Abortion

Abortion Methods

• Medical abortion – (also known as ‘the abortion pill’) involves taking medication to end a pregnancy.
• Surgical abortion – a surgical procedure to end a pregnancy.

In Ireland, abortion is legal up to 12 weeks into a woman’s pregnancy.

In Ireland, abortion after 12 weeks is not legal except in very exceptional circumstances.

Discovering you are pregnant can leave you feeling a mixture of emotions. Often this makes it difficult to know what to do next. Many women find it helpful to talk to somebody at this time.

At Gianna Care, we provide non directive counselling with a qualified counselling psychotherapist. If you are experiencing an unplanned pregnancy and wish to discuss your options, our friendly and qualified counsellors will be more than happy to meet with you and give you the support you need at the right time for you.

If you’d like to talk to someone we’re here to listen, support and discuss your options with you. Please contact us here, ring our 24/7 helpline or ask us via live chat.

At a pre-abortion consultation, a doctor will explain the abortion process to the woman and discuss potential risks and complications involved. The doctor is also required by law to certify that the woman will be no more than 12 weeks pregnant at the time of the abortion. To that end, a woman may be referred for an ultrasound scan so doctors can measure the baby and confirm how many weeks pregnant the woman is.

A woman is required to wait for a minimum of three days after the pre-abortion consultation before an abortion procedure can take place. This waiting period is like a ‘cooling off’ period. It gives a woman some time and space to consider her decision and seek counselling.

You are absolutely free to change your mind at any point up until the actual abortion procedure has commenced. An abortion is an irreversible procedure. Therefore, it is important that you take as much time as you need to ask questions , discuss your feelings and emotions and explore your options. Gianna Care is here to support you in this process.

• Mifepristone

Mifepristone is the first medication taken in the medical abortion process.

It blocks the hormone progesterone which is naturally produced by a woman’s body during pregnancy. Without progesterone, the lining of the uterus breaks down and causes the fetus and associated tissue including the placenta and pregnancy sac to detach from the uterine lining. The baby cannot continue to grow and survive without the nutrient rich lining of the uterus.

• Misoprostol

The second medication taken during a medical abortion is misoprostol.

Misoprostol causes the uterus to contract, causing strong, painful cramps and heavy bleeding. These symptoms are followed by explusion of the fetus and associated tissues including the placenta and pregnancy sac from the uterus.

If a woman is under 9 weeks pregnant, the first medication (Mifepristone) is taken at a GP surgery or woman’s health/family planning clinic in the presence of a doctor. The woman is given the second medication (Misoprostol) to take at home 24 to 48 hours later.

If a woman is more than 9 weeks pregnant, she must have an abortion in a hospital. This is because the woman is at an increased risk of complications. Increased risk is caused by the more advanced gestation of her pregnancy. Therefore, she will require extra medical supervision.

Most women will begin experiencing cramping and heavy bleeding about 1-4 hours after taking Misoprostol. They will pass the baby and associated tissue including the placenta in 4-5 hours.

For some women, the abortion process may take a number of days.

Most women will have strong, painful cramping during a medical abortion. These cramps are stronger than usual period pains.

It is common for cramping to continue on and off for a number of days following an abortion.

Bleeding is likely to be heavy during the abortion process. After the baby and associated tissues including the placenta and pregnancy sac are passed from the uterus, the bleeding will slow to that of a normal period and may last for a week or two. It is common for light bleeding and spotting to continue for a number of weeks after the abortion process has been completed.

Some women may experience a short episode of pain with a gush of blood or a clot several weeks after the abortion process.

A woman may bleed heavily and see large blood clots (as big as a lemon). She will also pass the baby and associated tissues including the placenta and pregnancy sac. Depending on the gestation of the pregnancy, the woman may be able to recognise the baby and associated tissues.

A woman may see the pregnancy sac which is white and fluffy with brown-red tissue surrounding it. At 9 weeks of pregnancy, a baby is about 22mm long from head to bottom, which is about the size of a strawberry. It’s important that the woman is prepared for the fact that she may see her baby and need to dispose of the remains. This can be very distressing and traumatic for the woman.

In addition to strong and painful cramping, bleeding and the passing of the baby, associated tissue and clots from the vagina – a woman may experience following symptoms.

1. Nausea
2. Vomiting
3. Diarrhoea
4. Dizziness
5. Temporary hot flushes or sweats
6. Tiredness and fatigue
7. Fever or chills
8. Anxiety
9. Back pain
10. Fainting
11. Sore/tender breasts
12. Milk leaking from the breasts

The risks and complications involved in a medical abortion include:

1. Unpredictable, irregular or prolonged bleeding after the abortion.
2. Prolonged cramping with/without bleeding.
3. Allergic reaction to the medications used.
4. Mental health complications including feelings of grief, regret, depression and PASS (Post Abortion Stress Syndrome) (see source A).
5. Incomplete abortion – retained pieces of the fetus/placenta/associated tissues in the uterus.
6. Incomplete abortion – continued pregnancy.
7. Needing further surgical treatment to complete the abortion.
8. Infection of the uterus.
9. Rupture of the uterus.
10. Excessive bleeding, requiring blood transfusion.
11. Undiagnosed ectopic pregnancy.
12. Hysterectomy- surgical removal of the womb.

These figures are official data from HSE Ireland and BPAS in the U.K.

The type of surgical abortion carried out in Ireland is called vacuum aspiration.

Vacuum aspiration uses suction to remove the fetus, placenta and associated tissue from the womb.

3 to 4 hours before the abortion takes place, medication is inserted into a woman’s vagina to soften the cervix (entrance to the womb).

The abortion takes place in a surgical theatre in a hospital. The woman lies on her back with her legs in the air, held open by supports.

An instrument called a speculum is inserted into the woman’s vagina. This holds the walls of the vagina open so the cervix can be seen by the doctor. The doctor inserts metal rods into the woman’s cervix to dilate the cervix.

A suction tube is inserted through the dilated cervix and into the woman’s uterus (womb). The doctor turns on the suction. The suction is strong and causes the baby’s body to come apart in pieces. The pieces are then suctioned through the tube, into a container, along with the placenta and other associated tissues.

A woman will require some form of pain relief/sedation to help her cope during a surgical abortion. The sedation a woman is offered varies from hospital to hospital but will be one of the following:

• Local anaesthetic – anaesthetic is injected into the woman’s cervix and numbs the area.
• Procedural sedation – some women will be drowsy but fully conscious and responsive whilst others may lose consciousness.
• General anaesthetic – the woman is completely unconscious and cannot move or feel pain.

Apart from those who receive a general anaesthetic, most women will experience strong cramping during and after the abortion procedure.

Most women experience bleeding similar to a menstrual period, and may pass blood clots after having a surgical abortion. The bleeding usually stops after 1-2 weeks, but some women experience light bleeding and spotting until their next period.

Some women may experience a short episode of pain, with a gush of blood or a clot several weeks after the abortion.

Some of these side effects are associated with the medications given for sedation whereas others are caused by the actual abortion procedure itself:

1. Nausea
2. Vomiting
3. Painful cramping
4. Bleeding and passing clots
5. Dizziness
6. Drowsiness
7. Headache
8. Low blood pressure
9. Decreased rate of breathing
10. Tiredness and fatigue
11. Loss of memory of the procedure
12. Anxiety
13. Fainting
14. Sore/tender breasts
15. Milk leaking from the breasts

The risks involved in a surgical abortion include:

1. Unpredictable, irregular or prolonged bleeding after the abortion.
2. Allergic reaction to the medications used.
3. Mental health complications including feelings of grief, regret, depression and PASS (Post Abortion Stress Syndrome) (see source A).
4. Incomplete abortion – retained pieces of the fetus/placenta/associated tissues.
5. Incomplete abortion – continued pregnancy.
6. Needing further surgical treatment including laparoscopy or laparotomy.
7. Prolonged cramping with/without bleeding.
8. Heavy or irregular bleeding.
9. Infection of the uterus.
10. Perforation of the uterus.
11. Excessive bleeding, requiring blood transfusion.
12. Injury to the cervix.
13. Injury to the bowel, bladder, blood vessels or serious injury to the cervix.
14. Hysterectomy- surgical removal of the womb.

The process of making an abortion choice, experiencing the procedure and living with the grief, pain and regret can be very traumatic. Some women may begin to develop problems with their mental health in the weeks and months following an abortion. For others, it may be years following their abortion experience before they start to experience these problems.

Our experience is that the sadness following an abortion is due to how final the decision is. Before making a decision to have an abortion it is very important to consider how you might feel afterwards and how it can affect your mental health.

Gianna Care offers confidential, compassionate support designed to help women and men work through these feelings. You are not alone. If you wish to begin the healing process from a past abortion or abortions, we offer one-on-one support, counselling and a monthly post abortion support group. Deciding to seek help may be one of the toughest decisions you have to make, but it may be one of the best. To talk to someone about issues from a past abortion, please contact us. All contact made with us is strictly confidential.