Women’s Health and Family Planning 

Abortion (Uterine Evacuation)

 2013-12-24

Abortion or uterine evacuation is the termination of an unplanned pregnancy with special methods. Abortion is not a birth control method.

Abortion is the most tangible example of the failure of birth control methods.

Abortion can be applied both under local anesthesia and general anesthesia. The general anesthesia is a contemporary way preferred so that the procedure can be done completely free of pain.

Abortion can be applied legally up to 10. gestational week. In case the pregnancy is medically unfavorable, this period can exceed 10 weeks. These cases are the diseases that can threaten the health of the expectant mother and the pregnancy is risky. Another important case is that it has been determined that the baby is disabled or died and in this case, it is inevitable to terminate the pregnancy in the later phases.

Firstly, the gestational week is determined by ultrasound; a very careful examination is made. If the application will be made under general anesthesia, the necessary procedures are started by the anesthetist. Abortion preparations start after you sleep. Then the inside of the uterus is evacuated with a special vacuum system applied by using very thin plastic cannulas.

The abortion procedure is a surgical operation. It is essential to keep big or small complication risk in mind in all of the surgical interventions.

  • The abortion procedure bears an infection risk just like every surgical intervention.
  • Sometimes the cervix is completely closed. The abortion can be done after applying a special medicine to loose the cervix.
  • Rarely, under local anesthesia, there might be an allergy against the local anesthetic substance and vasovagal syncope (fainting due to the tool attached in order to stabilize the uterus). It is temporary.
  • If the pregnancy is big, there might be excessive bleeding during the procedure.
  • If the pregnancy is too small, the abortion might be unsuccessful. In this case, it might be postponed to one week later by determining the most suitable period.
  • The cohesiveness developing as a consequence of the inner layer of the uterus being damaged is a rare complication (Asherman syndrome). It is rarely seen in regular evacuations and especially in the procedures done with vacuum. Asherman syndrome is treated with hysteroscopy by opening the cohesiveness.
  • In very rare cases, the uterus can be punctured during the procedure if the suitable measures are not taken.

You should also talk about protection methods with your doctor before the abortion. It will be forbidden to have intercourse for two weeks after the procedure. However, if any birth control method will be used, for example you may start using contraceptive pills the next day and the monthly injection right after the procedure. And the coil (IUD = Intrauterine Device) may be placed during the procedure. You should talk with your doctor for which one of these options is suitable for you.

It is rarely seen that the pregnancy continues. The abortion is unsuccessful and the pregnancy continues just like before the procedure. This can happen when the gestational sac is too small yet. In fact, an experienced physician considers this possibility when the material coming from the uterus is not much during the abortion and immediately warns you. The result of the procedure can be evaluated by checking the uterus with ultrasound during the procedure.

Another rare complication is the uterus being punctured. This is experienced generally in abortions at the late phases of pregnancy. When there is a puncture, the possibility to bleed is observed with tension and pulse being closely followed. If nearby organs (bowels) are punctured during the puncture a surgery is needed.

If bleeding, having material coming out from the vagina, excessive pain, fever are seen, you should immediately contact your doctor.