How and what to expect

On your first visit to the clinic, you can expect to be told what method of abortion will be used, why and what side-effects you may feel afterwards. If you are late and you need to have the procedure before the next cut off of either 12 weeks or 20 weeks, you may be required to have the procedure on the day you are at the clinic.

Make sure to bring your favourite fluids (a drink or tea in a flask), hot water bottle, extra supplies of Brufen, and some snacks. 

Silence bugging you in the waiting room? If you have music on your phone and your earphones ready, play all the music that relaxes you. 

If you have a trusted friend or family member, ask them to join you as support! If you prefer to do it alone, that is also okay. You are not alone in spirit! 

Some people experience pain and discomfort after an abortion. This is totally normal and, in most cases, nothing to worry about. There are various pain relief options for different methods and stages of pregnancy available. 

For many, medical abortion is viewed as possibly more painful, but it is important to remember that everybody is different and that this may not be the case for all. You should be given Brufen 2 hours or so after the second set of medicines (Misoprostol). Paracetomol is not likely to be effective. If you are allergic to Brufen, there are other prescription pain drugs (Analgesia). Please ask your health provider.

It is important to address possible pain and cramps to ensure that you are relaxed, so you can release the fetial sac. Following this, the pains are moderate and similar to a painful period.

In surgical abortion, Brufen is also generally used.

Other options can include conscious sedation, where you are given a tranquiliser to make you sleepy, or a paracervical bloc where local anaesthetic is injected into your cervix. For survivors of rape and younger anxious persons, more pain relief is regarded as good pain relief.

Are you scared of what might happen after you have a medical abortion?

Bleeding is often the first sign that the abortion has begun. As the abortion continues, bleeding and cramps may become more severe. Bleeding as part of an abortion is often heavier than a normal menstruation, and there can be clots. The longer the pregnancy has developed, the heavier the cramps and the bleeding will be. If the abortion is complete, the bleeding and the cramps diminish. When you notice a peak of heavier blood loss and experience more pain and cramps, this could be a sign that most of the abortion has passed.

The heaviest bleeding typically occurs 2-5 hours after using misoprostol and usually slows down within 24 hours. The most intense cramping and bleeding generally lasts for 3-5 hours, but this is just a guide, and in fact, it can last for less or more time. Some people bleed heavily for up to 48 hours and may pass clots, days or even weeks after taking the Misoprostol. This is common and is not dangerous, unless you soak through more than two maxi pads per hour for 2 hours or more, or when you lose heavy clots bigger than an orange. It is normal for your body to take time to empty the uterus completely. Every person’s body is different. Normally, the bleeding will continue lightly for one to three weeks after the abortion, but times may vary. The normal menstrual period usually returns after four to six weeks.

Emotions

In 1995, Professor Eleanor Nash from the Psychiatry Department at the University of Cape Town, shared her research in Parliament regarding the emotional impact and after-effects of abortion. She noted that the most overwhelming emotion following an abortion is that of relief.

The most reliable indicator of whether someone will experience feelings of distress after an abortion is their emotional stability before the abortion. Choosing to have an abortion is an important decision. The decision-making process may be stressful, even if the outcome is ultimately positive.

Although the most common emotion after completing an abortion is relief, there also can be feelings of loss or sadness. Some people may have difficulty after an abortion because of:

• The obstacles encountered while trying to obtain abortion care
• Feeling alone while making an important decision
• Being in an environment where choosing abortion may be stigmatised

Some may feel grief even though they know they made the right decision. There is no right or wrong way to grieve. The feelings are real, and you should give yourself permission to have them.

If you need help coping with your emotions, it is important to ask for a referral to pro-choice counselling services in your community.