First Trimester Abortion A first trimester abortion is one that is performed prior to 12 weeks gestation as determined by ultrasound. The standard procedure for this type of abortion is vacuum aspiration or suction curettage and is performed on an outpatient basis. This procedure can be done under local or twilight anestesia. Twilight anesthesia places the patient in a very light sleep. Local anesthesia allows the patient to be aware during the procedure.
As the procedure begins, the doctor will perform a pelvic examination similar to an annual gynecological exam. The doctor will then insert a speculum and clean the area with an antiseptic solution. Next, the doctor will begin the dilation procedure followed by suction and curettage. The doctor will check the uterine walls to make sure the pregnancy was successfully terminated. Some bleeding may occur. After the procedure, a certified nurse will monitor vitals and the patient's condition in a recovery room for at least an hour.
Second Trimester Abortion A patient that is 12 to 17.5 weeks of gestation as determined by ultrasound is in the second trimester. The abortion procedure for a second trimester pregnancy is done in two steps and frequently in two days. The first step consists of completing paperwork, labwork, bloodwork, ultrasound and inserting sterile laminaria (natural dilators) in order to begin dilating the cervix. The patient then goes home to rest for the evening. Some cramping is to be expected. Tylenol or Ibuprofen can be taken in order to ease the cramping. The patient must rest and stay off of her feet. She is unable to eat, drink, smoke or chew anything after midnight. Her final meal of the evening should be light (no pasta, pizza or greasy food). The patient then returns to the clinic the next morning for the second step. If the patient does not return, she risks an infection called Endometritis, an infection in the uterus which can lead to septicemia and other complications. The second step consists of completing dilation of the cervix followed by suction and curettage and possible D&E. (Dilation and Evacuation). No aspirin products can be consumed during the process and 2 weeks following because it is a blood thinner. Tylenol and Ibuprofen are acceptable forms of pain relief.
Before your Abortion
Call the clinic at least one day in advance for an appointment. All insurance benefits and coverage will be assessed at this time.
DO NOT HAVE ANYTHING TO EAT, DRINK, SMOKE OR CHEW AFTER MIDNIGHT THE NIGHT BEFORE YOUR SURGERY. ABSOLUTELY NOTHING!!! Your final meal of the evening should be light.
Payment is due before the procedure. We accept credit cards (Visa, Master Card, American Express and Discover) and money orders/cashier's checks. The credit card holder must be present to sign. We DO NOT accept any personal checks.
Bring any documents that were requested of you at the time of making your appointment.
Bring a maxi pad and an extra pair of clean cotton underwear. (no thongs)
Wear socks and warm loose fitting clothing.
Do not have any aspirin products from now until 2 weeks after your surgery. This is due to the fact that aspirin is a blood thinner. Ibuprofen and Tylenol are acceptable.
You must shower the morning of your surgery. DO NOT wear any nail polish, jewelry, contacts, tongue piercings, dentures, false nails or retainers.
You are allowed to bring one person with you on the day of surgery. Make sure that he/she brings a picture ID. Someone will have to drive you home.
No children are permitted in the clinic on the day of surgery.
What to Expect on the Day of Surgery
Due to sterile conditions and respect for all patients, no family members or friends will be allowed beyond the waiting room area at any time during the visit. This includes ultrasound, surgery and the recovery room.
Registration - Each patient will receive a registration packet to be filled out prior to surgery. The information asked will include your name, address, phone number, emergency contact name and phone number, your complete medical history, etc. Please be prepared to provide us with this type of information. An abortion consent form is also given to you at this time. You will need to read over it and sign the consent. If there is anything you do not understand, we will go over it with you in counseling.
Ultrasound - An abdominal ultrasound will be done for each patient. The results will provide us with an intrauterine gestation to determine the duration of the pregnancy. We do not offer prenatal ultrasounds at our center.
Lab - In lab vital signs are taken, a blood sample is drawn to determine Rh factor as well as red blood cell level and a urine sample will be analyzed. Test results will be processed immediately. Rh negative patients will need an injection called Rhogam and will need to pay an additional fee.
Payment - Payment is due in full on the day of the procedure. We accept all major credit cards (Visa, Master Card, American Express and Discover) and money orders/cashier's checks. We do NOT accept personal checks. At this time, we will also want to see a photo ID as well as any other documents requested at the time of the initial appointment. If you are going to be using pre-approved insurance then an insurance card and signed claim form would be required.
Counseling - The primary purpose of the counseling session is to completely explain the procedure, discuss paperwork and answer any questions. A health educator will discuss your medical history and pregnancy history as well as sign your consent form. At this time feel free to discuss your situation and present any questions or concerns that you may have.
Change for Surgery - The office staff will call you back after counseling to change for surgery. You will be required to remove all clothing except for your T-Shirt, bra and socks. A clinical gown will be worn and all jewelry and contact lenses must be removed.
Surgery - Surgery will be done in a private surgical suite. An IV will be put in your arm and the twilight anesthesia will be administered. The procedure itself as described at the beginning of this section will take less than 30 minutes. After the procedure a nurse will assist you into a wheelchair and take you to the recovery room.
Recovery - You will be required to stay in the recovery room for at least one hour. A nurse will monitor your condition and periodically take your vitals. You will be given some soda and crackers once you have been in the recovery room and are stable, awake and alert. After one hour your condition will be reassessed and discharge instructions will be given. You will also receive your prescriptions along with instructions on how to take them. Due to the anesthesia you should not drive for at least 24 hours and will need someone to drive you home.
Medication - You will need to get prescriptions filled and start taking your medications that same day. For your convenience, we do offer these medications at the center for $25-$30, depending on how far along you were in your pregnancy.
Methergine is prescribed to help your uterus contract back to pre-pregnancy state and minimize bleeding.
Tetracycline is an antibiotic prescribed to help avoid infection.
Pain medication prescriptions are given in case the patient needs them. We recommend over the counter pain relief such as Ibuprofen or Tylenol. If that does not cease cramping, then get the prescriptions filled.
Post-Abortion Care
Drink plenty of fluids and avoid alcohol while taking medications.
Rest the day of surgery. You may resume normal activities the following day but avoid any strenuous activities, exercise, heavy lifting (anything over 15 pounds) or standing for prolonged periods of time.
Do not drive, operate heavy machinery or make important life altering decisions for 24 hours due to anesthesia.
Monitor your temperature. If a fever of 101 degrees or higher occurs, contact the clinic.
Do not immerse yourself into water until after your follow up appointment (2-3 weeks). This includes tub bathing, swimming, hot tubs and douching. Do not have any intercourse or sexual contact until after your follow up appointment.
Do not use tampons for 6 weeks to avoid the risk of infection.
For the next two weeks, normal bleeding may vary between very light to heavy. Small blood clots may be passed. If a clot passes that is the size of a half dollar or larger, call the clinic. Your discharge may vary between bright red, pink and dark brown. If you experience extremely heavy bleeding (saturating 2-3 pads an hour) or pass half dollar size clots-call the clinic.
Your menstrual period will return in 4-8 weeks.
If you experience cramping, you may take a non aspirin product. DO NOT use a heating pad on your abdomen.
You will need to have a follow up exam 2-3 weeks after your surgery.
Please call our office if you have any questions. Our answering service is available 24 hours in case of emergency. ACCESS 1+800-403-3033.
