Considering an abortion

It is estimated that half of all pregnancies in Australia are unplanned and 1 in 4 pregnant people have accessed abortion in their lifetime.

Deciding if you want to have an abortion can be a difficult choice and every pregnant woman or person has the right to make their own choice about abortion. It is important to talk to your healthcare practitioner about your options as early in the pregnancy as possible.

In Western Australia (WA), pregnant women and people have access to holistic, client-centred, and non-judgmental pregnancy choices and abortion care services. For more information on abortion services in WA visit HealthyWA website (external site).

 

What is abortion?

The process to end a pregnancy is called an abortion. In WA, there are two types of abortion available in Western Australia: medical abortion (where medicines are used) and surgical abortion (when an operation is performed).

Note, the type of abortion chosen may be impacted by how many weeks pregnant you are and your individual circumstances.

 

How do I access an abortion?

You do not need a referral to access abortion services. If you are under 9 weeks gestation your general practitioner (GP) may provide you with an early medical abortion. If you are over 9 weeks gestation, your GP can refer you to an abortion care provider.

Alternatively, you can call Sexual Health Quarters on 1800 4 CHOICE (1800 424 642) who can assist you to find a provider based on your individual circumstances. You can also make an appointment with a service that provides abortion care to discuss your options.

When you make an appointment with your healthcare provider, they will:

• confirm the pregnancy
• discuss the medical risks of abortion and pregnancy and clinically assess your individual circumstances
• tell you where you can access an abortion or may provide you with a medical abortion if you are under 9 weeks gestation.
• if your healthcare provider does not provide consultations or abortion services, they must either refer you to a healthcare provider who can provide abortion services or provide you with information that specifies how abortion services can be accessed.

 

Abortion care at King Edward Memorial Hospital

King Edward Memorial Hospital (KEMH) does not provide a routine abortion service. However, it can facilitate care for women and people in specific medical or social circumstances.

When an abortion is performed at KEMH, support is available to assist you in making the best decision for your individual situation.

 

Is abortion safe?

When performed by a qualified health professional, an abortion is a safe medical procedure. It is one of the most common gynaecological procedures performed in Australia.

Generally, the earlier you have an abortion the safer it is. This is why it is important to discuss your pregnancy and options with a healthcare provider as early as possible. Your healthcare provider will discuss possible complications of having an abortion or continuing the pregnancy. Although serious complications are not common, all medical and surgical procedures have some risks. This will depend on your specific circumstances.

 

How much does an abortion cost?

The cost of the abortion will depend on how far along you are in the pregnancy, whether you have a medical or surgical abortion and where you have the procedure.

 

Is counselling and support available?

The decision to have an abortion is yours alone. It can be helpful to talk to someone you trust to be supportive and unbiased. The unplanned pregnancy counselling services listed below offer independent counselling to assist with decision making and post-abortion counselling. These services are free and optional.

Please advise the service if you are requesting unplanned pregnancy counselling so that your appointment is prioritised, or if you need an appointment for counselling following an abortion.

See abortion counselling and support for a list of providers.

 

What happens before an abortion?

Your healthcare provider will ask questions about your medical history and may do some tests and screening, which can include blood tests, screening for sexually transmitted infections and an ultrasound to confirm how many weeks pregnant you are.

You will be given information on the types of abortion available to you, what to do after the procedure and pain relief options, as well as information on relevant support services.

 

What is a medical abortion?

Medical abortion uses a combination of two medications to end a pregnancy. It is available up to 9 weeks of pregnancy via a general practitioner or community abortion provider. After 9 weeks, it is only available in a hospital setting.

The first tablet (Mifepristone) may be taken when you are at the clinic with your healthcare provider. This medication blocks a pregnancy hormone. To complete the abortion, you will be given a second tablet (Misoprostol) to take 36 to 48 hours later. It causes the womb (uterus) lining to break down and you will experience vaginal bleeding, cramping and you should pass the pregnancy tissue. This usually occurs within four hours. However, in some cases, it may occur anywhere between 30 minutes and 48 hours after taking the misoprostol tablets. The bleeding lasts on average 10 to 16 days and may be heavy.

If no bleeding has occurred within 24 hours after taking the misoprostol, you should contact your healthcare practitioner as soon as possible.

There is a known small risk that a medical abortion may not be fully completed, and a further surgical procedure may be required. Your healthcare provider will provide you with information and contact details so you can access help if there are any complications.

 

What is a surgical abortion?

A surgical abortion removes the contents of the uterus using gentle suction and will be undertaken at a clinic or hospital. The day procedure is performed under anaesthetic. Occasionally patients do not have sedation and instead a local anaesthetic may be used to numb the cervix (neck of the womb). For a pregnancy over 13 weeks, a slightly different process is used.

The table below provides a summary of medical and surgical abortion. You should talk to your healthcare provider before deciding which one is right for you.

 

	Medical abortion	Surgical abortion
What happens in this type of abortion?	This procedure uses medication, given in doses over two or more days that induce miscarriage-like symptoms.	This is usually performed by an operation called a suction curette under anaesthetic as a day procedure. In more advanced pregnancy (after 13 weeks), the procedure is technically different, called dilation and evacuation.
Where will the abortion take place?	It can take place in a clinic or at home.	It will take place in a clinic or hospital as a day procedure.
How long does it take?	You will usually pass the contents of pregnancy within four hours of taking the second medicine. Contact your healthcare practitioner if no bleeding has occurred within 24 hours of taking misoprostol. Bleeding may take several days to settle.	It usually takes less than 20 minutes, depending on how far along your pregnancy is. You should expect to spend up to several hours for the whole process if your care is in a clinic. If your care is in a hospital, you may need to stay for several hours or overnight on a ward.
Is the abortion painful?	You may have some pain (mild to severe) and bleeding or clotting (like a heavy period). Pain relief medication, as ordered by your healthcare provider, should help with any discomfort.	Some cramping or mild abdominal pain after the procedure is normal and pain relief medication (ordered by your healthcare provider) or a hot pack should help with any discomfort.
How much bleeding will there be?	You will have vaginal bleeding during a medical abortion. This is usually heavier than your normal period. After passing the pregnancy, bleeding can last for about 12 days but should get lighter day by day.	You will have vaginal bleeding after surgical abortion. Bleeding can last for 10 to 14 days but should get lighter day by day.

 

What if I am under 18 years old?

If you are under 18 years old, you will be able to make the decision about abortion without the involvement of your parent / legal guardian, unless there are concerns about your ability to make the decision. This will be discussed with you by the health practitioner involved in your care.

If you do not want your parent or legal guardian to know about your pregnancy, and the health professional has concerns about your ability to make a decision, then you can apply for an order to the Supreme Court or Family Court of WA who will decide on your behalf. Legal assistance for this is free via Legal Aid WA. This legal service can help you with the application and putting your case to the court.

Web: Legal Aid Western Australia (external site)
Telephone: (08) 9261 6222

 

What if I am 23 weeks pregnant or more?

If your pregnancy is 23 weeks or more, abortion is available. Please speak to your healthcare provider about your individual circumstances and preferences for accessing abortion care.

 

Registration requirements

If the gestational of the pregnancy is over 20 weeks, it is a legal requirement to register the birth and death with the Registry of Births, Deaths and Marriages. The required forms will be provided to you before leaving hospital.

 

What if I am getting pressured by others to make a decision?

Reproductive coercion is behaviour by a partner or family member that interferes with the autonomy of a person to make decisions about their reproductive health. Reproductive coercion can also be called reproductive pressure, and it includes any behaviour that has the intention of controlling or constraining another person’s reproductive health decision-making, for example:

• Controlling or sabotage of another person’s contraception.
• Pressuring another person into pregnancy.
• Controlling the outcome of another person’s pregnancy, eg; forcing someone towards abortion, adoption, care, kinship care or parenting.
• Forcing or coercing a person into sterilisation, including tubal ligation, vasectomy and hysterectomy.

If you are experiencing any of these issues and / or do not feel safe or respected in your relationship, please approach your nearest women’s health centre for support and information.