Pregnancy termination

Abortion

If you’re pregnant but don’t want to have a child, explore the options available for terminating your pregnancy (an abortion) with your doctor. This is a big decision, so it’s important to involve your parents/caregivers if you are below the age of 16.

Sometimes parents/caregivers are shocked or angry, and sometimes they’re understanding. There’s really no way to know how yours will feel unless you talk with them about it. It might help to find a time when you can talk in private and there are no distractions. If you’re feeling nervous or scared, you can ask a friend or other family member to be there with you during the conversation. That way, you’ll have support no matter what happens.

If you really feel like you can’t talk to your parent, talk to a sister, brother, aunt, uncle, cousin or a professional you trust like a nurse or social worker.

Are you thinking about terminating a pregnancy? Or not sure what to do about it? Then speak to your doctor or a Public Health Nurse can help to advice you.

Early termination?

If your period is less than 16 days late, you can have an early termination to end the pregnancy. ‘Late’ is from the day your period should have started.

If you don’t know when your period should have started, you can still work out how long you’ve been pregnant. Count the number of days from the first day of your last period until now. That is the length of the pregnancy. If you’ve been pregnant for less than 6 weeks and 2 days and you want to have an early termination with the abortion pill you can make an appointment with your doctor at Saba Cares. You will need an ultrasound by the doctor first and then you can start an early termination straightaway.

An example:
If you look back in your Calendar or Period Tracker, you may remember that your period started on a certain day. Count from that day the number of weeks and days until today. That’s how long you’ve been pregnant.

Methods

There are different ways to terminate a pregnancy. Choose the method that suits you best. The possibilities will also depend on how long you’ve been pregnant.

Abortion pill. If you’ve been pregnant for less than 9 weeks, you can terminate the pregnancy with a medical abortion. This is called the ‘abortion pill’. You can get these pills from your doctor at Saba Cares clinic.
Vacuum aspiration. A vacuum or suction aspiration is possible if you are less than 13 weeks pregnant. A thin plastic tube is inserted through the vagina to empty the uterus. During this surgical procedure, the pregnancy is gently sucked out of the uterus. This cannot be done at Saba Cares Clinic, but you can make an appointment with your doctor at Saba Cares to get more information. If you want this procedure, the doctor can refer you to a center where they can do this, for example to Bonaire. At SMMC they are not allowed by law to do this procedure.
If you are more than 13 weeks pregnant, an abortion is still possible. This can be done up until 22 weeks. The uterus is then emptied using a tube and some special instruments. This procedure cannot be done at Saba Cares clinic, but you can make an appointment with your doctor at Saba Cares who can refer you to a center where they do this treatment, for example to Bonaire. At SMMC they are not allowed by law to do this procedure.

Ultrasound Scan

You need to have an ultrasound scan first, to find out the exact length of the pregnancy and to make sure that it is not an ectopic pregnancy. Ectopic means that the pregnancy is outside the womb. That is also necessary to see which method can be used for the termination. You can tell the doctor if you don’t want to see the screen and tell the doctor if you do or do not want to know details, for example if a heartbeat of the embryo is seen.

Too soon?

If your period is only a couple of days late, the ultrasound might not show anything yet. The doctor can then discuss with a gynecologist to decide what to do. The doctor must be sure that the pregnancy is inside the womb by seeing it on the ultrasound. The abortion pill will not work and is even dangerous to give if there is an ectopic pregnancy, A vacuum aspiration won’t be effective if you have only been pregnant less than 6 weeks (this means less than 2 weeks late for your expected period or 6 weeks after the 1^st day of your last period). The embryo is too small.

Appointment

When you go to Saba Cares clinic for a termination, they will ask you some questions:

When did you last have your period?
Can you explain why you want to have an abortion?
Have you thought about it properly?
Is an abortion your own choice?
Are you unsure about your decision?
Would you like to talk to someone about it?
Would you like to look at the ultrasound scan?
Is there any risk of you having an STI?
Have you thought about contraception after the abortion?

Doctors and nurses do not judge your situation in any way. They respect your decision, whatever that is. They will give you information about the different ways to terminate the pregnancy. You will also be told about possible side effects and risks, and about pain relief.

Are you under 16?

If you’re not yet 16, you cannot decide about an abortion yourself. You need the consent of a parent or guardian.

If you don’t you have their consent or you are worried about how they will react. An abortion is still a possibility if you are aged between 12 and 16. The doctor will arrange for you to talk to another adult. Another doctor for example. The doctor does this to make sure that no one is making you have the abortion, and that you have thought about it properly. We always encourage you to talk to your parent or guardian about this decision.

Forced to have sex?

Were you forced to have sex? Tell the doctor. You can trust them. They are obliged to keep things confidential.

Doubts

Perhaps you want to have an abortion, but you’re still a bit unsure. Talk to the doctor about your doubts or worries. You can always change your mind. You can also take more time to decide. What’s important is that you’re sure you are making the right choice.

Support

An abortion can be a difficult decision. It helps if you can talk to your boyfriend, parents, or a close friend about it. Get support from people you trust. Make sure you don’t have to deal with it all on your own!

When you go to get an abortion, you can take someone with you. Your partner or a female friend, for example. The doctor will only talk to you. If you have any doubts or questions, or problems with your relationship, you can talk about those then. Health professionals are obliged to keep anything you tell them confidential, so they cannot tell anyone else. That is only allowed if you give your consent.

Emotions after an abortion

After an abortion, you may experience all kinds of emotions: relief, sadness, guilt, or shame. Some women feel unsure afterwards whether they made the right decision to have an abortion. That’s quite normal. Mostly those feelings go away again with time. Talking to someone about them does help. You can talk to your doctor or someone you trust.

Some people ”say” you can develop mental health problems after an abortion. That’s not actually the case. Women who have mental health problems after an abortion often had those problems before the abortion. People or organizations who say things like this are often against abortion.

Check-up

After the procedure you will have an appointment with your doctor. Your doctor will tell you when the new appointment is. The doctor will repeat the ultrasound to check whether the termination went well. They will also give you advice about contraception. If you have physical problems, or difficulty dealing with your feelings about the abortion, tell the doctor about it.

Very occasionally, the pregnancy hasn’t been terminated. You can do a pregnancy test yourself to check that you’re no longer pregnant. If it is negative, you are no longer pregnant. But if you had the abortion pill you can still have pregnancy hormone up to 2 weeks even if the termination went well. If the test is still positive you need to repeat it at least 2 weeks after the procedure.