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FAQ

Prior to treatment

Is there a waiting list?

Usually, you can have an appointment at our clinic within a week.
If you are more than sixteen days late, we are obliged to take the 5-day consideration period into account when booking an appointment.

Why is there a 5-day consideration period?

Dutch law stipulates a consideration period of 5 days. This means that after you have spoken to a doctor about a possible termination, you have to take at least five days to seriously think over your decision to terminate your pregnancy. The abortion can take place from the sixth day onwards.
If your pregnancy is shorter than 16 days, the mandatory 5-day consideration period does not apply.

Can I get help without a referral?

If your pregnancy is shorter than 16 days, you don’t need a referral letter.

If your pregnancy is longer than 16 days, a referral letter from your GP or other doctor is proof that you have taken at least five days to consider your decision to terminate the pregnancy.

If you don’t want to consult your own doctor, you can speak to one of our doctors about your wish to terminate the pregnancy. Treatment can take place from the sixth day after this consultation and you won’t need a referral letter.

I am underage, do I need my parents’ permission?

If you are 15 or younger, you and one of your parents or legal guardian need to give permission for treatment, so you can never be forced to have an abortion. If you are unable to notify you parent(s) or guardian, please call us.

If you are 16 or older, you don’t need your parents’ or guardian’s permission.

What can I expect during the initial consultation with the doctor?

After you have completed a list of questions, you will meet with one of our doctors. The doctor wants to speak to you in private, without your companion being present, to make sure the abortion is really your decision. The doctor will discuss your decision to terminate the pregnancy and assess your health. The doctor will carry out a preliminary examination and will use an ultrasound scan (on your belly or vaginally) to determine how long you have been pregnant. This is done to determine the treatment method. The doctor will also advise you on contraceptives you can use after the abortion.

Can I receive an ultrasound image?

During the preliminary examination, the doctor will make an ultrasound. If you ask the doctor beforehand, you can have a copy of the ultrasound image to take with you. If you decide later that you would like to have a copy, you can pick one up during weekdays at the reception desk, on presentation of your ID. If you can’t or don’t want to come around, please send us an email with your request and a scanned copy of your ID.

I am overweight or underweight. Does that affect the treatment?

If you are obese (BMI > 40) or underweight (BMI<18), sedation (light anaesthetic) can entail some risks. Make sure to mention you are obese or underweight when booking an appointment.

I have had an abortion before. Is that a problem?

A previous abortion poses no physical objections for the treatment.

I dread having the abortion. Can I share my experiences with someone?

If you feel uncertain or find it hard to come to a decision, you can contact FIOM. FIOM is a Dutch organisation that offers help with unplanned pregnancy. For a location near you, please check their website at www.fiom.nl. On the day of your treatment, prior to the abortion, you can have an extensive talk with one of our nurses.

I don’t want to go to my GP for a referral letter, or my GP does not want to provide a referral. Where can I go?

You can book an appointment at our clinic for the initial consultation. If you are pregnant for longer than 6 weeks and 2 days, we can only carry out the treatment 6 days after the initial consultation due to the mandatory waiting period (5 days).

Abortion pill

How likely is a bad experience with the abortion pill?

The risk of complications with the abortion pill is slim. The main complication is bleeding without actual termination of the pregnancy. That is why there is a follow-up 4 weeks after the termination. After 4 weeks, you can also take a pregnancy test yourself

For some women, the abortion pill is a painful and emotional experience. The abortion pill causes abdominal cramps that can last for hours. These abdominal cramps are comparable to severe menstrual cramps. Other possible side effects include nausea, vomiting, chills and diarrhoea. In combination with (sometimes heavy) bleeding, the amniotic sac is being rejected by the body.

How long does the pain last?
In the beginning, the pain can be severe and bleeding can continue for two weeks, comparable to menstrual bleeding. Make sure you have stocked up on painkillers, e.g. Ibuprofen or Aleve, also in suppository form in case you feel nauseous and won’t be able to keep the painkillers in your stomach due to vomiting.

Is it normal to develop a fever when taking the abortion pill?
A slight temperature is normal. If your temperature is over 38.5 C, please contact us.

Are there any risks of the abortion pill?

There is a remote chance (1-4%) that the abortion pill will not work effectively and the pregnancy has not ended. This means you would still need suction curettage. There is a minor risk of infection.

How likely is an infection after the abortion pill?

The chance of infection after the abortion pill is extremely remote. It is however important to stick to the following rules for two weeks after treatment:

  • 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.

Can I receive the abortion pill by post?

In the Netherlands, the abortion pill can only be distributed at an abortion clinic or hospital. It is illegal to send the abortion pill by post.

Warning: Abortion clinics Haarlem and Amsterdam NEVER sell the abortion pill online
There are (Polish) websites that sell the abortion pill using the name of Abortion Clinic Amsterdam. This is a scam. Abortion Clinic Amsterdam does not sell abortion pills online.

Day treatment

Is the treatment painful?

During treatment with local anaesthetic you are conscious and will feel the procedure. The amount of pain is different for every woman. Usually, you will experience cramping during the treatment, best compared to severe menstrual pain.

For treatment under sedation (light anaesthetic), you will be administered a sleep-inducing drug and a painkiller through a needle in your arm. During sedation you will have no awareness of the treatment. You will wake up immediately after the treatment, feeling drowsy and sometimes a bit dizzy.

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 my partner or companion be present during the treatment?

You may come with one companion to the clinic.
Your partner or companion can be present during the consultation and preliminary examination by the doctor and during the additional interview with the nurse. However, the doctor will first want a quick word with you on your own. Your partner or companion is not allowed to be present during the actual treatment.

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.

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 happens with the embryo and the abortion tissue?

After the treatment, the embryo will be carefully kept at the clinic. At a later date, it will be collectively cremated by a specialist company.

I am having a pregnancy termination due to a foetal abnormality. Can I say goodbye?

This is only possible at Bloemenhove Clinic Haarlem. There are several ways to say goodbye to your baby in case of a pregnancy termination due to medical (foetal) abnormalities:
- collective cremation
- collective cremation and scattering of the ashes
- individual cremation
- individual burial, if you reside in the Netherlands

For more information, please click this link

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.

Is sedation (light anaesthetic) dangerous? What is the difference between sedation (light anaesthetic) and general anaesthetic?

Sedation is lighter than general anaesthetic. Your breathing is unsupported, so there is no intubation (no breathing tube is inserted into the trachea). After light sedation you wake up and recover much faster than after general anaesthetic.

The doctors in the clinic will always check if sedation is a safe option for you. For some illnesses, allergies or medication use, sedation is not a safe option. And if you don’t have an empty stomach, sedation can be dangerous. Your stomach content can transfer to your lungs, which can cause serious complications. That is why you have to be fasting prior to an abortion under sedation. If the doctor decides that sedation is safe for you, you will experience that this form of light anaesthetic is safe and comfortable. You will not be aware of the treatment, and many people quite like the feeling of the sedation.

Please note: 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.

Contraception

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 best contraceptive?

Contraceptive choices are personal, and depend on your personal circumstances and preferences. Do you want (more) children? Is it important to you to have periods? Do you want to prevent the risk of an STD or AIDS? Do you prefer a contraceptive that contains hormones? During a consultation, the doctor will discuss all these options with you. For more information about all contraceptives, please visit www.anticonceptie.nl  or www.zanzu.nl.

Who can use an IUD?

An IUD, or coil, suits almost all women, including women who have not (yet) given birth.

A copper coil is less suitable when you experience pain or heavy bleeding during your periods. In that case, a contraceptive implant may be better.  On the other hand, a contraceptive implant is less suitable for women who experience many side effects with hormonal contraception.

Before we fit an IUD, we have to check for any infection in your vagina, uterus and ovaries.

How does an IUD work?

An IUD disables the endometrium for the implantation of a fertilised ovum. In case of a copper coil, the copper kills the sperm. The contraceptive implant blocks the sperm from penetrating the

mucous membrane of the cervix. These are both safe forms of contraception with a very low failure rate.

After removal of the IUD, how long does it take before you can become pregnant?

As soon as the IUD is removed by a doctor, you can become pregnant.

I am younger than 21. Is an IUD free?

If you are younger than 21, the cost of the fitting of an IUD and the IUD itself are covered by your basic health insurance. Please note that the cost will be deducted from your health insurance’s deductible excess (‘eigen risico’). If you’re younger than 18, the deductible excess does not apply and the fitting of an IUD and the IUD itself are free of charge.

Are there any side effects for the contraceptive implant?

The first months there is a chance of irregular vaginal bleeding. Over time, menstruation may no longer appear. This is harmless: after removal of the contraceptive implant, menstruation will reoccur within weeks.

Contraceptives that contain only progestogen pose no increased risk of thrombosis or cardiovascular diseases.

Aftercare

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.

Do I need to have a follow-up after the abortion?

It’s important to have a follow-up 4 weeks after the treatment. You can have the follow-up at our clinic or at your GP surgery. A follow-up at our clinic is usually done by phone. If directly after the abortion you have been fitted with an IUD or there were some complications, the follow-up will take place at our clinic.

During the follow-up, the doctor or nurse will check if you have recovered physically, if you (still) have any symptoms and how you are doing emotionally. The doctor or nurse will also ask you how you have experienced the treatment and how you are coping. In addition to this, we will discuss contraception.

During a follow-up at the clinic, the doctor discusses the same things as during a follow-up by telephone. Also, you will take a pregnancy test and have an ultrasound scan.

I had an abortion but feel emotionally shaken. Where can I get help?

Having an abortion can be an emotionally taxing procedure. Even when women know for certain they don’t want a child, an abortion is a difficult decision. Many women struggle with ambivalent feelings. Hormonal changes can make you feel sad, gloomy or unstable. If you need someone to talk to, please contact FIOM. This organisation supports women before and after an abortion.

Can I know the baby's sex?

During the ultrasound, the doctor only looks at details relevant to the medical treatment, such as gestation and placenta position. The doctor does not look at the embryo’s sex, therefore we hold no information on the sex.

After the treatment

When can I have sex after an abortion?

To prevent infection, you can’t have vaginal sex for two weeks after the treatment. During these two weeks, you are also not allowed to use tampons, swim or take a bath, but taking a shower is fine.

Will my periods resume after an abortion?

Usually, you will have your period within 4 to 6 weeks. At first, your menstruation may be a bit different from your normal cycle. If you are on the pill, bleeding will usually appear after you finished the first strip.

After an abortion, when will I be fertile?

You are fertile immediately after an abortion.

When can I go back to work or exercise after an abortion?

Following an abortion you can go back to work or school the next day. Generally speaking, you can also exercise the next day. Depending on how you feel, we advise you to take it easy during the first week after the treatment. You are the best judge of what you can and can not do.

I am breastfeeding; when can I resume breastfeeding after the treatment?

The medicines you are given during and after the treatment do not affect breastfeeding. Very occasionally we have to administer a medicine that does affect breastfeeding. In that case, it’s best to postpone breastfeeding for a few hours. Of course we will discuss this with you beforehand. During the intake, always mention that you are breastfeeding so we can take this into consideration.

Other questions

What can I do after unprotected sex or when something went wrong with the condom?

If this happened less than three days ago, you can buy the morning-after pill (Norlevo®) at the chemist’s or pharmacy. You don’t need a doctor’s prescription. The morning-after pill does not offer 100% protection. If your period is more than one week late, take a pregnancy test. You can buy a pregnancy test at the chemist's or pharmacy.

If you had unsafe sex less than 5 days ago, you can also have a copper coil (IUD) fitted in your uterus. It prevents continuation of the pregnancy and prevents a new pregnancy.

How effective is the morning-after pill?

Did you have unprotected sex? You can take the morning-after pill up to 72 hours (Levonorgestrel) or up to 120 hours (ellaOne) to prevent a pregnancy.  The morning-after pill prevents 85% of probable pregnancies. The longer you wait taking the morning-after pill, the less effective it will be (95% within 24 hours, 85% within 24–48 hours, 58% within 48–72 hours). Its effectiveness after 72 hours is unknown.

Where is the morning-after pill available?

You can buy the morning-after pill at the chemist’s or pharmacy. You don’t need a prescription. The morning after pill is available free of charge for young people up to 21 with a doctor's prescription.

Can an abortion cause uterine adhesions?

There has been a lot of research into uterine adhesions after suction curettage. Much of this research focused on women who underwent suction curettage with methods completely different to the methods we use. Suction curettage of an intact pregnancy (not a miscarriage), with preparation of the cervix with medication and antibiotics afterwards, has negligible risk of adhesions: approximately 1 in 1500. As a matter of fact, adhesions do not necessarily affect fertility.

Can an abortion make me infertile?

This complication is extremely rare. If it occurs, it’s usually due to infection. To prevent infection, you are given antibiotics at the clinic. There is no scientific proof for diminished fertility after an abortion.

Reasons why women don’t get pregnant after an abortion:

  • Increasing age associated with declining fertility
  • Latent chlamydia infection
What are my options if I am facing an unwanted pregnancy but don’t want an abortion?

Is your pregnancy unwanted but you are against an abortion? You can choose to carry the pregnancy through and give your baby up for adoption or foster care. Your GP can support you or you can contact FIOM. FIOM is an organisation specialised in support and guidance for unplanned pregnancy, abortion and adoption. For a location near you, please check their website at www.fiom.nl.

When is there a heartbeat and what does that mean?

From about six weeks of pregnancy (about four weeks after conception), there may already be heart activity. This means that a few cells have been created that will later form the heart. These cells beat and circulate blood. However, this is not yet a fully formed heart; that doesn’t happen until about twelve weeks of pregnancy.

Are abortion costs covered by my health insurance?

No. If you live or work in the Netherlands, you don’t have to pay for the abortion. The costs are fully covered by the Long-term Care Act (Wet Langdurige Zorg; WLZ; a national insurance scheme for exceptional medical expenses). We don’t inform your health insurer about the abortion and no money is deducted from your health insurance’s deductible excess (‘eigen risico’). You remain anonymous.

How about my privacy?

We handle your personal information extremely careful and only give information to family or friends after your explicit consent. For example, if you know a family member or friend will call us to inquire after your health, please let the receptionist know. Also, we don’t pass on any treatment information to your health insurer.

How can I request a copy of my file?

At your request you can receive a copy of (part of) your file. You can collect the copy at reception on weekdays during our opening hours. You need to show your ID. If you can’t or won’t come in person, you can submit a request in writing. Please include a scanned image of your passport or ID card.