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ABORTION PROCEDURE - HEAVY SEDATION PLAN B
For the woman who is concerned about discomfort, but is less concerned
about total privacy and time. Plan to be in our office 4 to 4-1/2 hours.
Plan B patients share a waiting area with other women also choosing abortion.
After your fee is paid, an ultrasound and lab work will be done. You will
then fill out a medical history and consent forms and will meet privately with
an educational counselor who will answer your questions and review your medical
history.
While you are in our office, birth control methods will be reviewed and most
women can be started on the birth control Pill before leaving the clinic. The
birth control shot is also available the day of the abortion procedure if you
choose. Please speak with a staff member when scheduling if you have questions
about this highly effective method of birth control.
Patients who choose Heavy Medication Plan B will be given a pelvic exam to
check the position and size of the uterus. Either the assistant, the nurse, or
the doctor will check your blood pressure with the arm cuff. The physician will
explain what he/she is doing so that there will be no surprises. Your assistant
is there to lend support, talk to you and help you relax.
The heavy anesthesia consists of a "cocktail" of medications which
work together to provide relaxation and pain relief. Valium 10mg is a
tranquilizer to help you relax before and during the procedure. Vicodin is a
pain medication to help relieve discomfort during and after the procedure. Also,
you will receive an injection of Toradol by the nurse for cramping along with
800mg of Ibuprofen. IT IS IMPERATIVE THAT YOU TAKE NO MEDICATIONS BEFORE YOUR
APPOINTMENT THAT WE ARE NOT AWARE OF. DEATH CAN RESULT.
Each patient may react differently to the medications. As always, it is
important for you to relax. The more you relax, the better your medications will
work.
The procedure begins as the doctor injects lidocaine into the cervix and the
surrounding area. This drug is similar to Novocaine at the dentist's office. You
may feel a pinch or a slight sting, a ringing in your ears, and you may even
have a funny taste in your mouth. Do not be alarmed...these are normal side
effects, and will pass quickly.
The doctor will begin to dilate the cervix. The cervix is a tight, round muscle
which closes off the uterus from the vagina. It does this to keep germs in the
vagina away from the uterus, and it supports the uterus during pregnancy. It has
a natural opening called an "os". The os will be gently stretched to
give an opening approximately as big around as your little finger.
Dilation will take approximately one and a half to two minutes. During
dilation you will experience a few minutes of moderate to strong cramping. Every
woman reacts to pain/discomfort differently, but every woman will have less
discomfort if she relaxes as much as possible. If you will relax your legs and
let them go limp in the stirrups, your abdomen will automatically relax, and
that helps lessen the cramping you feel. Controlling your breathing will help
lessen the cramping even further. Your assistant will help you get into an even
rhythm with your breathing. Take a deep breath through your nose, hold it for a
count of five, then blow out through your mouth, letting your whole body relax.
After the dilation is complete, the cramps will probably lessen somewhat during
aspiration.
After the cervix is dilated, the aspiration process begins. The aspirator is a
machine which produces a vacuum, a gentle suction. A tube is attached to the
aspirator which is then attached to a vacurette (a plastic straw-like tube much
like what your dentist uses to suction your mouth). The vacurette goes through
the cervix into the uterus, and the suction removes the pregnancy and the lining
of the uterus. This will take approximately two to three minutes. When the
suction is complete, the physician will use a curette, a blunt, spoon-shaped
instrument to feel the inside walls of the uterus to make certain the uterus is
empty. The entire abortion procedure at 12 weeks or under will take five to six
minutes or less. Since you are awake and aware, you will hear the aspirator
making a humming noise. This is just a machine noise, and does not have anything
to do with your body. Cramping will continue to decrease after your abortion
procedure is complete.
You will stay in your room for about 15 minutes so that your assistant can
monitor your bleeding and your vital signs. After that time she will help you
dress, and will walk with you to your recovery area. We will ask your guest to
join you in that area if you choose. one of the assistants will briefly remind
you of how to take care of yourself, check your bleeding and vital signs and
will make certain you have all appropriate medications and prescriptions. After
about 15 minutes you are discharged from the medical area.
You must make arrangements with someone such as a friend, relative or taxi to
drive you home if you wish to schedule for Plan B. With these medications you
may not drive, walk, or take the bus home alone. These medications may interfere
with your concentration and with your ability to drive or walk unassisted.
Please get something to eat soon after leaving the clinic as you will probably
feel better if you do.
Please remember that complications of abortion in the first 12 weeks are
rare, a first trimester abortion being at least 8-14 times safer than
childbirth. Although the rate of complications will increase once you pass the
12th week of pregnancy, even at the 18th week of pregnancy, abortion is still a
safer procedure than childbirth.
The most common complication associated with abortion is infection. This is not
because of the abortion itself, since all the instruments used in abortion have
been sterilized, but most often occurs because some patients do not follow the
detailed verbal and written suggestions we give for taking care of themselves
after the abortion. For a few weeks following the abortion procedure the cervix
and uterus are vulnerable to infection, so patients simply must follow
instructions to help prevent infection of the cervix and uterus.
Occasionally a pregnancy, pregnancy tissue or uterine lining is missed by the
suction, and is retained in the uterus. If there is a missed abortion, or if
retained tissue does not pass on its own with bleeding after your abortion, it
is possible that a resuctioning of the uterus could be necessary. Your physician
does check the uterus to attempt to make certain a missed abortion has not
occurred. This is one reason why a follow-up visit is very important after an
abortion.
One of the possible complications is perforation (puncture) of the uterus or
laceration of the cervix. Anytime instruments are used in or around these soft
organs there is a risk of tearing or puncturing them. According to the Center
for Disease Control, this occurs in about 1% of abortion procedures nationwide.
If this complication should occur, the most common treatment is hospital
observation to make certain the uterus repairs itself. Only in the most extreme
cases would surgery be required.
All patients are instructed to return here for a post-operative check-up. If
you choose not to come to New Woman Health Care, it is imperative you see your
own physician or Health Center. You must tell your physician that you have had
an abortion, and approximately how far in the pregnancy you were. This check-up
is considered the final step to assure the abortion was complete, and that you
are on your way to a healthy reproductive future.
Please remember that New Woman Health Care would be happy to help you with
the birth control pill, Depo-Provera which is know as the birth control shot, an
IUD, a diaphragm, and if necessary, emergency contraception...the Morning After
Pill, as well as regular pelvic exams and Pap smears.
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