|The Royal Women’s Hospital believes that all women have the right to accurate and non-judgmental support and information when they are facing an unplanned or unwanted pregnancy.|
|We believe that women have the right to choose the option which is best for their individual circumstances. This may include:|
- continuing the pregnancy to have and care for the child
- to consider adoption or another care arrangement
- having an abortion.
What you can expect from services at the Women’s
Counselling, discussion and support
|You may or may not be clear about what you want to do, or you may want more information and the chance to discuss your situation further. Pregnancy Advisory Service (PAS) counsellors are available to discuss all your options with you in a nonjudgmental way. The aim is to support you to do what you want to do. PAS counsellors will not attempt to talk you into any decision.|
Confidentiality and privacy
|All services at the Women’s must protect your confidentiality. Staff cannot disclose any information about you to others unless you agree and consent to it.|
|The Women’s has a charter of patient rights, which describes our commitment to providing patients with caring, professional and respectful support and care.|
Age and consent
|If you are under 16 years of age, it is generally necessary for a parent or guardian to give consent for you to have surgery. However, if you have any concerns about this, please let us know so we can discuss this with you and help you consider all your options.|
Cultural and linguistic diversity
|Interpreters are available free of charge to assist any woman using the public hospital system.|
The Women’s understands that women from different cultures have diverse needs and beliefs about abortion and we strive to be sensitive and responsive to these.
Individual needs and access
|PAS wants to ensure that women who have special or individual needs have access to our services and support in using our services. Please let staff know if there are particular issues for you such as a disability, health issues, problems in your life or circumstances, or difficulties like having to travel a long way.|
Confirming you are pregnant
|If you are not sure if you are pregnant there are a number of places where you can have a pregnancy test including:|
- the Women’s Health Information Centre at the Women’s (free of charge if you have a Medicare card) 9.00am–4.30pm Monday to Friday
- a GP
- a women’s health service.
|If you would like further information or to discuss any of these issues, please telephone PAS on (03) 8345 3063.|
Having an abortion at the Women’s
|If you wish to have an abortion at the Women’s, appointments are available through the public hospital system, or through private consultations with doctors who work at the Women’s. For both public and private appointments please telephone PAS on (03) 8345 3063.|
If you attend the clinic or the private doctors’ rooms, please bring:
- letter or referral from your doctor which confirms your pregnancy
- Medicare Card or number and Health Care Card if applicable
- blood group card, if you have one.
|Your visit at the public clinic may take several hours and you will need to allow sufficient time for this. If you are running late or cannot attend your public or private appointment, please telephone our service or telephone the rooms of the doctor you were to attend as soon as possible.|
|When you see the doctor you will be examined to safely plan for your abortion and decide on the method. This check-up will usually include an internal vaginal examination and blood tests. After the examination and further discussion, a decision will made regarding an abortion.|
The different options will be discussed in full during your consultations, so you can make an informed choice.
Your abortion will usually take place within a few days after your first visit with the doctor.
The doctor or nurse will also talk with you about contraception and follow up appointments.
Types of abortion
|There are two types of abortion, surgical and medication abortion. Medication abortion (using tablets) may be an option at the Women’s depending on medical factors, your choice and available bookings.|
|Abortion using medication|
|There are medications available to bring about an abortion. In most cases you would need to be between about 5 and 9 weeks pregnant. There are some exceptions to this but only where it is recommended by a doctor. An abortion using medication is done under supervision at the hospital.|
An abortion using medication takes place over three days. You take one tablet (on day one) and then return to the hospital two days later for further medication. After this, the abortion will usually happen within four to eight hours. As the abortion happens you will usually have crampy pains and bleeding which is heavier than a normal period.
You will be asked to return to the hospital in one to two weeks after the abortion. Follow up is very important because sometimes, though it is rare, the abortion will not succeed. Up to one in twenty women (or 5 out of 100) may need a curette afterwards for this reason or because of ongoing pain and bleeding due to retained pregnancy tissue.
|Things to consider about medication abortion|
- Some women feel this is a more natural approach and feel more in control of the situation.
- Some women may be concerned when the bleeding gets heavier, especially if they pass blood clots, or even a recognisable embryo.
- Although excessive bleeding and the need for a blood transfusion are very rare, they are slightly more common with a medical abortion than with surgery.
- With surgical abortion there are risks, both with the surgery and with general anaesthetic. Though these are rare, a medical abortion means they can be avoided.
- The medication has side effects, which usually ease off after a few hours, but can be unpleasant for some women. These include nausea, vomiting, diarrhoea, fever and chills. The tablets can be swallowed or dissolved under the tongue or they can be placed inside the vagina which may reduce side effects. This will all depend on your individual circumstances.
- Most women will stay in hospital for a few hours after the medication is given to wait for the pregnancy to pass.
- A few women still need to have surgery, sometimes urgently, if they develop infection, bleed heavily or if the pregnancy does not pass.
- If you are breastfeeding you will need to stop until the treatment is complete.
|Most women have a surgical abortion between weeks 7–12 of pregnancy (calculated from the first day of your last menstrual period or measured by ultrasound). The operation usually involves the use of a suction curette and in most cases is done under general anaesthetic.|
After 12 weeks, the procedure is a little more demanding physically and, for some women, emotionally. If you are unsure of the gestation, or you are over 12 weeks pregnant, our service will discuss the various options with you.
|Things to consider about surgical treatment|
|The risk of a curette are very low, but include:|
- a risk that the surgery has not removed all of the pregnancy. This can cause prolonged or heavy bleeding and occasionally the operation may need to be repeated. This will happen in up to one in fifty women (or 2 out of 100).
- infection needing antibiotics:some studies suggest this is more common after a surgical abortion than a medical abortion, while others suggest the rates are similar.
- a risk that the cervix or uterus is damaged during surgery. This is very rare (1 in 1000) and, when it does happen, it is usually a small hole or tear which will heal itself.
- excessive bleeding. This is very rare; in a few cases (1–2 in 1000) a blood transfusion will be needed.
- anaesthetic risks. These are very low for healthy women, but no anaesthetic or operation is without risk.