Where to get an abortion on a long term? There are many clinics, but there must be good reasons for this. Not every doctor will take on such responsibility. When planning an abortion, it is necessary to understand that it has a large number of adverse effects. An abortion on such a period is entitled to appoint only a doctor, relying on adverse medical indications for the mother or fetus.
If a pregnant woman has contraindications to childbirth that threaten her life and well-being, then she is advised to undergo surgical abortion. Another factor according to which an abortion can be performed for long periods is a severe anomaly in the fetus.
Terms up to 12 weeks
There is no difficulty in making an interruption in the first weeks of pregnancy. Clinics where you can get an abortion for a long time, much less. In accordance with the law, any woman has the opportunity to terminate unwanted pregnancy up to 12 weeks. The faster the abortion is performed, the more minor the negative consequences for the patient will be in the future. The most safe for the health of women consider drug interruption of pregnancy. The term when it is allowed to perform should not be more than 7 weeks. Another relatively safe method of abortion is vacuum aspiration. It is allowed to carry it up to 12 weeks.
If it is not possible to perform a drug or vacuum termination of pregnancy in the early stages, the doctor will advise medical abortion. It is performed by surgery. There is a pattern: the longer the period during an abortion, the greater the consequences after the operation. These include physical problems in the patient, and mental disorders.
Causes and indications
At the initiative of the patient to carry out later abortive intervention is impossible. Such permission can only give a medical commission. Its representatives make a positive decision and give approval for the procedure in such situations:
- Conception came due to violent sexual acts against the girl.
- It turned out that the child is outside the uterine body.
- Late abortions can be carried out in the presence of fetal abnormalities: genetic abnormalities, abnormal organ placement, pathogenic effects on the child of external factors (radiation, chemical elements, or physiological effects).
- Death of the fetus.
- Physical immaturity of the patient, for example, if the conception comes in a girl under the age of fifteen.
- The presence of a girl's disease states that threaten her life, for example, urinary, endocrine, blood-clotting pathologies or diseases of the peripheral structures of the nervous system.
- The patient, being in a position, suffered from serious illnesses or underwent therapy, which could negatively affect the formation of a child (carcinomatosis, rubella, or antibiotic therapy). In this case, the medical council is able to approve a positive decision on termination of pregnancy at a later period.
Sometimes this conclusion is made in situations where a pregnant woman has not been aware of her situation for a long time, so she led an immoral lifestyle without restrictions (she took alcohol, drugs). In this case, the lady registered in the antenatal clinic is not a member and does not intend to become a mother. In this case, the doctors conduct an examination to clearly see which pathologies are present in the baby. If they are found, then an abortion is performed.
It is worth paying attention to the reviews of those who have had an abortion for long periods. Women write that he caused irreparable harm to both physical and mental health.
After 12 weeks of pregnancy, the girl will not be able to perform an abortion procedure of her own accord. How long is it possible to terminate a pregnancy? Practicing doctors know the episodes, when the ladies performed abortive intervention and at 8 months. However, from a moral point of view, it is believed that after 3 months in the womb there is a tiny little man who has the right to exist. Therefore, it will be necessary to substantiate that the destruction of this life is expedient. In the clinic, where abortions are done on a long term, they will want to know about the reason. After all, it can hold because of the social status of women:
- The death of a spouse.
- Lack of housing.
- The presence of a family of more than 4 children.
- Small age of mother (till 16 years).
- Pregnancy due to rape.
- The arrest of the father or mother.
It should be noted that there are a lot of "important" social reasons for abortion. In Russia and other civilized countries, abortion in late periods is allowed only for medical reasons, and in some states it is prohibited under any circumstances.
What needs to be done before an abortion?
Since abortion at a later date can be carried out according to special indications, the lady is obliged to undergo a full examination before the operation (not only by the gynecologist, but also by specialists of other profiles). As a rule, examination involves the mandatory implementation of a gynecological examination in a chair and laboratory tests - bakposev from the cervical canal, smears from the urethra and vaginal cavity, biochemical and general blood and urine tests.
In addition, the patient is prescribed tests for HIV, the Rh factor and the group, antibodies to hepatitis C, syphilis, etc. In addition, FOG, rapid pelvic ultrasound, and an ECG may be required. After receiving all the results of the examination, the pregnant woman turns to a consultation with a professional of therapeutic profile and related specialties - a gynecologist, endocrinologist, oncologist.
Next, the doctors decide on the termination of pregnancy and what method will be used this abortive intervention. Up to a 20-week period, interruption is performed under abortion conditions. After 20 weeks, the procedure is carried out in the hospital of the obstetric department.
- The patient needs to receive specialized psychological help and support.
- Ladies are obliged to notify about the various methods of abortion.
- The doctor is obliged to advise the patient about the likely negative consequences and complications associated with abortion.
After completing the procedure, the woman should stay in the clinic until the end of the recovery period. Next, she should undergo a final examination. What are the cons of late abortion? First, surgery can adversely affect health and provoke complications. Secondly, abortion is considered an invasive surgery, which makes it rather painful. Third, a woman may experience bleeding and cramping. Fourthly, the anesthesia used during the procedure can cause unpleasant sensations.
According to the statistics of medical institutions, approximately 2% of women in the total number of abortions perform abortion at a late term.
What are the methods?
Selection of the method of abortive intervention depends on the duration of pregnancy and the general health of the woman. There are 3 methods of late abortion: saline pouring, artificial labor and small cesarean section. When saline in the amniotic bubble is punctured. Under the control of ultrasound, a hypertonic fluid (sodium chloride) is injected, causing the fetus to die, causing miscarriage. Artificial birth is possible due to specific substances that activate contractions in a pregnant woman. Then everything is done, as in typical childbirth. If a surgical method has been selected for an abortion, then the patient is given a mini-cesarean section on the cervix and in its lower region in order to extract the fetus. This method is used if the pregnancy threatens not only well-being, but also the life of a pregnant woman.
Such an abortion procedure is very rarely used in obstetric practice. The whole interruption procedure takes about 3-4 days. The termination of pregnancy with this method begins with the expansion of the cervix. In order to facilitate the patient's well-being, it is recommended to drink antispasmodics. Around the second day, the lady begins to feel contractions.
With the assistance of ultrasound technology, the doctor establishes a fetal presentation, then covers the legs of the fetus with special clamps and pulls the embryo out, while the head remains inside the female body. In order to prevent ruptures of the birth canal, the doctor incised the fetal neck and pumped the brain out of the skull with a special suction. As a result, the head of the fetus is reduced in size and easier to extract outside. Then, with the assistance of vacuum aspiration, placental tissues are aspirated, and the uterine cavity is scraped out with a curette, freeing from embryonic fragments and blood clots.
Such an abortive process hardly differs from the classical cesarean procedure. A surgeon makes a small incision in the lower abdomen of a woman, through which the fetal extraction is carried out. When the embryo is alive, it is killed. Such an abortive procedure may adversely affect the patient's subsequent reproductive abilities, but sometimes it is impossible to do without such an intervention.
Usually, a small cesarean section for termination of pregnancy in the later periods is prescribed when there are contraindications for independent deliveries. In most cases, doctors resort to this method in urgent situations if the fetus is to be extracted immediately.
Fill or saline abortion
From a psychological point of view, the method of salt abortions, which is used to terminate pregnancy in the later periods, is quite serious. It is justified in cases where developmental pathologies are found in the fetus, but with other types of abortion (for example, with artificial birth), it can be born alive. The process of filling:
- A needle is inserted into the amniotic bubble. Through it, pumping of amniotic fluid is performed (approximately 200 milliliters).
- Next, a mixture of sodium chloride is injected into the bubble.
- Under the influence of this solution, the fetal heart stops.
- This abortive method is very cruel, since under the salt influence the fetus feels unimaginable sufferings, receiving significant burns of absolutely all the planes of the body and mucous internal organs.
- A woman clearly feels everything that happens to the baby.
- Two days after the death of the fetus, the woman is provoked by artificial birth.
Such an abortion often leads to emotional trauma in women. Often, the appearance of the skin of children who are killed in this way is terrifying even to the medical staff. The worst thing is that some children after such a blasphemous method of killing are born alive. Most of them die within a day, but there have been cases when such children remained alive, however, they became complete disabled.
Complications of late abortion
With each method of abortion in late periods the problems are very serious, therefore pregnant women are warned about them in advance. In some cases, this information forces a woman to change the decision. After the procedure, you should undergo a rehabilitation course that helps to restore mental health, the state of the reproductive organs and the organism as a whole.
Complications in the process of abortion
At the time of the operation, cervical tears are frequent, which can cause difficulties during subsequent labor. Sometimes serious injury to the uterus, including perforation, occurs.
In addition, during abortions in the later periods, bleeding often occurs.
Another unpleasant moment is the placenta fragments remaining in the uterus. In such cases, carry out scraping.
Complications after the procedure
The following complications may occur after a long term abortion:
- Inflammation, suppuration of the endometrium - the inner mucous layer of the uterus. This is fraught with difficulties with the subsequent conception.
- Infections of the ovaries and fallopian tubes. Danger of clogging of the fallopian tubes.
- Adhesions in the fallopian tubes can cause ectopic pregnancy.
- Hormonal disruptions initiated by a sudden termination of pregnancy.
- Burdens due to Rh-conflict. In the case of a negative Rh factor, medication is needed.
- The imminent threat of miscarriages at various periods during subsequent pregnancies.
- Infertility. Therapy may be ineffective.
Who is contraindicated?
Late term abortion has many contraindications, which include coagulopathic conditions associated with bleeding disorders, which is why there is a risk of post-sports bleeding.
Also contraindications for such interruption are:
- The first pregnancy and the lack of medical indications.
- Aggravated chronic pathology.
- Long-term hormone therapy with glucocorticosteroids.
- Infectious diseases and inflammation of the reproductive organs.
If the patient finds at least one restriction for the operation, the doctor is obliged to interpret the real reasons for the refusal of such an intervention, its dangers and consequences.
Women in the responses about abortions on a long term of pregnancy, even many years after the procedure, were greatly regretted what had happened. Many write about severe psychological trauma, prolonged depression after an abortion. Many of these women managed to get pregnant again and safely give birth to a healthy baby. They write that they went for an abortion only for medical reasons and warn all women that they need to be very careful about their health in order to reduce the risk of developing pathologies in the fetus.
What you need to know?
According to the law, termination of pregnancy on the initiative of the woman herself is possible strictly up to 12 weeks, that is, in the early stages. Thus, 3 months is the latest term for abortion.
The earlier an abortion is performed, the less negative consequences for the woman’s body and the development of any complications.
Termination of pregnancy after 12 weeks refers to termination in the later periods. The operation is possible in three cases:
- Pathology of the fetus.
- Pathologies that are dangerous to the health and life of women.
- Social factor
If there are social reasons, termination of gestation is done up to 6 months, according to medical - in any month. The decision to have an abortion or not, in the long run is always for a woman. But the doctor should be brought to the pregnant woman all the information, why an abortion is required and what its possible consequences are.
Abortion pregnancy with pills (for example, Mifepristone and its analogues) or folk remedies in the later periods is impossible. Moreover, it is dangerous and can be fatal.
Termination of pregnancy in late periods: indications
Abortion is an artificial intervention in which the fetus is removed from the uterus of a pregnant woman at her request or for medical reasons.
Termination of pregnancy in 2 and 3 trimeters is possible only with the permission of the medical commission.
- pathology of fetal development,
- frozen fruit
- ectopic pregnancy,
- pregnancy in a girl less than 15 years old
- the course of treatment with antibacterial drugs or cytostatics,
- infectious diseases carried by a woman - measles, rubella and others.
The testimony for social reasons is the same - the conception that occurred as a result of rape.
It is not always possible to carry out an abortion at the request of a woman in the early stages or if there are weighty medical indications without serious complications.
Contraindications for intervention:
- the presence of rhesus-conflict and the first pregnancy,
- problems with blood clotting,
- infectious and inflammatory processes in the reproductive organs,
- long-term use of corticosteroids by women.
At the same time, existing contraindications can not cause a categorical refusal to conduct an operation.
In view of the fact that the cessation of gestation at any time can lead to complications, the possibility of an operation in 2 and 3 trimeters should be considered individually in each case.
Before the procedure
Termination of gestation in late periods is a serious external intervention in the functioning of the female body. Before the operation, an examination is appointed, which makes it possible to assess the state of the pregnant woman's body:
- blood test,
- determination of hCG level
- analysis for the detection of sexually transmitted diseases,
- smear from the genital tract,
- puncture of amniotic fluid (if interrupted for reasons of genetic abnormalities in the embryo).
Если запланировано сделать аборт по медицинским показаниям на большом сроке, после проведенного обследования собирается врачебная комиссия, которая решает вопрос целесообразности проведения операции.
Дилатация с эвакуацией
Метод применяется на сроке с 12 до 22 недель. Проводится под общим наркозом. A woman is given medication to widen the cervical canal. Then, using the tools, the cervix is opened and fixed and the embryo together with the amniotic fluid is removed with a vacuum apparatus.
The whole process is carried out using ultrasound scanning, which is necessary to monitor the operation and prevent damage to internal organs.
The duration of the operation is from 4 to 20-24 hours. After completion, the woman is left in the hospital for observation for several days.
Dilatation and curettage of the uterus
The method used to stop gestation in 2 and 3 trimesters. It is based on the use of a curette - a surgical knife, which is used instead of a vacuum aspirator.
Simply put, curettage is curettage of the uterus to extract the fetus.
The operation has a high risk of injury and perforation of the uterus.
Later, the operation has a serious negative effect on the woman’s body, since it has already had hormonal changes aimed at gestation and childbirth.
Possible complications after abortion in late periods:
- uterine injury,
- infectious process as a result of residues of the embryo in the uterus,
- purulent complications
- uterine bleeding,
- endometriosis - the growth of the endometrium outside the uterus,
- endometritis - inflammation of the endometrial tissue in the uterus,
- violation of the menstrual cycle,
- disruption of the ovaries due to hormonal failure.
- secondary infertility
- appearance of adhesions in the pelvic organs,
- urinary tract infections.
Long-term abortion is a great stress for a woman, both in terms of physical and psychological health.
For the speedy recovery of the body, the doctor makes recommendations:
- rejection of sexual activity within a month after surgery,
- lack of exercise
- refusal to use hygienic tampons,
- taking vitamin and mineral complexes,
- protein diet
- control of temperature, pulse rate and blood pressure level,
- control of vaginal discharge.
In addition, after the intervention, the woman is prescribed a number of drugs - antibacterial and hormonal, which must be taken strictly according to the prescribed scheme.
How many weeks do they have an abortion? Read the article about early and late termination of pregnancy, indications and contraindications, types of abortions, as well as about the procedure and the possible consequences.
What are the signs of missed abortion? Details here.
Termination of pregnancy in the later periods is unacceptable only on the one desire of the woman. To do this, there must be serious medical or social indications. If you had to have an abortion, it is important to follow all recommendations of the doctor after the procedure and carefully monitor the condition of your body.
Long term abortion methods
It is necessary to have very good reasons to decide on a large abortion in pregnancy of 12-28 weeks, since the fetus is practically developed and even viable, and for the life of a woman, abortion of late pregnancy is extremely dangerous. In addition, the psychological aspect of large abortions should be taken into account, in almost all cases of abortion a viable child is taken out, dying outside the womb, or he is brutally killed in the uterus.
There are the following main methods of abortion for long periods:
- The method of opening the water bubble is applied from 13-18 to 28 weeks of pregnancy. After opening, special forceps are superimposed on the presenting part of the fetus, a weight of 250-500g is suspended from them for the gradual removal of the child. In more than half of women, the course of such a large abortion can be delayed for a day or more, and its consequences can be infection, bleeding, ruptures on the cervix,
- Small cesarean section - done for a period of 18-27 weeks, in exceptional cases, to save a woman’s life for medical reasons, such an operation can be carried out for a period of 13-18 weeks. The fetus is extracted through a cavity incision in the lower abdomen, often the extracted baby moves its limbs and even cries. He dies from hypothermia, for this the fruit is placed in the refrigerator. More than 3% of women who have undergone such an operation further suffer from vascular occlusion (thromboembolism),
- Intraamnial replacement of amniotic fluid with a concentrated solution of sodium chloride and glucose is carried out for a period of 18-27 weeks. The cervix is grasped by a special instrument, the cervical canal is dilated, and a thick, special long needle is inserted into the uterus, which pierces the amniotic sac. A part of the amniotic fluid is sucked through a needle and a special solution is injected, after a few hours the labor activity begins. The fetus is virtually expelled from the uterus, dying a painful death. For a woman, such a procedure is fraught with penetration of the solution into the circulatory system, an increase in sodium content in the blood (hypernatremia), which may result in a drop in blood pressure, chest pain, headaches, shock, destruction of red blood cells and, in exceptional cases, death,
- Drug method - for up to 27 weeks, intravenously injected drugs containing prostaglandins, which have a strong effect on the tone of smooth muscles, causing contractions and labor. In most cases, the child is born alive, dying afterwards. The use of prostaglandins for a large abortion can cause nausea, vomiting, stomach pain, bronchospasm, slow heartbeat, a drop in blood pressure, and severe uterine bleeding.
Contraindications for abortion in late pregnancy can be acute infectious diseases, any inflammatory processes, fever, diseases in the female genital area, cervical or ectopic pregnancy.
When the pregnancy period is large, an abortion can be done only after a comprehensive examination. You need to do an ultrasound of the uterus and fetus, determine the Rh factor and blood group, do a clinical blood test, tests for RW, HBS, HIV, hemostasiogram (platelets, prothrombin index, blood clotting time for bleeding), a complete biochemical blood test for glucose, cholesterol , total protein, bilirubin, creatinine, urea. An urinalysis should be submitted, including a study of vaginal smears, cervical canal and urethra for a bacterioscopic examination, to determine the presence of antibodies to the hepatitis C virus. Make an ECG, an x-ray of the chest organs, undergo an examination by a therapist, and other doctors if necessary.
Complications after major abortions
An artificial termination of pregnancy in the later periods is possible only in hospitals, where there are all conditions for the provision of emergency medical care - resuscitation, surgical, intensive care by physicians with special training. Despite such a qualified approach to abortion over long periods, the likelihood of the following complications is high:
- Cervical tears,
- Accumulation of blood in the uterus - hematometer,
- Incomplete removal from the uterus of the uterus fragments of the ovum or fetus with their further decomposition and infection of the abdominal cavity of a woman,
- Damage to the walls of the uterus - perforation,
- Placental polyp,
- Various purulent and inflammatory processes.
The progress of a large abortion should be monitored on an ultrasound scan, or it should be done immediately after the abortion is completed; it is important to make sure that parts of the fetus and placenta are completely removed.
After such an operation, the patient must visit the antenatal clinic in order to undergo the necessary rehabilitation measures and select individual contraceptives for a more reliable protection from unwanted pregnancy in the future.
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Causes, dates and consequences of late abortion
Late abortion is an abortion in the period from 12 to 22 weeks. It can be spontaneous, then it is called a miscarriage, or artificial. In the case of spontaneous abortion, it is necessary to undergo an examination to identify its cause. Especially if a woman plans pregnancy again in the near future. It is necessary to take a blood test for TSH, TORCH infections (rubella, herpes, toxoplasmosis, cytomegalovirus), sowing on Listeria.
If it is a question of having an abortion at a later date, that is, artificially ending the pregnancy, then the woman should know that, by law, she has the right to do so of her own accord only up to 12 weeks. This is the latest date for abortion in Russia. Although in the case of surgery at this time, it usually does not end without consequences. A woman has a long time to recover. Later, you can get rid of the child only if there are good reasons.
- tuberculosis (of any organs, not just the lungs),
- severe cardiovascular diseases,
- psychical deviations,
- oncological diseases,
- sugar and diabetes insipidus,
- congenital deafness and deaf-mutism, etc.
In addition, this may include diseases and malformations of the fetus:
- genetic disorders (Edwards, Down syndrome, etc.),
- lack of brain, bladder, kidneys, etc.,
- hygroma neck.
Dates of late abortion are not limited. The difference will be only in the name of the interruption procedure - “abortion” or “artificial labor”, but the essence will not change.
But there are social reasons why you can terminate a pregnancy for more than 12 weeks. These are serving time in a correctional institution, deprivation of parental rights, pregnancy as a result of rape, and some others. In this case, the timing of the abortion is limited to 22 weeks.
Late (at 20 weeks) abortion takes place in the form of artificial childbirth, which doctors call using different methods, but always in stationary conditions.
This may be the use of prostaglandins and kelp sticks. Births occur within 12 hours.
Or the procedure under the difficult name “amnioinfusion of hyperosmolar solutions” - when part of the amniotic fluid is replaced with a solution of sodium chloride. In the people - "fill". Births occur within 30 hours after that. Prostaglandins are often used together with the introduction of this solution into the uterus. This is the best way for a period of 20-22 weeks.
For a period of 13-16 weeks, doctors, under local anesthesia or with the use of general anesthesia, widen the cervix of the woman, as in the case of classical surgical abortion, extract the contents and carry out cleaning. By the way, cleaning is an obligatory procedure after artificial birth.
Has a late abortion contraindications, doctors take this into account. It is necessary to cancel or postpone abortion, if there are inflammatory, infectious diseases of the genital tract. There are other serious diseases.
A negative Rh factor in a woman is not a direct contraindication to abortion. But after it, it is necessary to introduce human immunoglobulin Rhesus (D).
The consequences of abortion in late periods can be quite severe, significantly affecting the reproductive capabilities of women. Here are some of the possible consequences.
1. Heavy bleeding. It happens more often in women for whom this abortion is not the first. The uterus does not contract well and a hematometer may occur. It is treated by prescribing drugs for better contractile activity, hemostatic and antibacterial.
2. Infectious complications, endometritis, resulting in adhesions, an increased risk of infertility and ectopic pregnancy. Antibiotic therapy helps reduce the risk of these complications.
3. Perforation of the uterus. Since the doctor works blindly, does not see the uterus from the inside, is guided only by his feelings and experience, he may accidentally pierce the organ with a sharp instrument. An urgent operation for suturing the uterus is required. But it may be useless, and then the uterus will have to be removed.
4. Damage to the endometrium that occurs with too thorough cleaning. An inferior mucous membrane can grow at the site of injury, because of this, menstrual dysfunction occurs, scars appear.
5. Injuries to the cervix. Arise as a result of its expansion. As a result, it becomes the cause of cervical insufficiency, and a woman cannot bear a child without suturing the cervix.
6. Psychological injury, violation of libido. Of course, such consequences in the first place will be for those women for whom pregnancy was desired, and for an abortion who agreed for medical reasons.
Abortion in the long term of pregnancy is a great stress for the body. Often a woman needs the help of a psychologist. As for the recovery and the next pregnancy, it is desirable to wait 3-6 months. During this period, oral contraceptives can be taken. This will help restore hormones, the ovaries will rest, and pregnancy will quickly come to the removal of contraceptives.
Sexual life is not recommended for 1 month after abortion, you need to wait for the next menstruation. Until complete elimination of vaginal discharge can not take a bath, swim in pools and ponds. Avoid hypothermia, strong physical exertion. In case of an increase in temperature that is not associated with a respiratory disease (ARI, ARVI), immediately consult a doctor.