Options for terminating a pregnancy

There are different options for terminating a pregnancy. Which do you choose?

Abortion pill

The ‘abortion pill’ is a combination of different tablets. You take the first tablet in the doctor’s office. This tablet (mifepristone) blocks the pregnancy hormones and makes your womb sensitive for the misoprostol. You’ll hardly notice anything after taking this first tablet, possibly some bleeding or stomachache.

You are given 4 tablets (misoprostol) to take at home 1 or 2 days later. Usually, the doctor advises you to insert the 4 tablets into your vagina. If you don’t want to insert the tablets in your vagina yourself, you can make a new appointment with the doctor to do it for you. But you can also let the tablets melt in your mouth. This medication makes the uterus contract, and the pregnancy tissue passes through the vagina, with some bleeding. It looks like a heavy period. You can compare it to a natural miscarriage.

How long doest the bleeding last?

The bleeding usually lasts for about 2 to 3 weeks, but sometimes for a shorter or longer period. How much you bleed also varies per person. Depending on how long you’ve been pregnant, you may see the pregnancy sac in the blood. It is a transparent ball with a tiny embryo in it. But sometimes you won’t see it between the blood clots. 

An abortion pill is not a morning after pill.

An abortion pill is different to a morning after pill. You take a morning after pill soon after having unprotected sex. A morning after pill can prevent pregnancy. You take an abortion pill when you’re already pregnant. The abortion pill ends the pregnancy.

Does an ‘abortion reversal pill’ exist?

You might have heard about a pill that will stop a medical abortion tablet if you regret having taken it. This information comes from organizations who are against abortion. There is no evidence of a medication working like that. Nor any proof that this would be safe for your health. 

Vacuum aspiration

How it works

During a vacuum aspiration, the uterus is emptied through the vagina using a thin tube. Usually you are given medication beforehand to gently open the cervix (entrance to the uterus), and also some pain relief. Then the doctor puts a special instrument into your vagina, which keeps it open. The cervix is given a local anesthetic, so you won’t feel anything. The doctor removes the pregnancy from the uterus through a thin tube. 

After the abortion

After the procedure, you are advised to stay at the abortion clinic for a while to recover. If you had sedation, you cannot drive yourself. Usually, the cramping goes away after the procedure, but you may have some stomach cramps for a couple of days afterwards. You’ll be given an antibiotic to prevent infection and some advice about pain relief. There is usually some bleeding, something like a normal period.

Could you become infertile?

No, your fertility doesn’t change after an abortion. Fertility does decrease as you get older. Usually from the age of 35. Your doctor can tell you more about possible complications after an abortion.

Is it painful?

You may feel a short, sharp pain as the local anesthetic is given. You may also feel some cramps during the procedure. These cramps are like bad period pains. Some clinics offer sedation. Then you are asleep during the procedure and don’t feel anything. 

How long does the bleeding last?

You may feel a short, sharp pain as the local anesthetic is given. You may also feel some cramps during the procedure. These cramps are like bad period pains. Some clinics offer sedation. Then you are asleep during the procedure and don’t feel anything. 

Which method is more affective?

Both an abortion pill and a vacuum aspiration are effective in terminating a pregnancy and they are both safe. With either procedure, there is a slight chance that the pregnancy hasn’t ended. That’s why it’s important to do a pregnancy test after 3 to 4 weeks. 

Placing a Coil

Would you have like to use a hormonal or copper coil after the abortion? If you have a vacuum aspiration, the coil can be placed immediately. If you decide to have the abortion pill, a coil can be fitted 3 to 4 weeks later. A contraceptive implant can be placed in your arm straightaway. 

Which method is best?

Consider the two methods side-by-side

Abortion pill

  • This medical abortion can be done up to 9 weeks of pregnancy.
  • It can be done at the Saba Cares clinic.
  • After the first pill at the doctor’s office, you take the other pills at home, or take them with your doctor.
  • It is like a natural miscarriage.
  • You may have painful stomach cramps and more bleeding than with a vacuum aspiration or a period.
  • Your partner, or someone to give support can be there.
  • There is not a doctor with you, but you can always call a doctor if you’re worried about anything.
  • You don’t know beforehand when the termination will start and how long it will take.
  • You do not need an antibiotic afterwards.
  • You can have a coil fitted 3-4 weeks later. A contraceptive implant can be placed immediately.

Vacuum Aspiration

  • This surgical abortion can be done up to 13 weeks of pregnancy.
  • It can’t be done on Saba so you have to go to a different place for it, usually Bonaire.
  • A doctor carries out the procedure
  • You don’t see the embryo or fetus after the abortion (unless you want to).
  • With a local anesthetic, you might have some pain.
  • If you have sedation, you won’t feel anything. You will be attached to a drip through one of your veins.
  • Usually, no one is allowed to be with you during the procedure.
  • You have the support of the medical team.
  • With sedation, you’re not aware of the abortion itself, which you are with a local anesthetic.
  • The lower part of your body is uncovered for the procedure
  • You know when the procedure will be done and how long it will take.
  • You will be given an antibiotic to prevent infection.
  • You can have a coil or contraceptive implant placed immediately. 

Abortion after 13 weeks

It is possible to have an abortion after 13 weeks. But this isn’t offered by all abortion clinics. During the procedure, the uterus is emptied using a suction tube and special instruments. Ask your doctor or an abortion clinic about the options. 

More than 22 weeks pregnant?

If you are more than 22 weeks pregnant, you can no longer have the pregnancy terminated at an abortion clinic. If there is a serious defect in the fetus, you can have a pregnancy termination carried out in a hospital. That is possible up to 24 weeks. 

Planning your pregnancy

Planning ahead with anything, especially with pregnancy, can help you get through the challenges that a pregnancy and birth can present.

Many women would like to get pregnant and prefer to do so when they are ready and best capable to provide and care for the baby.

Some people don’t plan their pregnancy, and therefore are not prepared for the emotional, financial, and physical aspects of pregnancy.

One’s life changes drastically after a baby.

Benefits of planning your pregnancy:

  1. You are better able to take your financial stability into account / steady career and or income.
  2. No surprises or stress when missed periods.
  3. You can take the time to further educate yourself about pregnancy.
  4. You can take vitamins and supplements to help your fertility levels
  5. You have time to consciously adapt your lifestyle and behavior for example reaching a healthy weight.



Need more help with planning your pregnancy?  Talk to the Public Health Nurse or your doctor.