What to Expect Before, During, and After Abortion Surgery

Abortion surgery, also known as surgical abortion, is one of the two primary methods used to terminate a pregnancy. This procedure involves removing pregnancy tissue from the uterus using suction and other surgical instruments. It is a common and medically safe option, usually performed during the first or early second trimester.

Learn what to expect, from pre-procedure preparations to follow-up care, to help reduce anxiety and support proper healing.

Before the Surgery: Preparation

Before a surgical abortion, you will have a medical consultation to assess your overall health, medical history, and any previous pregnancies. The doctor will perform a physical examination and may order an ultrasound and lab tests to confirm the pregnancy and determine its gestational age.

Once the results are reviewed, the doctor will confirm if surgical abortion is appropriate and safe for you. You will then be asked to sign a consent form, acknowledging your understanding of the process, potential risks, and alternatives. In Singapore, a mandatory waiting period of at least 48 hours is observed, giving you time to carefully consider your decision before proceeding with the surgery.

During the Surgery: What Happens

There are two main types of surgical abortion, with the most suitable option depending on the gestational age of the pregnancy:

Vacuum Aspiration: This is the most common type of surgical abortion, typically used during the first trimester, generally up to 12 weeks of pregnancy.
Dilation and Evacuation (D&E): This method is for surgical abortions in the second trimester, after 12 to 14 weeks of pregnancy.

Surgical abortion is typically performed as a day procedure and takes about 10 to 30 minutes. Here is a step-by-step overview of the process:

Upon entering the procedure room, you will be positioned comfortably on an examination table and receive anaesthesia to ensure comfort throughout the procedure.
The surgeon will then gently dilate (open) your cervix using medication or small instruments called dilators. For D&E abortions, this dilation may be more extensive and could take more time.
Once your cervix is adequately dilated, the pregnancy tissue is removed from the uterus. In vacuum aspiration, a gentle, handheld suction device is used to extract the uterine contents. For the D&E method, a combination of suction and specialised surgical instruments is often employed.
After the tissue removal, the surgeon may use a cannula or ultrasound to ensure all tissue has been removed and that there is no excessive bleeding.
Once the procedure is complete and the suction (and instruments) are removed, you will be moved to a recovery room for monitoring.

Physical Recovery: What to Expect

After a surgical abortion, most patients experience mild cramping, vaginal bleeding, fatigue, breast tenderness and dizziness. These side effects are usually temporary, with most resolving within a few days to a week after the procedure.

It is essential to rest and allow your body time to heal. To avoid physical strain, you should not drive, exercise, lift heavy objects, or swim. Also, refrain from inserting anything into the vagina, including tampons, or engaging in sexual activity for approximately two weeks, or as directed by your doctor.

If you have concerns about your physical symptoms or if you experience high fever, severe abdominal pain, heavy bleeding (soaking more than two pads for an hour) or foul-smelling discharge, you should contact your doctor immediately, as these could be signs of a complication.

Emotional and Psychological Recovery

Going through an abortion can bring a wide range of emotions, and it is completely normal to feel a mix of emotions. Alongside relief, it is also common to feel sadness, guilt, anxiety or even confusion afterwards. All these feelings are valid and part of the recovery process.

Having a strong support system during this time is essential. Whether it is a trusted friend, family member, or partner, having a non-judgmental space to share your feelings openly can ease the burden. Seeking professional help is also highly encouraged. Emotional support will not only help you process your emotions but will also ensure that you are not alone in this journey.

If you have any questions about surgical abortion, please contact us. Led by Dr Lien, our clinic offers compassionate and confidential care for women.