannot be carried out because the size of the embryo is so small that it cannot be viewed through the external scan.

Step2: A medical abortion is safe only in very early stages of the pregnancy. So if you are 10 or a maximum of 12 weeks pregnant (ideally under 10), the gynaecologist will give you a pill to swallow which will cause the cervix to soften.

Step 3: After 24 hours of having the oral pill you come back to the clinic to take another medicine which is placed inside your vagina.

Medical abortion does not mean magic pills which cause the embryo to evaporate. There are no injections involved but this is no short, painless procedure either (Photo courtesy: Tumblr/@FuckinClassy)

Step 4: Within a few hours, (you can be at home), the pill, misoprostol, will cause excessive cramping which expels the embryo from your uterus.

Step 5: You will cramp a lot and bleed a lot. But you are not hemorrhaging.

Step 6: The procedure lasts a few hours and is pretty painful, almost debilitating with the worst kind of period cramps. You will feel a little sweaty and woozy throughout, precisely why there should be someone else with you at home.

Step 7: Doctors say when the sac comes out through your vagina, you will know. The bleeding will taper down drastically but the entire procedure can take nearly 6 hours.

Caution: If the bleeding doesn’t completely stop after a day or two, get a medical exam scheduled ASAP: it could mean an incomplete abortion.

Surgical Abortion

There are two kinds of surgical abortions, which one your doctor advises for you, will depend upon how long you’ve been pregnant.

Vacuum Aspiration (Up to 15 weeks)

This is a 5-to-10-minute procedure which involves suctioning the embryo and emptying it.

Dilation and Evacuation or D&E (15-24 weeks)

Medically the procedure is similar to Vacuum Aspiration but involves dilating the cervix.

Deciding on the abortion options is mostly about personal preference if you are at an early stage in pregnancy. Do you feel like you would emotionally benefit from being able to do it at home, or you will process the termination better if it was a standard medical setting? (Photo: iStock altered by The Quint)

How Both the Procedures Work

Step 1: Vacuum Aspiration is a first-trimester option and can occur in the 5 to 15-week window after your last period.

Step 2: An invasive (vaginal) ultrasound will determine the extent of your pregnancy and then after a 12-hour fasting you come to the doctor’s clinic to get the procedure done.

Step3: A series of injections will prepare you for the short procedure.

Step 4: A local or a general anaesthesia is given and doctors strap your legs to the stirrups to get a good look at the uterus.

Step 5: A special syringe sucks out the embryo. If the pregnancy has advanced to the second-trimester, the D&E method is used where your cervix will be gently widened using forceps and a suction tube will remove the pregnancy.

Step 6: Both types of procedures are fairly safe if done by a trained doctor and will require you to take antibiotics to prevent infection.

Step 7: You will be dizzy for a couple of hours because of anesthesia, so it’s always safe to have a confidant who can drive you back home.

You Can Get Pregnant After an Abortion

It is totally natural to worry about getting pregnant after an abortion, but the reality is, if you’ve had a straightforward procedure from an experienced doctor, the risks are rare.

(Photo courtesy: Tumblr/UCResearch)

After an abortion wait for a week to have sex, and at least a month to plan a baby; your body has gone through a lot and needs time to rest before it can nurture another life.

I hope that you never have to deal with the issue again but if you do, know your options well.

Also Read: Mums, Stop Blaming Your Bumps for the ‘Pregnancy Brain’!