Abortion

What is abortion?

Abortion is the termination of pregnancy before the fetus is capable of life outside the womb (28 weeks of pregnancy in Ghana). Most abortions are done during the first 12 weeks of pregnancy and abortions after 28 weeks of pregnancy are done only if the mother’s or the baby’s life is in danger. Abortion may be spontaneous (without deliberate intention) or induced and legal issues surrounding them vary all over the world. The incidence of spontaneous abortion has been estimated at about 20% of all pregnancies.

In which ways are abortion carried out?

Abortion may be carried out using medicines (medical abortion) or using surgery (surgical abortion).

Medical abortion

A medical abortion is performed by taking two medications in a pill-form: mifepristone and misoprostol both of which are covered by the Ghana’s National Health Insurance Scheme. These two drugs work together to end a pregnancy. You can use this method until your 10th week of pregnancy. A medical abortion is not for everyone.

Your medical practitioner might suggest that you avoid this method if: your pregnancy has implanted outside of the uterus (ectopic pregnancy), you are allergic to mifepristone or misoprostol, you have a bleeding disorder or you take blood thinners, or you have an intrauterine device (IUD).

A medical practitioner will give you mifepristone in the health facility. This medicine blocks the hormone progesterone, which the embryo needs to implant in your uterus and grow. You may be given the misoprostol to take home with you and take it a few hours or up to 4 days after the first pill. You may either take the medicine by mouth or by placing the pills into your vagina.

Misoprostol makes your uterus contract to push out the pregnancy tissue. You may start to cramp and bleed heavily 1 to 4 hours after taking misoprostol. Most people pass the pregnancy within 4 to 5 hours after taking the pills. Others take up to 2 days. You might want to take a couple of days off from work because of the discomfort. Your periods usually restart about 4 to 6 weeks after an abortion.

You may start to ovulate about 3 weeks after you take the medicine. Once you ovulate, you can get pregnant again. Your medical practitioner might recommend that you wait to have sex for a week or two after your abortion and use a contraceptive to avoid another pregnancy. A medical abortion shouldn’t affect your ability to get pregnant in the future, if done well. This method may fail and surgical abortion may be resorted to.

Surgical abortion (Vacuum aspiration)

Vacuum aspiration is usually done during the first 12 weeks (sometimes up to 16 weeks) of pregnancy. Some people choose vacuum aspiration as the main method for having an abortion. Others need it after a medical abortion fails to end their pregnancy. This method might not be right for you if you have: an abnormally shaped uterus, blood clotting disorders, a pelvic infection or other serious health problems. Vacuum aspiration uses gentle suction to pull the fetus and placenta out of the uterus. You’ll have this procedure by a registered medical practitioner in a registered health facility.

You may need to stay at the health facility for a few hours afterward to make sure the abortion is complete and might need to take a day or two off from work or school because of the discomfort. It is advisable to avoid sex for at least a week after the procedure and use a contraceptive to avoid another unwanted pregnancy. Your periods may return about 4 to 6 weeks afterward. Having this type of abortion shouldn’t affect your ability to get pregnant in the future.

Surgical abortion (dilation and evacuation)

Dilation and evacuation (D & E) is an abortion procedure that is used after the first 12 weeks of pregnancy. It’s usually recommended for someone who’s delayed getting an abortion, or for someone who chooses to end a pregnancy because the fetus has a severe abnormality or medical problem. D & E uses a combination of vacuum aspiration and other instruments to hold and remove the fetus with the placenta. The procedure may be done over a two-day period. On the first day, the doctor dilates (or widens) your cervix to make it easier to remove the pregnancy tissue. On the second day, the doctor uses a holding instrument called forceps to remove the fetus and placenta, a tube to suction blood out of the uterus, and a scoop-like instrument called a curette to gently scrape out the uterine lining.

You’ll have this procedure in a hospital or a clinic. Your doctor will give you a numbing medicine to prevent pain and discomfort. You may need to take off a few days from work or school due to discomfort and wait for about two weeks to have sex after the procedure. It is advisable to use a contraceptive to avoid an unwanted pregnancy and also avoid heavy exercise for one week after the procedure. Your periods may restart 4 to 8 weeks after the procedure and having a D & E shouldn’t affect your chances of getting pregnant in the future.

Spontaneous abortions (Miscarriage)

This usually occurs when the fetus dies or does not form well because of genetic diseases, ill health of the mother, womb abnormalities, father and mother being advanced in age, physical or emotional trauma to the pregnant woman or as a result of taking some medications or drugs. When there is a miscarriage, or unusual bleeding during early pregnancy, a medical practitioner may check for the viability of the pregnancy and advise.

If the pregnancy is not viable the doctor may proceed to make sure the womb is emptied using any of the relevant procedures described. It is advisable that you seek medical advice from a licensed medical practitioner if you need an abortion so you can avoid unnecessary long-term complications of unsafe abortions.

Does Ghana’s law allow abortion?

Under the current laws of Ghana, an induced abortion may be carried out by a registered medical practitioner in a registered health facility under the following conditions: in case of rape, defilement or incest; threat to the physical and mental health of the mother; presence of fetal abnormality and mental illness of the mother.

What are the dangers and misconception of abortion?

Both spontaneous and induced abortions may be complicated by infections or profuse bleeding. Resorting to the use of unlicensed practitioners and unlicensed medicines or concoctions to effect an abortion can wreck lifelong health damage or even lead to death.

How is the advice to those seeking abortion?

Safe abortion procedures are healthcare. Speak to a midwife or doctor at a clinic or hospital when the decision is made to have an abortion. Avoid over the counter medications or quacks who claim to be experts in such procedures.

Abortions may be psychologically traumatic. Take full advantage of family planning methods and services to avoid unplanned pregnancies.