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FIRST TRIMESTER ABORTION
First trimester abortion
Abortion up 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.
When you come to our offices 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 2-4 hours.
Prior to coming to the office, we will explain to you the pre-operative instructions
During your visit you will:
- Complete a self-medical history.
- Have a sonogram to estimate the length of pregnancy.
- Have a simple blood test with finger stick.
- Meet with a patient educator to discuss medical history forms and payment options.
- She will also discuss the procedure, possible complications, necessary aftercare, birth control options and you will sign the consent forms.
- See the doctor for an examination and the abortion procedure.
- Recuperate with the nurse in the recovery room (Approx. 1 hour).
LAB TESTING
There are some laboratory tests that we will need to perform.
For these tests we will need samples of your urine (only if medically necessary) and blood. We will use your blood sample to check your iron count and your Rh factor (only applies if you are over 12 weeks).
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.
LENGTH OF PREGNANCY
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.
If you are early in your pregnancy, we will perform an internal ultrasound that gives us better visualization of the pregnancy and pelvic anatomy. A transvaginal ultrasound consists of a narrow wand shaped transducer that is covered with a sheath and inserted into the vagina.
Although you may have had a sonogram elsewhere before coming to our office, we must perform our own sonogram.
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.
PATIENT EDUCATION
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.
The patient educator will 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.
ANESTHETIC CHOICES
At All Women’s Medical, 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 — a physician injects medicine into your cervix that numbs the area to block pain.
You will be fully awake during the procedure, but your cervix will be numbed by the anesthesia. You can expect to have moderate cramping during the procedure.
- Monitored Anesthesia Care (asleep) 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 an Anesthesiologist, who is a physician specially trained to prevent patients from feeling pain during surgical procedures.
1ST TRIMESTER PROCEDURE
Before the anesthesia of choice is administered, the physician will perform an internal exam to determine the position of your uterus.
This is done by inserting two fingers into your vagina and pressing down on your lower abdomen.
Next, a speculum is placed inside the vagina to keep the vaginal walls apart.
The physician will hold the cervix, the opening to the uterus, with an instrument called a tenaculum.
The physician will then insert a series of narrow metal instruments, called dilators, into the cervix to open it slightly.
Next, the physician will then use a slender suction cannula to remove the pregnancy from the uterus.
RECOVERY
Following the abortion, you will be transferred to our recovery room.
If you were asleep, this is where you will awaken.
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 nurse monitors how you are feeling.
You can expect to be in our recovery room for about one hour.
PRE-OPERATIVE INSTRUCTIONS
POST-OPERATIVE INSTRUCTIONS
Proper post-operative care is essential to your wellbeing. 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.
- To protect against infection, we will provide you with antibiotics. It is essential that you take all medications prescribed by the physician in the manner explained.
- All RH negative patients over 12 weeks are given an injection of Rhogam.
- If the physician deems it necessary, you will be given Methergine to help your uterus to contract.
- Our physicians are on-call 24 hours a day for medical emergencies.
- You will need to have a post-operative exam two weeks after your procedure.
If you were referred to our office by your own OB/GYN, we encourage you to return to your physician for your post-operative care.
However, complete post-operative care and on-going gynecological services are available at our office for all patients.
POSSIBLE COMPLICATIONS
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:
| Complication | How frequently the complication occurs |
|---|---|
| Infection | less than 1% |
| Heavy bleeding | 1/2 of 1% |
| Incomplete abortion | 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 |
Call our office if symptoms of any complications do occur.
Our physicians are on-call 24-hours a day to respond to your medical concerns and to handle any medical emergencies.
PAYMENT
At All Women’s Medical, we require your entire fee to be paid before the abortion is performed.
The basic fee for the procedure includes: a review of your pertinent medical history, an educational/counseling session, an ultrasound screening, routine urine and blood testing, the abortion procedure, 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 MasterCard, VISA, American Express, Discover, Apple Pay, Google Pay, and Android pay.
Medicaid and most insurance plans are also accepted, but must be verified prior to your visit.
ADDITIONAL FEES
Laboratory Fee
The products of conception removed during the abortion are sent to an off-site laboratory to be examined by a pathologist. The pathologist’s examination confirms that a pregnancy has been removed and examines the tissue for certain abnormalities.
The fee for this service is approximately $25.
Although the off-site laboratory has no relationship to our office, we do collect the fee on their behalf unless you have opted to use a third-party payor. Therefore, the fee is payable in cash at the time of your procedure.
Because of the importance of this laboratory test, 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 & 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 essential that you receive a Rhogam injection if you are over 12 weeks pregnant.
REFUND POLICY
If the abortion 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.
DISCLAIMER: Your medical history or conditions may alter treatment plan.
Sonogram Guided Abortion
At All Women’s Medical, we do more because we care.
Don’t settle for a blind procedure when your doctor, through sonography, can view the procedure as it is performed.
Your safety is our #1 priority. For that reason, 100% of our procedures are performed under COMPLETE SONOGRAM GUIDANCE.
Unlike a “blind” procedure in which a doctor goes solely on his sense of feel, we use Sonography to give the additional benefit of sight for a gentler and safer procedure. The use of sonography guides our surgeons directly to the pregnancy so the risk of injury or retained tissue is kept at a minimum. Sonography also lowers the amount of time the procedure takes thereby helping the doctors to decrease the amount of time you spend under anesthesia.
No two women are created the same and neither is their uterus. Previous medical conditions such as fibroids, prior cesareans and the number of pregnancies all contribute to the uniqueness of each uterus. With the use of sonography, we are able to see the uterus in three dimensions assuring us that the uterus is empty of products of conception.
Safe Individualized Anesthesia Care — Two doctors are better than one!
Every patient who enters our operating room is greeted by two doctors, a surgeon and an anesthesiologist. Just as no two patients are the same, neither are their individual needs for anesthesia. Our team of physicians discusses the specific needs of each patient before her procedure for maximum safety and comfort. Should you choose to be asleep for your procedure, you may take comfort in the fact that your individualized anesthesia options are tailored specifically for YOU.
We’re a member of the National Abortion Federation (“NAF”).
You matter
In no uncertain terms, we care about you. Be assured that we will do everything possible to make certain that your experience at our office is as safe and as comfortable as possible.