Surgical Abortion

Casebank Counselling
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Data gathering
PC? Scheduled Abortion?

  • Explore? Preg?
  • Weeks? Planned? Scan!
  • Partner?

Closed Q? DD/Red F

  • Symptoms? Pain? Bleeding? N.V
  • Other Options? Medical?

General Q?

  • РМН? Preg? TOP?
  • Med? Contraception?
  • Family? Supp/Aware

Impact on Life

  • Partner/ Family
  • ICE

Examination

  • Vitals - MSU

Investigations

  • FBC, Clotting etc

Counselling

  1. Benefits

    • Effective; Simple, 15mins,
    • Recovery 30mins
    • Can have PCM/NSAIDS prior

  2. Risks

    • Bleeding, Infection, Injury
    • incomplete evacuation, failure

  3. Post Op Care

    • Needs Contraception
    • Avoid Sex for a week
    • May experine period like 1W

  4. Leaflet/ FU

    • If >1 week
    • If delayed Period 6 weeks
    • Condoms

M A V (Manual Vacuum Aspiration)

  • A surgical procedure of Womb evacuation done under local anaesthetic, numbing agent on neck of womb; awake; no pain; small vaccum tube, to remove products of conception; 15 mins
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8 week pregnant, abortion clinic appointment done, don’t discuss about legality here, as she already has appointment

P: I want to know about Surgical abortion.

Let me ask you how many weeks are you along the pregnancy?
What’s the reason why you going for abotion? Pt- it was unplanned
Do you know how abortion is done?
What do you know about abortion?
What information you are looking for?
Are you concerned about anything?
Is there anything in particular you are looking for?

  1. Obstetric Hx: children? Any termination? Any miscarriages? Do you have any children?
    any procedure done in your tummy?
  2. Period Hx:
  3. General Health:
  4. Social Hx: do you have family over here? Does your family aware? How is your financial situation? Any other reason? Any cultural reason? What do you do for living?

Explain surgical abortion

  1. Preparation-not much preparation required, same day procedure, no fasting required
  2. Local anaesthesia- numbing agent gel on the opening of wound and inject
  3. Procedure- Type1: MVA manual vaccum aspiration, suck out all the pregnancy product with the tube, 15 minutes, Type 2: sometime D&C- rod to dilate, curates to remove the products, wait for some time and then go home
  4. After care- pain killers, normal bleeding, we’ll provide complication information on abnormal bleeding & infection, ask to rest 24 hours, resume normal activity when you feel comfortable- exercise sex work, contraception as you’ll be fertile, after procedure feel relieved but some feel sad guilty we can offer post abortion counselling

Will this affect my future pregnancy? If rx not complicate It should not affect.

Will we be supported? Yes, medical and psychological NUPAS , telephonic support helpline

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Please add mife 24-48hrs before procedure to initiate softening and dilatation and miso 3-4 hrs before procedure to enhance its effects.

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Support groups like Marie Stopes UK,BPAS

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