What is Abortion?

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Abortion or curettage is popularly known as abortion. The word meaning of abortion is the removal of a piece from the uterus. Abortion is not just a voluntary abortion. Sometimes it is done to clean the inside of the uterus after a miscarriage, and sometimes to take the dead baby. It is also applied to terminate an empty pregnancy (anembryonic pregnancy). Under normal circumstances, abortion is not performed in an ectopic pregnancy, but sometimes abortion can be performed to diagnose an ectopic pregnancy. The diagnosis is confirmed by sending the material to pathology.

Abortion can also be applied for diagnostic and therapeutic purposes in women who are not pregnant but have heavy bleeding, irregular and prolonged menstrual bleeding. It can also be performed for diagnosis and treatment when ultrasonography shows irregularity, polyp or increase in wall thickness in the uterus. Abortion is also performed to remove the intrauterine device whose thread cannot be seen. It is performed for diagnosis and treatment purposes in women who have vaginal bleeding one year after menopause or who have thickening of the inner wall of the uterus during menopause. This abortion is called Probe Abortion. In these cases, the material taken by abortion is definitely sent to pathology.

Abortion can be done to all married or single women. But abortion is a physical and psychological trauma for all women. Therefore, in such a situation, women should be approached very sensitively. He should try to understand their concerns, anxieties and fears, and show the necessary sensitivity accordingly.

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Considerations in Abortion

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There are many points to be considered in abortion.

Patient Privacy

We care about the privacy of the patient. Emotional tensions are very high in women who come for abortion. On the one hand, getting rid of an unwanted pregnancy as soon as possible, on the other hand, the emotional trauma and guilt experienced with the maternal instinct.

Emotional Support

I try to comfort and support our patients emotionally so that they can overcome this situation with the least trauma. Sometimes couples can become pregnant despite being protected, and I provide detailed information on how to effectively protect them so that this does not happen again.

I assure

I guarantee that they can contact me in case of any problem after abortion. 

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Considerations After Abortion

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You should not have intercourse for 10 days after abortion, take a tub bath, and not enter the sea or pool for 10 days.

In which cases should a doctor be consulted after an abortion?

Heavy bleeding after abortion
- Severe pain in the lower side after abortion, even if you use painkillers
-A foul-smelling discharge from the vagina after abortion
-Fever (above 38 degrees)
Continuing bleeding after 10 days after abortion
- Absence of menstruation after 45 days after abortion

What not to do after abortion

– Do not have intercourse for 10 days after abortion
– Take a shower in the form of a bath, not a tub bath
- Do not enter the sea and the pool for 10 days

If there is still bleeding after 10 days, you should consult your doctor!

post abortion

It is normal to have bleeding between 1-10 days after an abortion. Sometimes this bleeding starts immediately, sometimes after a few days, it becomes like menstrual bleeding. Sometimes it can be just brown spotting.
Nausea and vomiting may occur in the first 1-2 hours after abortion.
Light foods can be eaten 1-2 hours after the abortion.
The day of the abortion is considered the first day of menstruation. After 25-40 days, menstrual bleeding is expected.
- If there is a blood incompatibility, if the mother's blood group is negative and the father is positive, the blood incompatibility injection should be done within 72 hours.
-There should be absolutely no sexual intercourse in the first 10 days.
Any contraceptive method should definitely be used in the relationship after 10 days.
-After abortion pregnancy test is not negative immediately, it becomes negative over time depending on the pregnancy size.
- It should be protected for at least 2 months after abortion performed for medical reasons (dead pregnancy, empty pregnancy).

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Is the abortion process understood later?

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After a certain period of time after the abortion, it cannot be understood by examination and ultrasonography that the patient has an abortion.

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How to prevent pregnancy after abortion?

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Abortion is never a method of contraception. We must never forget this!

– Condom (CONDOM): It is a suitable method for the man to use in the relationship.

-Birth control pills: Can be used immediately after abortion. The day of abortion is considered the first day of menstruation, and birth control pills are started on that day. If there is no risk associated with using birth control pills, it is a good contraceptive method.

-Intrauterine devices (IUD): After abortion, copper intrauterine device, Mirena (hormone intrauterine device), gynefix can be applied immediately. However, based on my 25 years of experience, I prefer to apply intrauterine devices one month later. When applied on the day of the abortion, pain and bleeding may increase and the chance of dislocation of the intrauterine device increases. That's why I don't prefer it.

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What are the risks of abortion?

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What are the risks of abortion, it should be known very well.

In experienced hands, the risk that may occur in an abortion procedure performed under appropriate conditions and in a suitable week is very low.

Continuation of pregnancy: Pregnancy may continue in abortions performed before the gestational sac is seen or when it is very small. Therefore, even if the pregnancy test is positive, abortion should not be performed before the sac is seen and before 5 weeks. Again, ectopic pregnancy can be missed in abortions performed without a sac. In order to eliminate this risk, abortion should not be performed before the gestational sac is seen. In addition, all patients should be checked with ultrasonography after the intervention and 10 days later.

– Accumulation of blood in the uterus: With the drug or by re-entering the cannula, the accumulated blood is allowed to flow.

– Injury to the uterus: Sometimes the plastic cannula cannot be inserted directly through the cervix. In such cases, the cervix should be widened with a metal instrument. While entering with a metal instrument, the uterus may be punctured, severe bleeding may occur, and the uterus may need to be removed. In cases where the cervix cannot be entered with a plastic cannula, the patient is kept waiting and a softener is given to the cervix. As this method softens the cervix, it reduces the risk of perforation and rupture of the uterus. In early abortions, this risk is very low. This risk increases as the gestational week increases.

– Infection risk: This risk is minimal in abortions performed under sterile and appropriate conditions. However, appropriate antibiotics given by your doctor should be used against this risk.

-Adhesion (Asherman's syndrome) in the inner lining of the uterus (endometrium): If the patient says "I am not menstruating" after abortion, adhesion is considered. First, a cyclic drug is tried on the patient and if there is no menstrual period, hysteroscopy is performed to diagnose and the adhesions are opened. This condition is usually seen after previous curettage abortions or due to infection.

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What are the risks of abortion?

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FAQs about abortion

The legal limit for abortion in our country is 10 weeks.

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How long can an abortion be done for abortion?

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The legal limit in our country is 10 weeks. This is done by calculating from the first day of the last menstrual period. Usually, couples calculate from the day they have intercourse or the day of ovulation and they are wrong. For this reason, ultrasonography should be done, it should be confirmed that the pregnancy is a pregnancy in the normal uterus, there is no ectopic pregnancy and its week should be confirmed.

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Who can have an abortion for abortion?

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-Women over the age of eighteen who are married can have an abortion with the consent and signature of their spouse.
– Single women over the age of eighteen can have an abortion voluntarily.
– For women under the age of eighteen, married or single, the consent and signature of their parents is required for abortion.
Girls under the age of fifteen cannot have an abortion, even with their parents' permission. This should be reported to the judicial authority.
- If the patient comes in emergency with bleeding and it is life-threatening, his/her consent is sufficient.

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Who Performs Abortion?

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Abortion is performed only by obstetricians.

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In what special cases should abortion be performed?

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If pregnancy poses a threat to the life of the mother, an abortion should be performed. If the drugs that the mother has to use due to a serious heart, kidney, liver disease or hypertension are harmful for the pregnancy, the pregnancy should be terminated by considering the mother's life.

Pregnancy over 10 weeks can be evacuated by the decision of the health board in the detection of a genetic disease incompatible with life or an anomaly that will greatly affect the life of the baby by ultrasonography, chorionic villus biopsy (CVS) or amniocentesis, or when a stillborn baby is detected. This type of pregnancy evacuation is called therapeutic abortion.

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How is abortion done?

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It should not be forgotten that abortion is a serious operation. Therefore, it is necessary to obtain detailed information from the patient beforehand. The patient's surgeries, allergy status, medications (whether he uses blood thinners or drugs, aspirin, etc.), blood type should be learned. If the couple's blood group is not known, it should be learned and if the mother's blood group is negative and the father's blood group is positive, a blood incompatibility injection should be made within 72 hours. The incompatibility needle is necessary for subsequent pregnancies.

Before the abortion procedure, ultrasonography is performed on the patient and the location and week of pregnancy are examined. Afterwards, the patient is taken to the gynecological table and a detailed pelvic examination is performed. Local or sedation anesthesia is used in abortion. Local anesthesia is performed by the obstetrician, but an anesthesiologist is required for sedation anesthesia. For sedation anesthesia, the patient should be hungry and stay for 4-5 hours. Local anesthesia is performed by the obstetrician and only the cervix is anesthetized. No matter how much it is anesthetized in local anesthesia, the patient feels some pain in the groin, like menstrual pain, during the procedure.

If the patient is single and has not had a normal vaginal delivery before, sedation anesthesia is preferred. Sedation anesthesia is performed by an anesthesiologist. If sedation anesthesia is to be administered, the patient is informed about being hungry and thirsty 4-5 hours beforehand. The purpose of this is to ensure that the stomach is empty, to prevent nausea and vomiting that may occur during anesthesia, and to prevent the stomach contents from escaping into the lungs. Before starting the sedation, the anesthesiologist also informs the patient about how the sedation anesthesia will be. Vascular access is opened in the patient's arm. In general, the only pain that the patient will feel during the procedure is the opening of the vascular access. The anesthesiologist puts the patient to sleep by administering the intravenous sedation drug.

The patient is placed in the lithotomy position, a manual pelvic examination is performed, and then the vagina is opened with a special tool called a speculum and the cervix (cervix) is made visible. The vagina is cleaned with antiseptics. Afterwards, the cervix is held with a special instrument called teneculum and the uterus is brought to a flat position by pulling it slightly. If local anesthesia is to be applied, our local anesthesia drug is injected into the cervix (cervix). Sometimes, if the cervix is very closed or the gestational week is large, it is necessary to widen the cervix with special instruments called bougies. Afterwards, the uterine cavity is reached by passing through the cervix (cervix) with a plastic, sterile, thin cannula. Pregnancy material is drawn into the injector by applying a negative pressure with a vacuum technique with a special injector. After the procedure is finished, it is usually checked whether there are any pieces left inside with trans-vaginal ultrasonography. The procedure usually takes 5-15 minutes. If the patient has received sedation anesthesia, it takes approximately 30 minutes for the patient to fully recover.

In the past, abortions were performed with sharp metal instruments called curettes. Currently, only vacuum abortion is used for termination of pregnancy. We use these curettes for diagnostic (biopsy) abortions (probe curettage). We also sometimes use the string to remove invisible intrauterine devices (IUDs).

In the abortion performed with sedation, the patient does not feel anything. In this way, the mental and physical trauma that our patient will experience is minimized.

Abortion should be done in experienced hands in sterile and appropriate conditions, and the patient should be able to reach his doctor easily in case of any problem.

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Abortion Antalya

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I am doing abortion in my practice in Antalya. Please do not hesitate to call to ask your questions. To make an appointment0532 050 240 74 You can contact the number.

My practice, İsmet Gökşen cad  No:28/6 Şirinyalı Lara/Antalya.

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