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Suction curettage

Suction curettage (vacuum aspiration) is possible up to 12 weeks of pregnancy. This treatment removes the pregnancy by gentle suction. Suction curettage is performed under anaesthetic. You can choose local or light anaesthetic (i.e. light sedation, which means that you sleep briefly).

Preparation

To relax your cervix, you are administered two pills of Misoprostol by the nurse. The medication needs an hour to take effect and can sometimes cause light cramping.

Anaesthetic

If you have chosen light anaesthetic (light sedation), you will be given a short-acting sleep-inducing drug through a drip connected to your arm. This will take place in the surgery. Within 30 seconds you will fall asleep for the duration of the treatment. The sleep-inducing drug is not a general anaesthetic.

Nil by mouth
For light anaesthetic your stomach needs to be completely empty. This means that from 6 hours before the treatment you are not allowed to eat anything, and from 2 hours before the treatment you are not allowed to drink anything. Before this time, you are allowed to drink some tea or water (but not any dairy products). For 24 hours after the light anaesthetic you are not allowed to ride a moped or bicycle or drive a car, motorcycle or motor scooter.

If you have chosen local anaesthetic, the doctor will administer it just before treatment. This is done with a number of minor injections in your cervix. Usually these are not painful. Because this will not completely numb the cervix, you can experience some cramping during the treatment.

Suction curettage treatment

During the treatment you are in a gynaecological examination chair with support for your legs. An abortion doctor performs the treatment, assisted by at least one nurse. The doctor inserts a speculum into your vagina to display your cervix. Then a suction device is used to gently empty your uterus.
Following the treatment you can have a hormonal coil (IUD) or contraceptive implant inserted.

After the treatment

After the treatment you will stay in the recovery room for an hour to make sure you are doing OK. For infection prevention you will be given antibiotics.
After the treatment you may experience cramping and bleeding. The symptoms can last from a few days up to several weeks and will gradually diminish. Pregnancy symptoms will diminish after a week. If symptoms persist or if you have a fever or are unwell, please contact us.

Will I have general anaesthetic, an epidural or local anaesthetic?

We never administer an epidural. For pregnancies up to 13 weeks you can choose either local anaesthetic or light sedation. Sedation means you are given a short-acting sleep-inducing drug through a drip connected to your arm. From 13 weeks of pregnancy, the treatment is always performed under sedation. For 24 hours after treatment under sedation you are not allowed to ride a moped or bicycle or drive a car or motorcycle.

Can you fit a coil (IUD) after the abortion?

For pregnancies up to 15 weeks, directly after the abortion treatment you can have a coil (IUD) fitted. If you have chosen for the abortion pill, you can have an IUD fitted during the follow-up, four weeks after the abortion.

If you have health insurance in the Netherlands, the IUD insertion procedure is free of charge, but the IUD itself is not free, and can be purchased at our clinic. Both hormonal and non-hormonal IUDs are available. Some health insurances cover (part of) the costs of the IUD. Please contact your health insurer for any medical cover. If you are younger than 18, both IUD insertion procedure and IUD are free.

Can you fit a contraceptive implant (Implanon)?

Yes, we can fit the contraceptive implant Implanon after an abortion. The procedure is free, but you have to pay for the Implanon at the clinic. Also, if you did not have an abortion at the clinic, you can book an appointment to have Implanon fitted. In that case you have to pay for the insertion procedure.

What is the probability that the treatment will fail?

It sometimes happens that the pregnancy is not terminated after the abortion. With the abortion pill this is 1 - 4%, with other abortion methods this is 1 - 2 %. If this happens, we need to perform a (second) suction curettage.

There is also a slight risk of persistent bleeding or severe discharge. This usually occurs when there is some organic tissue left in the uterus after the abortion. If the tissue is not passed naturally, a follow-up treatment is needed to remove these last bits of tissue.

Our clinic has a partnership agreement with a nearby hospital, where medical support can be provided, if necessary.

What is the probability of infection after a day treatment in the clinic?

The chance of infection after an abortion is extremely remote. As an extra precaution to prevent infection, you will be given antibiotics in the clinic after treatment.

Because of risk of infection after the abortion, please follow this advice:

  • For the first two weeks, do not use any tampons.
  • For the first two weeks, do not have sexual intercourse.
  • For the first two weeks, do not take a bath or go swimming; a shower is allowed.

A fever (over 38.5°C), which lasts more than a day, AND stomach pain after treatment can be possible signs of an infection. If this happens to you, please contact us or your GP as soon as possible.

How much bleeding can I expect after an abortion?

Usually most bleeding is expected after 4 to 7 days and can be more severe and last longer than during menstruation. You can also pass clots of blood. The bleeding often ends with brownish discharge.

What symptoms should I be concerned about after an abortion?

Normal symptoms in the first days after the abortion:

  • Bleeding and cramping
  • Abdominal pain or backache
  • Slight temperature
  • Emotional instability
  • Diarrhoea or nausea caused by the antibiotics

Any additional pregnancy symptoms usually disappear within 2 to 14 days. Because your body still contains pregnancy hormones, a pregnancy test may be positive up to 3 weeks after the abortion.

It’s advisable to take a pregnancy test 3 to 4 weeks after the abortion. If the test is (weakly) positive, you still feel pregnant, or have other symptoms, please contact us.

The chance of developing an infection is remote, but if you feel unwell and have a fever (over 38.5°C) that lasts longer than a day and abdominal pain, this could mean you have an infection. In that case, please contact us as soon as possible.