This page provides information about the option of a surgical termination of pregnancy. It supports the information that is given to you over the phone or in clinic but medical and nursing staff will be very happy to answer any questions you have.

• This operation takes place under a general anaesthetic so you will be asleep while it happens.
• Because you are having an operation you will be told not to eat or drink for a certain number of hours before you come into hospital.
• Somebody can come with you to the ward but nobody will be able to be with you during the operation.
• Somebody will need to take you home after the operation and stay with you overnight.

What happens during the operation?

You will be given a general anaesthetic, which means that you will be asleep throughout the operation and will not feel anything. During the operation the neck of the womb (the cervix) is gently made wider using dilators and the pregnancy is removed using suction through a thin plastic tube.

About an hour before you go into the operation theatre you will be given 4 tablets of a medicine called misoprostol which are inserted into the vagina, or they can also be put under the tongue. These tablets soften the cervix and make the operation easier to perform. These tablets do not have a licence for use in this procedure but are used all over the world and are very safe. You will also be given an antibiotic that is a suppository (into your bottom) to prevent infection.

If you would like an IUD (also called a coil) then the surgeon doing your operation can put it in at the same time as doing your procedure. This option is often appealing to people who are a bit anxious about getting an IUD put in while they are awake, and prevents you having to come back for another appointment. If you would like this option you can mention it to the clinic staff or to your surgeon when you see them before the operation.

What will happen before the operation?

A nurse will get you ready for surgery. Either a nurse can put in the misoprostol tablets or you can do this yourself. You will be given your antibiotics and have things like your blood pressure and pulse checked. The nurse will complete a checklist making sure everything is ready for surgery. You will then be taken to theatre on your bed or in a wheelchair and transferred into the care of the theatre staff.

The theatre staff will check all your details with you before taking you to the anaesthetic room where you will meet your anaesthetist. This is the doctor who will put you to sleep. A small cannula (drip) will be put into the back of your hand and some monitoring equipment attached so that the anaesthetist can care for you while you are asleep. The anaesthetic is given to you through the little drip in your hand and you may be given some oxygen to breathe as you go to sleep.

What are the risks of a surgical termination?

The procedure is very safe but like all forms of surgical treatment there are some risks. The risk of anything happening is small but the main risks are:

• Infection (about 8% risk). We give you an antibiotic when you come into hospital to help reduce this risk.
• Failure of the procedure, meaning either you are still pregnant after the operation (1 in 500 risk), or a small amount of the pregnancy is left in the womb. If this were to happen we might need to give you medicine, or do another operation.
• Damage to the neck of the womb (less than 1% risk)
• Perforation of the uterus (a hole is made in the womb), sometimes this can require a further operation. The risk of this is about 1 in 1000.
• Haemorrhage – excessive bleeding so that you might need a blood transfusion. The risk of this is about 1 in 1000.
• You will also be given a separate information page about the risks of a general anaesthetic, but generally for most people it is safe to have an anaesthetic.

Having a termination of pregnancy will not affect your ability to get pregnant or to have healthy pregnancies in the future.

The operation lasts about 15 minutes.

Once the operation is over you will wake up in the recovery room and then be brought back to the ward.

What will happen after the operation?

Most people who have this procedure have some period like crampy pain for a short while after the operation. There are lots of painkillers prescribed for you and please do ask for them if you need them. In some people the pain lasts a few days but should go away with paracetamol or ibuprofen.

When you go to the toilet please ask for help as the anaesthetic may make you unsteady on your feet. You will have some vaginal bleeding which should not be heavier than your normal period. If you are worried please tell the nurse looking after you.

You will be offered something to drink when you are back in the ward and later something to eat. Some people can feel sick after an anaesthetic and if you feel sick or vomit there are medicines to help you with this that you can have.

You will usually be able to go home by the end of the day. Most people stay about 3-4 hours after the operation. Sometimes it is necessary to stay overnight so we would recommend you bring overnight things with you just in case.

When can I have sex again?

You can have sex when you feel comfortable to do so. If you do not want to become pregnant again then using contraception will help prevent this. You will be able to discuss all forms of contraception with the clinic staff when you first attend, and we can give you most methods home with you from the hospital to make it easier for you to start.

Do I need to contact the ward after I am sent home?

You will not usually need to contact the ward, unless you are asked to by the nursing staff, however if you experience any of the following you should contact your own doctor.