Faq

A surgical abortion involves an experienced doctor removing the pregnancy through the vagina using a procedure called vacuum aspiration (a suction method) or dilation and evacuation (D&E).

The procedure for a surgical abortion is different in different gestations (how many weeks you have been pregnant). We may offer the procedure with or without anesthesia, and your choice will be discussed during your consultation.

The instruments used can be plastic or metal with rounded edges. You may be given antibiotics to lower your risk of infection.

In CMA, surgical abortion is available up to 22 weeks + 6 days pregnant.

Read our surgical abortion page for more details on the procedure.

The procedure for a surgical abortion may differ depending on how many weeks you have been pregnant. However, no matter how far along you are in your pregnancy, surgical abortion is a very safe and quick procedure.

Prior to your treatment, our receptionist will review your notes to make sure all the details are complete. If you have not already had an ultrasound or blood work done, this will be completed prior to your admission for treatment, if applicable.

Most people who miscarry with CMA will be able to receive NHS funded treatment, however, if you are not eligible for this, we will pay for your treatment prior to your admission. Unfortunately, we will not be able to proceed with treatment without payment; please read our fees page to see the cost of each procedure and the types of payment we accept.

Our doctors will review your notes and make sure you are medically fit for the procedure, and then once everything is ready for you, you will be taken to the pre-treatment waiting room. If you have any questions or need information about what happens to your pregnancy after the abortion, one of our nurses will be available to answer them.

Depending on how many weeks pregnant you are, you will receive one of the following types of procedures. This will be explained to you during your appointment, where you will have the opportunity to ask any other questions you may have:

Before 12 weeks of pregnancy

The pregnancy is removed from the uterus by vacuum aspiration (this involves a suction method), which is used to remove the pregnancy through the cervix (neck of the womb) and vagina.

This is a very quick and simple 5 to 10 minute procedure.

If you are less than 10 weeks pregnant, you may choose not to receive any anesthesia. General anesthesia is not needed before 12 weeks of pregnancy, but we can offer sedation.

12-18 weeks + 6 daysí6 days of pregnancy

In this range of gestation, we may need to dilate (gently open) the cervix. A medication is placed in the mouth between the cheek and gums or placed in the vagina to dissolve. This causes the cervix to dilate (gently open) for a few hours. You will wait in the center during this time.

Between 12 and 14 weeks gestation, a suction method is used to remove the pregnancy through the cervix and vagina. This procedure is done under short-acting sedation.

Between 14 and 18 weeks gestation, specialized thin instruments will be used to dilate (gently open) the cervix and remove the pregnancy. This procedure is called dilation and evacuation (D&E). It is done under general anesthesia. The procedure takes 10-15 minutes, but you will be in the center for half a day.

In very rare cases, the medications used for cervical preparation may cause the pregnancy to be expelled. If at any time you begin to experience severe cramping, heavy bleeding, or the need to push, let one of our team members know immediately.

19 – 22 weeks + 6 daysídays of pregnancy

In this gestational range, treatment is done in two separate stages. You will be asked to arrive at the center early in the morning for the first stage, which involves preparation of the cervix (neck of the uterus). A medication is placed in the cervix at the top of the vagina to cause the cervix to dilate (gently open) for 4 to 6 hours. You will wait in the center during this time.

To complete the procedure, the second stage will take place later that day. You will be given general anesthesia. The cervix is opened further and the pregnancy is removed through the cervix and vagina using specialized thin instruments and suction. This procedure is called dilation and evacuation (D&E).

The procedure takes 10-20 minutes, but you will be in the center all day.

In very rare cases, the medications used for cervical preparation may cause the pregnancy to be expelled. If at any time you begin to experience severe cramping, heavy bleeding, or the need to push, let one of our team members know immediately.

If you have made an appointment to have a surgical abortion, read ‘How should I prepare for my abortion? For more information.

Most women will recover from a surgical abortion very quickly and can return to work in a few days. After surgical treatment of abortion, it is normal to experience:

• Bleeding: This may start immediately or up to 72 hours after the procedure. Bleeding may be more intense than a normal period, with small clots, but it is not a pear it can last up to 1-2 weeks.
• Pain: Cramp pain is normal after the procedure as the uterus contracts to its normal size. Cramps can be constant or intermittent, and it is not unusual to continue cramping for the first 2 weeks after treatment.

If you have had a procedure that uses cervical preparation medications, you may experience side effects such as:

• Nausea
• Diarrhea
• Chills or mild fever.
• Colic-type pain
• Bleeding: If you start bleeding after cervical preparation, tell one of our nurses right away so we can evaluate it.

We’ll give you advice on pain relief, such as acetaminophen or codeine. These pain medications will not interfere with any abortion medications, however, do not take aspirin as it may increase bleeding. Do not take ibuprofen until 12 to 18 hours after your procedure.

If you have any concerns about any pain or symptoms you experience after your abortion, you can call our post-934529930 care line at any time, day or night, to speak with a nurse.

For tips on recovery after an abortion, read our Post Abortion Care page.

We will do our best to make sure you feel comfortable before, during and after your procedure.

If you have general anesthesia, you will not feel pain during the surgical part of the procedure, as you will be completely asleep. If you are more than 14 weeks pregnant, you may be given some medications to help dilate your cervix and this can cause some cramps.

If you have sedation, you may feel some discomfort and pain in your lower abdomen as your uterus (womb) contracts at the end of the procedure. If you have sedation, you will also be given a pain reliever.

If you don’t have anesthesia, you’re likely to experience some pain, but you won’t have the side effects of medications used for sedation. If you do not have sedation or general anesthesia, you can take 400 mg of ibuprofen and/or 1 gram of acetaminophen one hour before your appointment. Tell the nurse upon arrival of any medicines you have taken. Do not take aspirin as this may increase bleeding.

For 2 weeks after the procedure, you may experience constant or intermittent cramping pain in your abdomen as your uterus contracts and returns to its normal size. We’ll give you pain relief tips, such as acetaminophen, codeine, or ibuprofen. These pain medications will not interfere with any abortion medications.

If you are concerned about the level of pain you are experiencing, or if your pain is not controlled with pain relievers, call our 24-hour back-care line at 934529930, go to an A&E department or consult your family doctor.

We offer three anesthesia options during the surgical abortion procedure. During your consultation, we can discuss which option would be recommended, given your unique circumstances and medical history.

No anesthesia

This is appropriate for clients who are less than 10 weeks pregnant, especially if you have delivered vaginally in the past. You may take ibuprofen and acetaminophen prior to the procedure. Some people should avoid using ibuprofen and others should use it with caution. Do not take aspirin because it may increase bleeding. You will be in the treatment room for about 10 minutes. The procedure is uncomfortable, but usually only lasts a short time. You will feel severe cramping pains that will pass when the procedure is over. Our nurses will stay with you and keep you distracted. We will give you a heating pad and other pain relief afterwards.

Benefits of no anesthesia include:

• Avoid the risks associated with anesthesia.
• Be able to eat and drink before the procedure.
• Faster recovery time
• Be able to drive home.

Sedationóanesthesia or general anesthesia

With both types of anesthesia, you are not likely to remember the procedure. Both involve giving the same types of medicines through a needle or cannula (small tube) into a vein, usually on the back of the hand. The amount of medication given is unique to each person’s needs. Our anesthesiologist will be with you at all times during this procedure.

If you have anesthesia, you will need to fast before your appointment. This means no food or drink for a few hours in preparation. Read “How should I prepare for my abortion” for details on when you should stop eating and what you can drink before your appointment.

Sedation anesthesia (usually for less than 14 weeks gestation): You are given a lower dose of medication, resulting in severe drowsiness or unconsciousness for the short duration of the procedure and a quicker recovery. You will maintain control over your breathing and reflexes, but you may not remember the procedure.

General anesthesia (usually for less than 22 weeks and 6days gestation)-You will be given a higher dose of medicine, resulting in a more profound loss of consciousness for a longer time. It will take a little longer for you to recover. You may not have control over your breathing and reflexes, so we may give you oxygen and help you breathe through a mask or a plastic tube in your throat. Anesthetic risks and complications (below) increase as the level of anesthesia increases.

Side effects of anesthesiaéside effects of anesthesia

• Drowsiness-You should not drive, sign important documents (such as contracts), or operate heavy machinery for 24 hours after the procedure. Some auto insurance policies specify that you should not drive for 48 hours after an anesthesia procedure, so check with your insurance provider.
• Nausea and vomiting-Inform your doctor or nurse if you feel nauseous, as we can give you medication to help.
• Heightened emotions – For some clients, this means that they may feel a variety of emotions after treatment. A nurse will be available to help and this feeling usually passes after 10-20 minutes.
• Bruising: You may develop some bruising and soreness when the cannula has been inserted into the vein. The bruising usually resolves within a week.
• Pain: You may experience a cold or aching sensation in the vein during the anesthetic injection. This resolves quickly and is not harmful. Sometimes you may feel pain in the vein after the procedure, which subsides after a few hours.

Possible Complications and Risks of Anesthesia

• Adverse drug reaction-Reactions to anesthesia medications are rare. They can range from mild (rash) to severe (anaphylaxis). The anesthesiologist will evaluate and treat any adverse drug reaction.
• Airway Difficulty: Spasm of the airway or vomiting during the procedure are rare complications. The anesthesiologist will monitor you during the procedure and treat any complications if they occur. However, if the anesthesiologist is concerned that vomit has entered the lungs, you will be transferred to a hospital service.
• Prolonged recovery: Most clients are fully awake, relatively comfortable and almost back to themselves within 30-60 minutes after waking up. On rare occasions, due to dehydration, recreational drug use, or other co-existing health problems, it may take longer to return to normal. We will not discharge you from our care until we are certain that you have fully recovered, are able to walk independently, and that your pain is well controlled. If you do not begin to feel like yourself within a normal period of time, or if you have persistent pain, this may be a sign that you need more attention to recover and we may transfer you to a more advanced care setting, such as a hospital.
• Difficulty or failure to obtain intravenous (IV) access: This is where the anesthesiologist has difficulty inserting the needle/cannula into the vein. It can be affected by the size and depth of the veins or dehydration. This is rare, but if it happens, it may mean that your treatment cannot continue today.

Keep in mind that anesthesia will not be right for everyone. During your consultation, we will discuss your medical history to ensure that the option is safe for you. We will take further advice as necessary to ensure that you are offered the safest option.

Side effects of surgical abortion are common, but short-lived. Any side effects you experience will depend on your procedure and anesthetic choice, and may include:

• Bleeding: This may start immediately or up to 72 hours after the procedure. Bleeding may be more intense than a normal period, with small clots, but it is not a pear it can last up to 1-2 weeks.
• Pain: Cramp pain is normal after the procedure as the uterus contracts to its normal size.

Side effects of cervical preparation medication (if necessary):

• Nausea
• Diarrhea
• Chills or mild fever.
• Colic-type pain
• Bleeding: If you start bleeding after cervical preparation, tell one of our nurses right away so we can evaluate it.

If you have any concerns about any pain or symptoms you experience after your abortion, you can call our post-93 452 99 30 care line at any time, day or night, to speak with a nurse.

Surgical abortion is a very safe procedure (many times safer than childbirth), but as with any medical procedure, it is not without potential complications or risks:

Infection: rare (affects less than 1 in 100 people)

It can be reduced by following our aftercare tips. If an infection is left untreated, it can lead to serious problems and infertility. If you have symptoms of pelvic inflammatory disease (PID), such as unusual vaginal discharge, fever, or lower abdominal pain and discomfort, you should seek urgent medical attention. See your family doctor or visit your Primary Care Center.

Retained Tissue (retained products of conception): commonretained tissue (retained products of conception): commonúretained tissue (retained products of conception): common (affects fewer than 5 out of 100 people)

This is where part of the pregnancy is not removed from the uterus, or a blood clot forms in the uterus after the procedure. Retained tissue, products, or clots will sometimes pass spontaneously, or may require additional treatment (medication or another surgical procedure similar to a surgical abortion).

Heavy bleeding (hemorrhage): rare (affects 1-4 in 1000 people)

This may happen during the procedure, immediately after, or up to 10 days after you have returned home. It may be associated with having had previous pregnancies, previous cesarean sections, and older age.

Perforation of the úperforation of the uterus: rare (affects fewer than 5 in 1000 people)

This is the risk that the instruments will puncture or rupture the uterus, bladder, or bowel. The risk increases at higher gestations. If we find this has happened, we will transfer you to a hospital.

Cervical damage: rare (affects less than 5 in 1000 people)cervical damage: rare (1 in 100 people)

This may happen during the surgical procedure. If this happens, the surgeon will make a decision about whether to repair the damage or transfer you to an NHS hospital.

Treatment failure (continuation of pregnancy)-rare (1 in 100 people)

This means that the pregnancy continues to develop, even after the procedure. Further treatment, such as medical (misoprostol) or surgical treatment, will be discussed. Transfer to another service can also be made if the pregnancy continues. We recommend a pregnancy test 3 weeks after treatment (any earlier test is not reliable).

Thrombosis (coáthrombosis (blood clots in the legs or lungs)

This is a risk of being pregnant and a risk of any surgery. There is also a risk of thrombosis with air travel. The risk increases with higher gestation.

Serious complications have warning signs. If you experience any of the symptoms below, call us immediately:

• Abdominal pain or discomfort that is not relieved by pain relievers or a tea pad
• Vaginal discharge that smells unpleasant.
• Feeling hot and chilly with a high temperature of 38° C or more
• Feeling generally unwell.
• Very heavy bleeding that soaks more than 2 pads (suitable for heavy flow) per hour.
• If you bleed a lot during or immediately after your treatment, we can often manage this on site, but may transfer you to a hospital.

Sepsis can be caused by an infection anywhere in the body. Sepsis after an abortion is rare, but very serious. The symptoms of sepsis can be like having the flu at first. If you develop any of the following signs, it is important to seek urgent medical advice:

• Feeling dizzy or faint.
• Confusion
• Slurred speech
• Extreme chills
• Severe muscle pain
• Being unable to urinate
• Severe dyspnea
• Loss of consciousness
• Cool, clammy, and pale or blotchy skin.

If you have any concerns about any pain or symptoms you experience after your abortion, you can call our aftercare line on 93 452 99 30 at any time, day or night, to speak to a nurse.

If you do not have any special requests, we always make sure that all fetal tissue is handled and disposed of in a respectful and professional manner. We also follow all relevant legislation in Spain, including the Human Tissues Act, which has a clinical framework for the storage and removal of fetal tissue.