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ABORTIONS TO 12 WEEKS

Abortion Services / ABORTIONS TO 12 WEEKS

You probably have many questions regarding a first trimester abortion. This information is designed to answer many of those questions. Please read the information carefully and if you have questions feel free to call our office at 1-800-370-0049.

When you come to our office for a first trimester procedure, we will try to make your stay with us as comfortable and as brief as possible. You can expect to be in our office for 2-3 hours.

Prior to coming to the office we will explain to you the pre-operative instructions.

During your visit you will:

  1. Complete a self medical history and sign consent forms.
  2. Leave a urine sample for a pregnancy test.
  3. Meet with an intake counselor to discuss medical history forms and payment options.
  4. Have a simple blood test by finger stick.
  5. Meet with a patient educator who will discuss; the procedure, possible complications, necessary aftercare (Post Operative Instructions) and birth control options.
  6. See the doctor for an examination and the abortion procedure.
  7. Be observed for a brief recovery period with the recovery area staff.

There are some laboratory tests which we will need to perform. For these tests we will need samples of your urine and blood. We will use your urine sample to perform a pregnancy test and we use your blood sample to check your iron count and Rh factor.

If your blood is found to be Rh negative (e.g. , O negative, A negative) you will need an injection of Rhogam after your abortion. Rhogam prevents antibodies from being formed in your blood that would cause problems with future pregnancies. If you are Rh negative, it is important that you receive a Rhogam injection with every pregnancy. Please note that there is an additional fee for all Rhogam injections.

A sonogram is considered the most reliable method of assessing how far you are into your pregnancy. A sonogram is a test that uses sound waves to see your pelvic structures. It is not an X-ray and there is no radiation. A sonogram is done while you lie down comfortably. A gel solution is applied to your abdomen and an ultrasound wand is placed on your abdomen. There is little or no discomfort while the sonogram is being performed.

It is proper clinical practice to determine the length of pregnancy based on your last menstrual period and not on the actual date of conception. Therefore, if you think you conceived 8 weeks ago, your last menstrual period was probably 10 weeks ago and you would be considered 10 weeks pregnant. Any abortion performed up to 12 weeks of pregnancy is, by definition, a first trimester procedure. If your ultrasound evaluation reveals that you are over 12 weeks of pregnancy, the procedure becomes a second trimester procedure.

You will meet with our patient educator who will go over the abortion procedure, explain how to take care of yourself afterwards and answer any questions you may have about your visit. This is the time to talk about your decision to terminate the pregnancy and any emotional or physical concerns that you might have. Legally, we must obtain your written consent for the abortion. The patient educator will obtain your consent at this time. Please be assured that we will not perform an abortion on any woman if she does not want one, regardless of age.

The patient educator will also discuss birth control options with you. If you choose, she will provide you with a method to use following the abortion. She will also schedule your follow-up appointment.

We offer you the opportunity to select the type of anesthesia that is right for you. You can choose to be awake or asleep for the procedure. Your anesthesia options are described in more detail below.

Local Anesthesia — Local anesthesia involves the injection by the physician of pain-stopping medication into your cervix . You will be fully awake during the procedure, but your cervix will be numbed. You can expect to have moderate cramping during the procedure.

General Anesthesia — General anesthesia is administered by injecting medication into your vein. This medication will allow you to sleep for the duration of the procedure. The medication is given by a Certified Registered Nurse Anesthetist (CRNA) who is specially trained in anesthesia. General Anesthesia is not available at all locations. If you choose this option, we will refer you to a location where general anesthesia is provided.

I.V. Sedation – Intravenous (I.V.) sedation provides a tranquil effect and helps to relieve the anxiety that women who undergo an abortion sometimes experience.

Before the anesthesia of choice is administered, the physician will perform an exam to determine the position of your uterus. Next, a speculum is placed inside the vagina to keep the vaginal walls apart, just like one does for a Pap smear. The physician will then insert a series of narrow instruments, called dilators, into the cervix to open it slightly. The doctor will then use a slender suction cannula to remove the pregnancy from the uterus.

Following the abortion you will be observed for a brief recovery period with the recovery area staff. You will probably have some cramps and bleeding at first. This is expected since the uterus must return to its normal size after the pregnancy is removed. The recovery staff will give you some medication for pain and monitor how you are feeling.

  • You may not eat, drink or chew anything for four hours before you come in.
  • Smoking is not advised prior to your appointment.
  • Please make arrangements for children to be left at home.
  • When you come to our office, unless you qualify for financial assistance or you have insurance coverage, payment in full will be collected prior to any services being rendered. For your convenience our offices accept Cash, Visa, MasterCard, AMEX or Discover. Personal checks are not accepted. Most insurance plans are accepted, but must be verified prior to your visit.
  • If you have I.V. sedation or General Anesthesia, you must have an escort to take you home following your procedure. You may not drive yourself home due to the fact that you will have received anesthesia.
  • Proper post-operative care is essential to your well being. We will provide you with clear, written post-operative instructions prior to your procedure.
  • You must have an escort to take you home following any procedure done with anesthesia other than local anesthesia. For your own safety, you may not drive for the remainder of the day.
  • You will be given a prescription for three medications. A routine antibiotic to protect against infection, a uterine contractor to control bleeding, and pain medication. It is essential that you take all medications prescribed by the physician in the manner explained. For your convenience, these medications may be purchased in our offices.
  • All RH negative patients are given an injection of Rhogam.
  • Our physicians are on-call 24 hours a day for medical emergencies.
  • You will need to return for a post-operative exam three weeks after your procedure. There is NO charge for this exam. If you were referred to our office by your own OB/GYN, we encourage you to return to your physician for your continued care after you have been released from our care. However, complete post-operative care and on-going gynecological services are available at our office for all patients.

First trimester abortions are one of the safest surgical procedures and are approximately 9-10 times safer than normal childbirth. There are both minor and major complications possible, but most are minor and easily treated. Possible complications include:

  • Infection (less than 1%)
  • Heavy bleeding (1/2 of 1%)
  • Incomplete (less than 1%)
  • Damage to the uterus or nearby internal structures (less than 1/2 of 1%)
  • Cervical tear (1/2 of 1%)
  • Continuing pregnancy (less than 1%)
  • Death (1 in 160,000)To help reduce your risk of complications it is essential that you follow all your aftercare instructions, return for your follow-up examination, and promptly call our office if symptoms of any complications do occur.

Our physicians are on-call 24-hours a day for medical emergencies.

The basic fee for the procedure includes: a review of your pertinent medical history, an educational/counseling session, routine urine and blood testing, the procedure, local anesthesia, and recovery room services.

Payment can be made in cash, by money order, or by credit card. For the convenience of our patients, we accept Visa, MasterCard, AMEX or Discover. Most insurance plans are also accepted, but must be verified prior to your visit. We are unable to accept personal checks.

Laboratory Fee — It is essential that our office have your correct phone number and address. If, in the unlikely event that the laboratory results indicate that you must return for repeat tests or procedures, we must have a reliable way to contact you. If we cannot reach you by phone, we will send a certified letter. We are very respectful of your need for confidentiality and will only contact you if there is an emergency. There is no additional office fee in the rare event that this occurs.

Medications and Testing — You may also incur additional fees if the doctor or medical staff find that you need extra medications or testing. These additional needs may include, but are not limited to: injectable antibiotics, an early detection urine pregnancy test, a urine culture, a throat culture, or a Rhogam injection. If you have an Rh negative blood type (e.g. , O negative, B negative) it is absolutely essential that you receive a Rhogam injection.

There are also some medications that you may choose to purchase on the day of your procedure. Depo Provera (injectable birth control) and certain brands of birth control pills are all available at our office for an additional charge. If you have any questions about the cost of these medications please contact us at 1-800-370-0049.

If the procedure is not performed due to patient request or physician advice, you will be responsible for payment for any services already rendered such as a pregnancy test, a sonogram and/or any laboratory tests. All other fees will be promptly refunded.