Surgical Abortion: What to Expect Before, During, and After

"I was overjoyed when I found out I was pregnant again! My first child came after years of waiting and hoping, so the idea of giving her a sibling felt like a dream come true. But my happiness was short-lived. At the end of my first trimester, a routine check-up revealed that my baby no longer had a heartbeat. Hearing that news felt like the ground had disappeared beneath me. I was told I needed a surgical abortion. The idea terrified me—not just the procedure itself, but the emotional weight of losing a child I had already imagined in my arms."

This is the story of Preeti, a mother of one, who has experienced both the joy of birth and the heartbreak of miscarriage. Like Preeti, many women face similar situations, feeling overwhelmed, scared, and numb as they prepare for a surgical abortion. The emotional and physical toll is heavy, and it’s hard to know what to expect.

Let's look at the step-by-step process of surgical abortion to understand what happens before, during and after the abortion procedure.  We'll also go through the emotional weight of the loss and how to make the coping process a little easier.

Before your surgical abortion, a doctor will check your health and confirm your pregnancy. They’ll explain everything, so you fully understand and feel comfortable with your decision. Counselling is also part of this process, giving you a safe space to share your feelings, ask any questions, and feel more prepared for what’s ahead. Let's take a more detailed look at what to expect, so you feel ready when the day arrives:

Clinical Assessment and Informed Consent

When Preeti went to see her doctor after the heartbreaking news, she was filled with questions: “What went wrong? I’m healthy—how could this happen?” The uncertainty was overwhelming. Her doctor reassured her by taking the time to explain the next steps. They gently walked her through her medical history, performed some tests, and helped her understand what had gone wrong.  

The first step in the process of a surgical abortion is a clinical assessment. Your doctor will ask about your health, your pregnancy, and any concerns you have. We are sure you might be wondering what went wrong and this is the moment when you get clarity and answers, not just about what has happened, but what the next steps are.

Whether it’s a medical or surgical abortion, your doctor will explain what’s best based on how far along you are and the condition of your pregnancy. Remember, it's okay to feel overwhelmed and have many questions.

This is your chance to ask any questions on your mind. The goal is to help you feel informed and confident in your decision. Your doctor will make sure you fully understand the process and only move forward with your consent. It’s a supportive step designed to give you a sense of control during this emotional time.

Counselling and Patient Education

Counselling plays an important role in your pre-abortion care. A trained counsellor listens to your feelings and concerns, creating a safe space for you to express yourself. The counsellor will explain the surgical procedure in a way that feels less daunting and more manageable, giving you the clarity you need to understand what will happen.

More importantly, this is your opportunity to ask any questions you may have. We spoke to a few mothers and these were a few questions they put forward. You might have several more, but might be a good place to start:

• How long will the procedure take?
• What will the recovery process be like?
• Will I need someone to help me after the procedure?
• How will this impact my future pregnancies?
• What emotional support is available after the surgery?

This counselling session isn't just about understanding the procedure—it’s also about emotional healing. It offers a supportive space to start to process your feelings as you brave the road ahead. It’s a chance to take a moment for yourself, to recognize that this is not just a medical event, but an emotional one as well. Thus, it is important to honour both your body and your emotional well-being.

As you get ready for your surgical abortion, know that your healthcare team is here to support and guide you, explaining each step so you feel more at ease. You’ll be asked to avoid eating or drinking before the procedure, and having someone you trust by your side can make the day feel a bit easier. Remember, you’re not alone in this—you have people who care about your well-being, and they're here to help you through every step as you focus on your health and recovery.

Cervical Dilation Methods

Cervical dilation is the first step in preparing for your surgical abortion, and it’s completely normal to feel a bit anxious. So far you have only heard of the process, this is when the reality hits. Cervical dilation is the process of gently opening your cervix to allow the surgical instruments to enter safely.

Your doctor may use medication to gently soften and open your cervix or special instruments to help with the process. You might feel some discomfort or cramping, but there are ways to manage this.

Sedation or anaesthesia is often offered to ease any pain. Many women reported that focusing on their breathing or having a loved one nearby can also bring comfort. Remember, this process is about ensuring your safety, and your care team will be with you every step of the way to help you feel as calm and supported as possible.

Don't be afraid of asking your healthcare team for anything that can make you feel a little more comfortable, may it be listening to your favourite song or even meditation mantras.

Sedation and Anaesthesia Options

It’s completely natural to feel anxious or restless before a surgical procedure, and your comfort is a priority. For your surgical abortion, there are different sedation and anaesthesia options available to help you feel at ease.

You might choose local anaesthesia, which numbs just the area around your cervix, so while you may feel a little discomfort, you won’t experience any pain. Another option is sedation, which helps you relax and stay calm, making the experience feel less overwhelming.

Your doctor will guide you through these choices, helping you find what works best for your comfort. In the end, it's your journey and your choice.

Knowing what to expect can help ease your anxiety about the surgical abortion procedure. It procedure usually lasts about 10 to 20 minutes, followed by a few hours of observation to ensure your safety. It’s natural to feel nervous but remember, you’re in capable hands.

Step-by-Step Process

Here’s a simple breakdown of what happens during the surgical abortion:

• Preparation: You will lie on an examination table, and your doctor will gently position you comfortably.
• Anaesthesia: You will receive either local anaesthesia to numb the area or sedation to help you relax, depending on your choice.
• Cervical Dilation: The healthcare provider will gently dilate your cervix using safe methods to prepare for the procedure.
• Vacuum Aspiration: A thin tube is inserted into the uterus, and a gentle suction removes the pregnancy tissue.
• Completion: Once the procedure is finished, the healthcare provider will check to make sure that everything is clear and safe. After this, you will be taken to a recovery area to rest.

Vacuum Aspiration Techniques

The vacuum aspiration technique, though it may sound intimidating, is a gentle and common method used for surgical abortion. In this process, a thin tube is carefully inserted into your uterus to remove the pregnancy tissue using gentle suction.

While the thought of it might sound a little scary, the procedure is usually quick and not painful, though you may experience some mild discomfort or cramping, similar to light contractions. These sensations are completely normal and typically subside once the procedure is over.

Your doctor may offer pain medication beforehand to help ease any discomfort, ensuring you feel as comfortable as possible. If you have any concerns or questions, don’t hesitate to discuss them at any point—your comfort and peace of mind are important. After all, it's your surgery.

After your surgical abortion, you'll have time to rest in a recovery room, where the medical team will monitor you closely and ensure you're comfortable. It's normal to experience some cramping and light bleeding, and the staff will be there to help manage any discomfort and guide you on caring for yourself at home. You know your body the best, so if you have any concerns, don't hesitate to stand your ground and ask for help.

Immediate Aftercare

After your surgical abortion, it’s normal to experience some cramping and light bleeding, similar to a period. Your doctor will offer advice on managing any discomfort, such as taking over-the-counter pain relief if needed. You’ll also be advised to take it easy for a few days, avoiding strenuous activities to allow your body the time it needs to heal. Listen to your body—rest when you need to, you deserve it.

Follow-Up Appointments

Your follow-up appointments are an important part of your recovery, giving your doctor a chance to check how you're healing and address any lingering questions or concerns. These visits are also an opportunity for you to talk about how you’re feeling, both emotionally and physically. If you are feeling up to it, you can also look into seeking professional help to come to terms with your thoughts and emotions. Remember, it’s okay to take your time as you heal, and you're not alone on this journey. Post-Procedure Recovery and Care

After your surgical abortion, you'll have time to rest in a recovery room, where the medical team will monitor you closely and ensure you're comfortable. It's normal to experience some cramping and light bleeding, and the staff will be there to help manage any discomfort and guide you on caring for yourself at home. You know your body the best, so if you have any concerns, don't hesitate to stand your ground and ask for help.

Surgical abortion, like most other invasive medical procedures is safe and usually does not have any concerning, long-lasting side effects. However, we always go by the popular adage - it is better to be safe than be sorry.

Common Side Effects

After your surgical abortion, it’s normal to experience some side effects as your body begins to heal. Understanding these can help you feel more prepared:

• Cramping: You might feel mild to moderate cramping, as your uterus contracts back to its normal size. Everybody experiences this cramping differently, but usually eases within a few days.
• Bleeding: Light bleeding or spotting is also common and may last for several days, as your body sheds the lining of the uterus. While some bleeding is expected, you should monitor it closely. If you notice heavy bleeding (soaking through a pad every hour) or large clots, reach out to your healthcare provider for guidance.

These side effects associated with surgical abortion usually resolve on their own. If you feel extreme discomfort, invest in a few strong over-the-counter pain relievers that can help you feel better.

Rare Complications

While surgical abortion is generally very safe, rare complications can sometimes occur. Infections may happen if the uterus isn’t fully cleared or if your wound seems infected, you might need immediate medical attention.

If you experience severe pain, heavy bleeding, or unusual symptoms like a fever that develop after the procedure, bring it to the attention of your primary healthcare provider. Your well-being matters, and staying informed about what to watch for can help you feel more confident and supported during your recovery.

If you find yourself in a situation where you need to consider an abortion, remember that you are not alone. Preeti, like many women, faced this journey with uncertainty and fear, but she learned that it’s okay to lean on others for support.

The experience can be physically, mentally, and emotionally challenging, but it does get better with time. Allow yourself the time and space to heal- both physically and emotionally - by focusing on nourishing your body with a balanced diet and engaging in gentle exercise.

Preeti reported that reaching out to her friends, family and community provided her with the distraction she needed as she found comfort in their understanding and love. Everyone talks about how it takes a village to raise a child, but healing from a traumatic event also needs a village, so hold yours close.

Prioritizing self-care was key for Preeti, as she took the time to nurture herself and process her emotions. Just like her, you deserve compassion and patience as you navigate this path toward healing.Conclusion.