What You Need to Know About Abortion

Abortion , pregnancy termination or vacuum abortion is a surgical abortion method used for maniging an unsucessfull or unhealthy pregnancy. Abortion In our clinic located in Ankara, the vacuum abortion method can be safely used both in pregnancies that result in miscarriage and in unwanted pregnancies up to the 10th week of pregnancy permitted by law. Abortion is a very worrying and sad situation for every woman. The most commonly used treatment method in pregnancies that end in miscarriage mostly in the early gestational weeks is abortion, which means surgically removing the pregnancy from the uterus . These surgeries, also called medical evacuation or curettage, can be applied in cases of unpreventable miscarriages, in cases where the fetus dies in the womb, in cases where the miscarriage is partial and tissues remain in the uterus, or in anembryonic pregnancies in which the fetus cannot form , as well as in unwanted pregnancies up to the 10-week limit allowed by the abortion law . . In other words, the legal abortion period is the 10th week of pregnancy. After the 10th week, the pregnancy can only be terminated by the decision of the medical board if an unfavorable condition develops during the course of the pregnancy and the development of the baby that would put the health of the mother and the baby at risk. Doctors who perform abortions in Ankara most frequently encounter the following questions, and I am compiling these questions and their answers for you to read.

What is Abortion?

Abortion is the process of removing the pregnancy inside the uterus from the uterus using thin cannulas or curettes . This procedure, which means surgical curettage ,or evacuation, is now performed with the vacuum aspiration method with the advancement of technology, and the technique may vary depending on the week of pregnancy.

Curettage , which is used to diagnose menstrual irregularities or intrauterine pathologies, is very similar to curettage used to terminate pregnancy . Probe curretage is different then pregnancy curetage .The purpose of this procedure, is to remove the endometrium tissues and send them for pathological examination. This process also plays a role in reducing and stopping bleeding in cases of excessive menstrual bleeding. At the same time, the samples taken can be sent to pathology to investigate the cause underlying bleeding problem.

What is Vacuum Abortion?

The vacuum abortion technique , which is more modern than other techniques , begins with the insertion of a very thin tube into the uterus, accompanied by an anesthetic intervention for a shorter period of time . After the tube is placed in the correct position, aspiration and cleaning are performed with negative pressure (vacuum pressure similar to a vacuum cleaner)

Why Should I Prefer Vacuum Curettage?

As we mentioned before abortion means completely removing the pregnancy and its appendages from the uterus by scraping the uterine wall. Although there is no limit to know how much the uterine wall should be scraped in this process, as the gestational age increases, the scraping process will take longer and a prolonged scraping process may damage the uterine walls. Another way to end this scraping process as soon as possible and to do it with less traumatic tools is to clean the tissues by vacuuming with a vacuum system without the need for long-term scraping, in which case the possibility of damage to the uterus decreases.

Probe Curettage ?

Probe Curettage is the process of taking a piece of the uterus for evaluation when there is no pregnancy, but the woman has a health problem with the inner wall of the uterus or excessive menstrual bleeding that does not respond to treatment . In case of symptoms that may affect women's health and indicate serious diseases (abnormal menstrual bleeding, thickened endometrium or before a planned uterine operations), your gynecologist. may choose to have a probe curretage procedure. In this case, a diagnosis can be made and a road map for treatment can be drawn by examining the sample taken. It even has a therapeutic role in reducing and stopping prolonged excessive bleeding.

Dilation and Curettage Mean?

As I mentioned above, abortion does not only mean termination of pregnancy . It is also the name of a cleaning process and has an important role in the diagnosis of many gynecological diseases.

Dilatation means expansion. It is used to mean widening of the cervix .. A subgroup of dilatation abortion is fractionated abortion . In this procedure, the cervix is dilated again and the removal process is not only from the uterine wall; It is also performed through the cervix (cervix) canal.

Is Abortion Prohibited?

The law places certain restrictions on abortions performed on demand. Abortion is not prohibited if performed within these limits. In other words, the law gives parents the right to terminate a pregnancy optionally until the 10th week of pregnancy. However, in cases where the mother is under 18 years of age, the consent of the parent or legal heir is required. For married women, their husband's approval is asked. In order for pregnancies greater than 10 weeks to be aborted, there must be life-threatening or incompatible problems in the health of the baby or the mother, and this must be approved by the medical board. When these conditions are met, the mother can be hospitalized and an abortion can be performed.

Until Which Week Can Abortion Be Performed Legally?

Within the framework of legal regulations, abortion can be performed up to the 10th week of pregnancy . According to the wishes of the woman or the couple, termination of pregnancy can be done legally up to the 10th week, without any justification. However, if the following conditions occur in the following weeks, abortion can be performed up to the 20th week. Termination of pregnancy after the 20th week is performed by giving birth, not by abortion technique.

• Detection of a permanent and legally defined health problem in the baby in the womb

• The baby's heartbeat cannot be heard and his heart has stopped

• The baby is not developing and negative health problems may occur due to this.

• Pregnancy status and progress pose risks that could endanger the mother's life

In this regard, calculating the gestational week is also an important issue. Many couples use the date of sexual intercourse as the starting date of pregnancy . This would be an incorrect gestational week calculation method. The date of pregnancy onset is based on the first day of the woman's last menstrual period . In regular menstrual cycles, this period indicates approximately 14 days before the date of intercourse. However, if we are talking about a woman experiencing menstrual irregularity, the week of development of the baby based on ultrasound examination is taken as basis and reported accordingly.

Another process controlled by law is the woman's age and marital status. If the person who wants to have an abortion is under the age of 18, the procedure can be done with the approval of his/her family or legal guardian. For women under the age of 18 who want to have an abortion, the issue must be reported to legal authorities, even if family approval is obtained. In operations to abort children under the age of 18, if the woman is married, both her family; Approval is also obtained from his/her spouse.

In Which Situations Can Abortion Be Performed?

many reasons for abortion, known as the termination of unwanted pregnancies :

• The idea that the couple is young and does not want to have a child

• Being in a situation where having a child is financially unaffordable

• Partners have doubts about the continuity of the relationship and have different expectations for the future.

• Health problems and risks that can be detected during the baby's development

• Baby's heartbeat stops in the womb

• Abnormal vaginal bleeding during pregnancy

• The expectant mother has an ongoing health problem and pregnancy will negatively affect this process.

• It will pose a danger during pregnancy; However, if there are medications that the mother must use for her health,

• It is important to clean the uterus due to the possibility of a piece remaining in the uterus after the miscarriage, and to avoid risking possible health problems and pregnancy again.

Can an Unmarried Woman Have an Abortion?

Unmarried women can have an abortion with their own consent if they are over 18 years of age . A woman can only request an abortion by applying to a gynecologist at her own discretion and within the appropriate week of pregnancy . For single women, the consent of the expectant father is not required for abortion approval.

Should Married Women Get Their Spouses' Approval for Abortion?

In order for married women to have an abortion, their spouses must also give their consent. If a married woman is over the age of 18, only her husband's and her own consent is sufficient for the abortion procedure. If under 18 years of age, both spouse's consent; The approval of the family is obtained and the situation is also reported to the legal authorities.

Should General or Local Anesthesia be Preferred in the Abortion Procedure?

Abortion is a psychological as well as physical situation. Even if there are valid reasons to terminate the pregnancy , and perhaps in some cases termination of the pregnancy is absolutely necessary, psychological difficulties of this situation may be encountered. Even though it is not seen in every abortion procedure, it can cause traumatic consequences for many women and they may be advised to seek psychological support.

These psychological conditions experienced by the woman have nothing to do with her feeling of pain or suffering during the abortion procedure. In general, the abortion process can be completed painlessly and painlessly . Moreover, the sensation of pain varies from person to person. A pain that one person tolerates easily, another person may not be able to tolerate and may overreact. We evaluate this as the difference in pain threshold .

Abortion with General Anesthesia

If the patient has a low pain threshold, has no previous birth experience, or has given birth by cesarean section , it is recommended to perform an abortion using general anesthesia. In this case, the patient should not consume food or drink for at least 4 hours before the operation.

We state that all examinations and operations regarding abortion and women's health can always be performed by expert gynecologists and that only gynecologists are authorized in these matters . We should also point out that when performing an abortion and applying general anesthesia, the procedure should be performed with an experienced anesthesiologist.

In the abortion procedure performed with general anesthesia, anesthesia is applied by opening a vascular access and the abortion procedure is completed . The procedure takes a short time and the patient remains under anesthesia for approximately 15 minutes.

After the patient recovers from anesthesia, mild dizziness, nausea, and mild balance problems may be observed. These effects are expected and will pass in a short time. Food and beverages can be consumed after an hour.

Although it is not valid for every patient, many women may prefer the general anesthesia method during the abortion procedure in order to avoid psychologically witnessing the procedure.

Abortion with Local Anesthesia

It may be preferred if the patient has previous normal birth experience or has a good tolerance for pain. In this case, the gynecologist who will perform the abortion without the need for an anesthesiologist can perform local anesthesia . An abortion can be performed by providing anesthesia only in the procedure area, without putting the patient to sleep as in general anesthesia .

A little pain may be felt during abortion procedures performed with local anesthesia. Regarding the effectiveness of the drug during local anesthesia, the patient may feel some pain during drug application and after numbness is achieved, there may be a feeling of pressure in the groin during the procedure. This pain can be felt as the cannula advances in the uterine canal. The process is completed in a short time.

The pain that may be felt during the procedure may vary depending on the patient's pain threshold.

local anesthesia or general anesthesia during the abortion procedure by looking at factors such as your age, weight, pain threshold, and having given birth before, and can inform the woman correctly.

In both cases, a follow-up examination should be performed after one week.

How to Get Prepared for Abortion?

Patients who want and decide to have an abortion should consult a Gynecologist and Obstetrician before the abortion to find out the week of pregnancy and location of pregnancy. After the examination, if it is seen that there is no obstacle to the abortion procedure, the timing of the procedure is made. If it is to be performed under general anesthesia, the patient must be hungry and thirsty during the procedure. If the patient is put to sleep with a full stomach, we advise our patients not to eat or drink anything for 4-5 hours before the procedure, as it will cause significant risks for the stomach contents to escape into the lungs. If the procedure will be under local anesthesia , this time can be reduced to 2-3 hours.

Legal processes must be checked before abortion . The age limit should be checked and appropriate procedures should be performed according to the age of the patient. If the patient is married, spousal consent must be obtained.

The blood type information of the couple should be obtained and if it is not known, tests should be requested for this. If there is a blood incompatibility problem between the spouses , blood incompatibility injections should be administered after the abortion to prevent risks that may occur in subsequent pregnancies.

The patient's general health condition should be examined. If there is a history of medication used regularly and an ongoing disease, this information should be taken into consideration during the abortion procedure and the risk group should be determined.

lasting 5 weeks or less, the sac may not be visible or the sac may be very small. The sac may not be visible; However, the BHCG level should be determined numerically. In this case, it may be possible that a piece remains or the baby cannot be removed as a result of the operation. The possibility of a possible ectopic pregnancy should also be kept in mind in patients who do not have a sac but have a positive pregnancy test . Therefore, your doctor should be expected to make the correct timing. In this case, the week of pregnancy should be determined by ultrasound control and, if necessary, a waiting period can be determined to ensure a healthier procedure.

It is important to know the blood type of patients and their partners before pregnancy evacuation, and if they do not know, blood group tests should be performed. Because, in cases where there is a blood incompatibility, that is, where the woman's Rh factor is negative and the man is Rh positive, there is a blood incompatibility situation, and a blood incompatibility injection (Anti-D) is given within 72 hours after the procedure, with the thought that the interaction that will occur in the woman during the abortion procedure may negatively affect subsequent pregnancies. is important.

Although abortion is classified as a minor surgical procedure, it is important for us , gynecologists, to have information about the additional health problems that the patient may have, as it carries many risks that may develop in a surgical procedure. For example, the patient's anemia, liver or kidney diseases, heart disease, thyroid disease, use of blood thinners, negative processes experienced in previous operations are problems that must be known before the procedure in order to minimize the risks, which will lead to serious complications if not known.

How Long Does Abortion Take?

The abortion process takes, on average, 10 minutes. However, in procedures performed while anesthetized, it may take up to 10-15 minutes for the patient to wake up from the effects of anesthesia and regain consciousness. During the abortion procedure, the patient can fully recover and be discharged in roughly 20 minutes.

What are the risks of abortion?

Cleaning the inside of the uterus during an abortion is a process that requires extreme care. Because the remaining tissue pieces that cannot be cleaned sufficiently may cause excessive bleeding, and the uterine wall, which is damaged while trying to clean it, may stick to each other in the future. It can cause the problem we call Asherman Syndrome In women with the syndrome , menstrual bleeding stops and the possibility of becoming pregnant again is extremely reduced, and hysteroscopic surgery is needed to remove adhesions. Therefore, efforts should be made to prevent any fragments from remaining inside the uterus, while also trying not to damage the uterine wall by digging too much.

Another important risk that may occur in curettage is the perforation of the uterus . This situation, which often occurs when the cervix is trying to dilate, causes the uterus to perforate and pass into the abdominal cavity, which can lead to both intra-abdominal bleeding and injury to surrounding organs.

If the curettage is performed without paying attention to surgical sterility or without correcting the existing infection in the woman , it can lead to uterine infection , which causes serious problems that can lead to sepsis . Therefore, it is recommended that abortion procedures be performed in centers that are experienced in this field and pay attention to sterility and hygiene . The problems that may arise in procedures performed by non-experts and in illegal centers, which we call makeshift abortions, are of vital importance and lead to tragedies that almost everyone has heard of.

Rarely, especially in pregnancies less than 6 weeks, it may be possible for the sac to fail to rupture . Therefore, during the control examination, it may be seen that the pregnancy is still continuing and a second procedure may be needed.

Considering all these risks, abortion should be the last surgical method preferred as much as possible, and care should be taken not to postpone the application of family planning methods in order to avoid unwanted pregnancies. It should not be forgotten that curettage is not a family planning method.

What is the Post-Abortion Process?

Abortion is usually performed as a day surgery and the patient can be sent home within 1-2 hours after the procedure. On that day, the patient is expected to have groin pain that responds to painkillers, and then the pain and the need for painkillers decrease and stop. Patients usually have a small amount of bleeding that lasts 1 week or 10 days, but it is also considered normal to have no bleeding.

The patient can return to daily life and work the next day. If he wants, he can do sports and travel. However, entering the pool, spa or having sexual intercourse before bleeding ends is not recommended as it may increase the risk of infection .

What Medications Should Be Used After Abortion?

Medication use after abortion may vary depending on the physician's decision. Most of the time, patients are given painkillers, anticipating that they may have pain after the procedure. Since it is an external intervention into the uterus, antibiotics are among the frequently prescribed medications. Which antibiotic will be used after the abortion should be taken into account, taking into account the patient's previous drug reactions and genital Antibiotics that are effective against infections are preferred.

Who Gets Blood Incompatibility Injection After Abortion?

Since the baby's blood cells begin to form in pregnancies past the 6th week, if the mother's blood type is Rh negative and the father's blood type is Rh positive, it is beneficial to take a blood incompatibility injection (Anti D) to avoid problems in subsequent pregnancies. It is recommended to do it within 72 hours after the procedure.

How Does Bleeding Happen After Abortion?

Patients usually have a small amount of bleeding that lasts 1 week or 10 days, but it is also considered normal to have no bleeding. The amount of bleeding is also related to the size of the gestational age. Generally, bleeding is expected to be less in younger weeks of pregnancy.

When Will You Get Your Period Again After Abortion?

A woman who has had an abortion returns to her previous hormonal balance when pregnancy hormones begin to be withdrawn from the blood. This means that the body prepares the uterus for the new menstrual cycle , which can take about 5-6 weeks . Therefore, it may take up to 5-6 weeks for the patient to menstruate after the procedure, but sometimes this period may take longer in patients whose hormonal cycle has been previously disturbed.

After an abortion, bleeding occurs within 1-2 weeks. However, this bleeding is not menstrual bleeding, but post-abortion bleeding due to abortion . The first ovulation after abortion may occur approximately 15 days after the end of this bleeding, and the first menstrual bleeding may occur approximately 15 days later. In this case, a new menstrual cycle will begin approximately 4-6 weeks after the abortion and continue accordingly.

How Long After Abortion Can You Get Pregnant Again?

Since hormones return to normal shortly after the procedure, it should be known that pregnancy can occur even in the month of the procedure, and therefore patients are advised to decide which birth control method to use after the procedure. However, if pregnancy is planned again in a short time, protection can be stopped 1 month after the abortion.

Is it necessary to have an abortion after miscarriage?

Miscarriage is defined in two ways: complete miscarriage and incomplete miscarriage. This distinction can be determined by an examination by your gynecologist . In case of complete miscarriage, there is no need for further abortion. However, in case of an incomplete miscarriage, an abortion must be performed as the remaining pieces inside may cause health problems.

It is normal for there to be some bleeding after a miscarriage. The general course of bleeding is such that it decreases day by day. However, in incomplete miscarriage, bleeding may be severe. In this case, after the examination, curettage should be performed and the uterus should be completely cleaned .

In case of incomplete miscarriage, it can be checked whether the miscarriage is complete or not by following the patient's course without having an abortion. However, since this process may take a long time for the woman due to bleeding and infection, abortion is recommended.

Is it possible to end the pregnancy with medication?

There are drugs whose main purpose is not to cause miscarriage, but are used to dilate the cervix and cause a miscarriage. However, the use of these drugs will not provide a definitive solution to miscarriage, nor can we talk about a healthy abortion procedure . Moreover, even if the medication causes a miscarriage, there may be a need for a repeat abortion as there is a high probability of parts remaining in the uterus.Also these medications can not be find in the pharmacies they can only be supplied form the hospitals

That's why we always recommend that you get all the information about abortion and unwanted, unplanned pregnancies from your doctor and decide on the procedure in line with their guidance.

Is it true that you cannot get pregnant again if you have an abortion?

Although this information is not completely accurate, it also carries some risks. Whether a person will become pregnant or not is a process that concerns both herself and her partner , and factors such as the woman's age, health history, past miscarriage-pregnancy history, and lifestyle also play an important role in pregnancy. Having an abortion does not constitute an obstacle to a new pregnancy. Especially in today's conditions, much more comfortable environments can be provided and abortion procedures can be performed compared to the past. Of course, while giving this information, let us underline again that abortion can only be performed by a specialist gynecologist.

Is it possible to encounter a situation where the baby cannot be removed during an abortion?

For the abortion procedure, your gynecologist will first examine you. During this examination, the baby's week of life will be determined, and the sac will also be visible during the ultrasound examination. In pregnancies earlier than 5 weeks, the sac may sometimes not be visible on ultrasound , and in this case, your doctor can tell you a more suitable date for abortion. Abortion in pregnancies less than 6 weeks It is also called regulation , and since thinner instruments are used in these pregnancies , a 2.3% chance of the gestational sac not being disrupted may occur . Yes, it may be possible for the pregnancy not to be terminated and to continue in abortions performed by unauthorized persons other than the guidance of a specialist physician.

Is there any harm in having a large number of abortions?

Unwanted pregnancies can be terminated for personal or physical reasons; However, using abortion as a birth control method would not be the right approach. Spouses or partners who have an active sexual life can decide on the birth control methods suitable for them by consulting with their physicians and thus prevent unwanted pregnancies . Abortion is a process that is experienced psychologically as well as physically. It is not recommended for doctors to engage in this mental state many times, and it may also have negative consequences for women's health. There is also the possibility of damage to the uterus in frequent and frequent abortions.

When can you have sexual intercourse after an abortion?

The process should be followed meticulously for a few weeks to avoid the risk of infection after the abortion procedure . Of course, although it is a situation that can be answered depending on women's health, it is not recommended to have sexual intercourse for 10-15 days after the abortion in order to avoid infection problems.

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Any kind of intercourse without coontraception is risky!

For a woman who has all the medical qualifications required for pregnancy, the monthly probability of becoming pregnant in unprotected intercourse reaches 50%. Effective protection is not possible as a result of malfunctions in the intrauterine protection device, condoms or birth control pills. Situations such as slipping of the spiral in the uterus, breaking of the condom and not taking the birth control pill are also included in the scope of unprotected intercourse. Since women who have unprotected intercourse have a higher risk of becoming pregnant, some precautions must be taken before intercourse. However, it is useful to be careful when taking these precautions. Because medications such as morning-after pills or menstrual stimulants taken after unprotected intercourse can cause serious problems such as ectopic pregnancy. Progesterone- derived drugs, known as menstrual stimulants , have a feature that supports the pregnancy process, in addition to preventing ectopic pregnancy problems. Therefore, although it is known among the public as a pregnancy preventer, this is very wrong. In addition, morning-after pills have the same effects as birth control pills taken in high doses and all at once. In addition to ectopic pregnancy, it can also cause problems such as menstrual irregularity.

Contraseptive Methods

There are many different methods of protection. These are control methods that can be applied by both women and men. They can be listed as pills, mini pills, monthly injections, quarterly injections, subcutaneous capsules, condoms, diaphragms, female condoms, spermicides , tubal ligation and vasectomy . There are also some natural prevention methods. However, these are not as effective as medical, surgical and instrumental protection methods. These can be listed as methods based on fertility signs, protection through breastfeeding, withdrawal and ejaculation.

Pill/Mini Pill
Effectiveness Rate: 99% Protection Against Diseases: Does not protect

Monthly Injection
Effectiveness Rate: 99% Protection Against Diseases: Does not protect

Three-Month Injection
Effectiveness Rate: 99% Protection Against Diseases: Does Not Protect

Subcutaneous Implants
Effectiveness Rate: 99% Protection Against Diseases: Does not protect

Condom
Effectiveness Rate: 70-80% Protection Against Diseases: Protects

Spiral
Effectiveness Rate: 98% Protection Against Diseases: Does not protect. It increases the risk of infection.

Spermicide
Effectiveness Rate: 91% Protection Against Diseases: Protects Against Some Diseases

Diaphragm
Effectiveness Rate: 94% Protection Against Diseases: Protects Against Some Diseases

Withdrawal
Effect Rate: 60% Protection Against Diseases: Does not protect

Calendar Method
Effectiveness Rate: 75% Protection Against Diseases: Does not protect

Tubal ligation
Effectiveness Rate: 99.8% Protection Against Diseases: Does not protect

Vasectomy
Effectiveness Rate: 99.8% Protection Against Diseases: Does not protect