Proper preparation for an abortion: what you can and cannot do

Abortion is the artificial termination of pregnancy using various methods. Since this procedure is associated with intervention in the body, and even if carried out medicinally in the early stages, it still poses a danger to the body. To reduce risks to a minimum, you need to get tested before and after an abortion.

Types of abortions and timing

The content of the article

The gynecologist decides which abortion will be performed, focusing on the timing of pregnancy. The list of tests to be taken depends on the method of abortion. The longer the period, the more extensive the examination should be.

• Medical abortion is allowed up to 6 weeks; it is the least traumatic and does not cause great psychological trauma.
• Also, for a short period of up to 6-7 weeks, vacuum aspiration is used, in which the fertilized egg is sucked out with a special pump. This method is called a mini-abortion, but it is still associated with mechanical influence. The risks also increase: remaining particles of the amniotic egg will lead to inflammation.
• Surgical abortion is performed between 7 and 12 weeks under general anesthesia. This is a real operation that has an extremely negative impact on a woman’s reproductive health. This is due to the artificial opening of the cervix, which subsequently leads to its weakening, and injury to the walls of the uterus, which become open to various infections.

Tests before the first abortion

Abortion of the first pregnancy is especially dangerous. It threatens further infertility and other health problems. Therefore, a young girl going to terminate her first pregnancy must first undergo the following tests:

• Complete blood test with determination of group and Rh factor.
• Biochemical analysis (blood sugar, cholesterol levels).
• General urine analysis
• Analysis - Wasserman reaction or RW (rapid test for syphilis).
• Test for hepatitis B and C.
• HIV test.
• Hemastasiogram (blood clotting).
• Analysis of a smear for vaginal flora.
• HCG analysis.

An ultrasound scan of the uterus is required, during which the doctor makes sure that the fertilized egg is implanted in the uterus and that the pregnancy is indeed uterine. An ultrasound will determine the exact duration of pregnancy.

Despite the impressive list, all tests are completed within 2-3 days, after which the doctor examines the results and sets the time for the procedure itself.

Where to begin

1. It is quite natural that when a woman’s period is late, she takes a home pregnancy test, which can be purchased at any pharmacy. If the test results are controversial, for example, the second strip is faded, or negative, and the woman is confident in the pregnancy and wants to terminate it as soon as possible, then a clinical blood test for hCG will come to the rescue. Human chorionic gonadotropin is a unique pregnancy hormone that begins to be produced immediately after implantation of the fertilized egg into the uterus. The essence of the study is similar to that carried out independently using a pharmacy test, however, the sensitivity of laboratory analysis is much higher. You can definitely determine the onset of pregnancy already 7-10 days after conception if you take a blood test at a medical institution.
2. The second stage of preparation for an abortion will be an ultrasound. It is necessary to accurately determine whether the pregnancy is intrauterine. Otherwise, it will not be an abortion, but another surgical operation to remove the fertilized egg.

Tests before the second and next abortions

If the patient has already given birth and had several abortions before, she needs to undergo much fewer tests, and they will depend on the type of abortion.

Regardless of the type of abortion, before the procedure begins, the patient undergoes tests, which, depending on the volume of examinations, are divided into minimal, extended and maximum.

Minimal or basic tests are carried out if the woman has already given birth and had abortions before.

• A woman undergoes an examination on a gynecological chair.
• Gives a vaginal smear for infections.
• An ultrasound is performed, which determines the location of the fertilized egg inside the uterus.

The examination is carried out by a gynecologist in order to identify diseases that the patient may not be aware of, but which, during an abortion, can cause a serious blow to health. For example, a follicular ovarian cyst is not a contraindication to medical abortion, but other types of cysts increase in size and even rupture after hormonal exposure. In case of fibroids, curettage is dangerous; it leads to damage to the endometrium and the muscular layer of the uterus, provoking tumor growth. During the examination, the doctor determines whether the size of the uterus and ovaries corresponds to the period of pregnancy, and in case of deviation from the norm, sends for further examination.

A vaginal smear determines the ratio of beneficial and pathogenic microflora. Lactobacilli should predominate, and leukocytes are present in a smear of a healthy woman in minute quantities. Coccus infection, leukocytes and erythrocytes indicate inflammation, a lack of epithelial cells indicates a decrease in estrogen, and gram-negative bacilli indicate vaginal dysbiosis.

Additional preparation for abortion

Having decided to terminate a pregnancy, a woman should familiarize herself with all the necessary information. She needs to know all the features of the method and the possible health consequences. Before an abortion, you need to clarify the appointed time of the procedure, when and where you need to come, and what to take with you. It is important to know how long you will have to stay in the clinic under the supervision of medical staff.

Psychological preparation before an abortion comes down to understanding yourself. The main thing is to understand whether the choice of artificial termination of pregnancy is conscious and voluntary. Those women whose decision was made under pressure from relatives experience abortion the hardest.

Before an abortion, you need to carefully weigh the pros and cons and take responsibility for what is happening. After all, a woman’s entire future life largely depends on the decision made.

Why get tested for Rh factor blood?

The examination necessarily includes tests to determine the Rh factor and blood type, because a negative Rh factor and an abortion performed against its background often leads to complete infertility in the future.

Already during the first pregnancy, in a woman with a negative Rh factor, when the fetus inherits a positive Rh factor from the father, the production of antibodies begins, which enter the embryo’s body through the placenta and begin to destroy its red blood cells (they are perceived as a foreign body due to the opposite Rh factor of the mother).

The fetus experiences oxygen starvation, develops pathologies and in some cases dies. Or, sensing a significant loss of red blood cells, the liver and spleen begin to intensively produce them, increasing in size. An increased amount of bilirubin, a breakdown product of hemoglobin, is produced, causing intoxication of the body, leading to improper development of the baby’s brain.

The antibodies produced by the mother's body during the first Rh-conflict pregnancy are not very active, so there is a high probability of bearing and giving birth to a healthy baby with concomitant therapy.

However, there is a problem: during the first pregnancy, so-called memory cells are produced. During subsequent conception, antibodies are produced in much larger quantities and are more active. A previous abortion especially increases the production of antibodies. Therefore, a woman with a negative Rh factor who decides to terminate her first pregnancy should know that the next baby may never be born. The only right decision is to continue the pregnancy.

To prevent further miscarriage or the birth of a baby with pathologies, the woman in labor is given an injection of anti-Rhesus immunoglobulin within 72 hours after the birth of the child. In extreme cases, such an injection is given after an abortion, but it is better that the first pregnancy ends in childbirth.

Why do you need an ultrasound before an abortion?

Ultrasound diagnostics not only confirms the fact of pregnancy, but also reveals the place of attachment of the embryo.

It happens that the patient has all the signs of pregnancy: delayed menstruation, enlarged mammary glands, changes in well-being. The test shows two lines, and there is a pregnancy, but it is ectopic. Ectopic pregnancy occurs in almost 3% - this is a fairly high percentage, so before an abortion you must make sure that the embryo has implanted in the intended place, i.e. uterus. If you start an abortion with an ectopic, severe bleeding begins. The patient expects an uncompleted abortion and other troubles.

Ultrasound is performed at 5-6 weeks from the moment of conception. At this moment, only the transvaginal sensor can see the fertilized egg, so you will have to undergo this procedure for an abortion.

Transabdominal (through the peritoneum) ultrasound is done at 10-11 weeks. However, the sooner the fact of pregnancy, especially ectopic pregnancy, is established, the fewer health consequences there will be after an abortion.

Contraindications for interruption

Abortion is an artificial intervention aimed at ending a pregnancy.
Conducting it in various ways. Before 12 weeks of gestation, any woman, based on her own desires, can have an abortion. But after a 12-week period, doctors can interrupt only for special medical or social indications (for example, rape). But with such a decision, it is still necessary that the patient has no contraindications to this procedure. Today, abortive procedures are carried out in several ways: medication, vacuum surgery. And each intervention has its own contraindications. Among the general prohibitions are:

• Late gestational age.
• Rhesus conflict between mother and fetus under the condition of the first pregnancy. In such a case, the patient will be able to bear the baby only during the first conception, so experts categorically insist on saving the child. With other gestations, as a rule, difficulties arise such as miscarriages, etc.
• Inflammatory diseases, abortion can only be done after a course of treatment. Abortion tests will help identify such pathological processes.
• Ectopic location of the fetal egg; in such a situation, an operation is performed aimed at removing the fetal tissue from the tube, ovary and abdominal space, depending on its attachment.
• Inflammatory or venereal pelvic diseases, with such diseases there is a real risk of the spread of pathological processes into the uterine body and other surrounding tissues.

This is just a list of general restrictions, but there are also individual restrictions for each type of abortion intervention. Medication or pharmaceutical abortion is considered the most loyal, because it is based on taking pills, but even with such a non-invasive method of interruption, certain problems may arise, so doctors do not perform such abortions if the patient has an allergic intolerance to the drugs used for medical interruption, a low platelet count, which is fraught with heavy bleeding. In addition, pharmabort is contraindicated for benign neoplasms, patients under 18 and after 35, and with a pregnancy period of more than 5-6 weeks.

What else do you need to know

Self-administration of medications is prohibited; it is very dangerous.
Vacuum aspiration, better known as a mini-abortion, involves removing the fertilized egg from the uterine body using a special vacuum pump. Before the procedure is prescribed, the woman must undergo an ultrasound scan to determine the exact location of the fetus. Contraindications for mini-abortion are bleeding disorders and recent termination of pregnancy (less than six months ago). Doctors will also prohibit mini-abortion if the gestational age exceeds 6 weeks. This condition is undeniable, because before this period the fertilized egg has not yet fully established itself in the uterus, so there are no problems with its vacuum suction. Also an absolute contraindication to vacuum abortion is ectopic.

As for surgical curettage, the contraindications are generally identical to other abortive techniques. Curettage curettage is not performed for any pathological inflammatory or infectious conditions, because there is a high risk of pathogenic microorganisms entering the bloodstream, which can lead to sepsis. That is why tests before an abortion are a necessary condition. In addition, exacerbation of any pathology of inflammatory origin is also a direct contraindication to surgical abortion. The reason is that during the curettage procedure, the internal uterine layers are damaged and bleeding opens. Also, a significant obstacle to traditional surgical intervention is any pathology of hematopoiesis, allergic intolerance to any anesthetics used during the intervention, etc.

HCG analysis

In the early stages, when an ultrasound still does not show anything, the fact of pregnancy is confirmed by an analysis of human chorionic gonadotropin, a protein produced by the villi covering the embryo.

In a non-pregnant woman, hCG is 5 honey/ml, but already from 1 week from the moment of conception it rises to 25 honey/ml, and by the end of 2 weeks it rises to 300 honey/ml. If the hCG is higher than that of a non-pregnant woman, but lower than the norm, then the patient is diagnosed with an ectopic pregnancy. This is perhaps the only way to detect pathology in the early stages. In this case, abortion is performed differently than in a normally developing pregnancy.

Psychological preparation

Psychological preparation for an abortion is of primary importance. If it is done at the request of a woman, she must carefully weigh everything before making a final decision. Any doubts must be overcome, otherwise severe depression cannot be avoided after an abortion. If an abortion is performed for medical reasons and the pregnant woman is not sure of the correctness of the diagnosis, she should consult with several specialists so as not to later realize that the risks were unjustifiably inflated.

Of course, you shouldn’t delay making a decision, because early abortion causes less harm to women’s health. However, it is also impossible to act thoughtlessly. It’s good if there is at least one person around who will provide moral and physical support. You can ask a friend, the child's father or a relative to meet and support you after the operation.

Important! Sometimes a woman’s fear of publicity and condemnation is so great that she decides to take medication on her own or have an illegal abortion. These methods do not guarantee results, but entail a lot of complications. The price of such fear will be not only the health, but also the life of the woman.

When an abortion has already been performed, you need to try to give in to memories and thoughts on this topic as little as possible. Now they will not be of any use. But many women after an abortion realize the importance of contraception and take a more responsible approach to the issue of protection from unwanted pregnancy. This is perhaps the only positive consequence of abortion for some women.

Expanded range of tests before surgical termination of pregnancy

If a surgical abortion is planned, the range of tests should be expanded.

• Advanced tests include tests for AIDS, hepatitis B and C, and syphilis.
• To avoid undesirable consequences, the woman undergoes additional urine tests. Using it, the doctor determines whether the patient has problems with the bladder or kidneys.
• You also need to undergo a PRC test for hidden infections that are not detected in a regular vaginal smear. In the case of a surgical abortion, pathogenic microflora will enter the injured uterine cavity. This will cause inflammation, severe bleeding and further infertility.
• A coagulogram reveals blood clotting disorders that lead to serious consequences. Glucose tests identify patients with diabetes mellitus, which increases the permeability of capillaries, arteries and blood vessels. Such patients should think a hundred times before agreeing to an abortion, and, if it is unavoidable, carry it out in accordance with the existing characteristics of the body.

In the presence of serious pathologies, additional studies are carried out. The examination includes examination of the heart, blood vessels, and kidneys. This will prevent complications after anesthesia.

A couple of decades ago, articles periodically appeared in the media that told how a girl died after an abortion or remained infertile. This usually describes cases of illiterate abortions, when the necessary tests were not carried out, the procedure was done hastily without taking into account the woman’s health characteristics.

Despite the negative impact of abortion on reproductive health, patients who contact a good specialist at the clinic retain the ability to reproduce without health consequences.

Vacuum aspiration (better known as mini-abortion)

Aspiration is the removal of the embryo using a vacuum pump. Before the procedure, the woman is given a referral for ultrasound diagnostics. What tests are needed to have an abortion? This is necessary to determine the exact location of the embryo. Additionally, standard tests for hCG are prescribed, which will confirm the fact of pregnancy, and general.

What other tests are needed for an abortion? Often (for any type of abortion), an additional test for Rh and group is prescribed in order to know this data if a transfusion is needed, PCR for hidden infections, a biochemical analysis to determine glucose levels (critical sugar levels can adversely affect the woman’s condition), a general urine test and fluorography.