Late-term abortion

At The Gynae Centre we offer late abortion for pregnancies up to 18 weeks gestation. Abortions between 12-18 weeks are considered to be late termination of pregnancy and are carried out with an outpatient surgical procedure.

Manual Vacuum Aspiration (MVA) and Electric Vacuum Aspiration (EVA) are different types of suction used to remove pregnancy tissue from the uterus during pregnancy termination surgery.

For pregnancies under 15 weeks, MVA is used. For pregnancies 15 weeks and over, EVA is used.

MVA is one of the least invasive procedures available, carried out with a mini handheld vacuum to create a gentle suction. Cramps of the uterus will be felt for small periods of 10-15 seconds, up to 3-4 times, allowing periods of rest in between.

EVA creates a stronger suction. This is required in order to keep the procedure quick and to help prevent excess bleeding.

No, as a registered outpatient facility, you will attend the clinic for your procedure and can return home a few hours after the procedure.

The removal of a pregnancy through surgical abortion is a safe procedure with a high success rate close to 100%. The procedure is carried out under abdominal ultrasound control and we routinely check with ultrasound to ensure success and exclude any remaining tissue.

According to 2022 data, complications were reported in 300 out of 251,377 cases. This equates to a rate of 1 in every 838 abortions.

Surgical abortion complications are rare. However, as with all medical procedures, there are risks associated with late abortion. These include infection from retained tissue, excessive bleeding, and perforation of the bowel. At The Gynae Centre we perform the procedure guided by ultrasound to reduce the risk of perforation and retained tissue.

Your consultant will advise you about how to prepare for late pregnancy termination, but preparation involves:

• Medication to be taken 24hrs before the procedure
• Nil by mouth (no food, drink or oral medication) for 6-8 hours before the procedure
• Medication to be taken in the clinic 1-2hrs before the procedure to prepare the cervix. This ensures it is easy to introduce the cannula during the procedure.

• Undress from the waist down only
• No need for fasting the night before
• You will be placed in lithotomy position with your legs supported by padded leg rests
• The vaginal area will be cleaned with antiseptics
• The lower body parts are covered with sterile drapes
• A speculum is inserted into the vagina
• The cervix will be cleaned with antiseptics
• A local anaesthetic is injected into the cervix while you are under sedation.
• A small cannula is introduced to the uterus, resulting in a small cramping feeling
• MVA or EVA suction is activated for up to 15 seconds and gentle curettage is carried out. During this step, the cramping feeling will worsen. Rest for 1-2 minutes, then the procedure is repeated up to 3-4 times
• Ultrasound is carried out to ensure that there is no remaining tissue
• Re-dress, followed by observation for 30-60 minutes, where you will be offered a drink and a snack
• Discharge

We provide a confidential, patient-centered approach to late-term abortion care.

A surgical abortion has common physical side effects including bleeding and cramping. Other side effects that may affect some patients, but not all, include breast tenderness; mucus-like vaginal discharge; gastrointestinal symptoms including nausea, vomiting and diarrhoea; chills; and fatigue.

The time it takes to recover from a surgical abortion differs from patient to patient, but most patients recover and can go back to their normal activities within three days. Your next menstrual period should begin four to six weeks after the procedure has taken place.

In the unlikely event you experience severe pain, excessive bleeding or fever, you should attend your nearest A&E.

Although some patients feel well enough to go back to work on the same day as their surgical abortion, you may wish to rest. This might mean taking some time away from work and other activities.

When caring for yourself after a late abortion, the following advice may be helpful:

• Take pain medication such as ibuprofen
• Use a heat pad to ease the pain of cramps
• Stay hydrated, especially if experiencing gastrointestinal symptoms
• Wear loose clothing and avoid trousers that are tight around your lower abdomen
• Ask a trusted friend or family member to support you during this time