Surgical Termination of Pregnancy

A surgical termination empties the uterus through the cervix, with no cut on the abdomen. The cervix is gently opened and the contents of the uterus are removed using suction, which takes only a few minutes once everything is in place. The whole attendance is a matter of hours.

It is used where the pregnancy is beyond the stage at which medicines are appropriate, where a medical approach has not fully worked, where there is a medical reason that makes it the safer option, or simply because it is what you prefer. Some women choose it because it happens at one appointment, under sedation, with the clinical team present throughout, instead of unfolding at home over a day.

In India this is governed by the Medical Termination of Pregnancy Act. It is carried out by a registered medical practitioner at an approved facility within the limits and on the grounds the Act sets out. For a woman over eighteen the consent required is her own, and the consent of a husband, partner or parent is not needed; for someone under eighteen a guardian consents. Your identity is protected under the Act.

You will be asked not to eat for about six hours beforehand. A medicine is often given a few hours ahead, by mouth or vaginally, to soften the cervix so that it opens easily and gently; it can cause cramping and some bleeding while you wait, and that is expected.

The procedure is done under sedation, so you are drowsy and comfortable and will usually remember little or nothing of it. Local anaesthetic is also placed around the cervix. The cervix is opened, a fine tube is passed and suction empties the uterus. It takes five to fifteen minutes. A coil can be fitted at the same time if you want one, which saves a separate appointment.

You wake in the recovery area and are observed for two to four hours while the sedation wears off and the bleeding is checked. This is a Day Care attendance and you go home the same day, but you must have a responsible adult to take you home and stay with you overnight, and you cannot drive, sign anything important or look after a small child alone for twenty-four hours.

Bleeding after a surgical termination is usually lighter and shorter than after the medical method: a few days to a fortnight, tailing into spotting. Cramping like a period lasts a day or two and settles with simple pain relief. Most women feel able to return to work within one to two days.

Use pads instead of tampons and avoid sex, swimming and tub baths until the bleeding has stopped, usually one to two weeks, to reduce the risk of infection. You may be given a short course of antibiotics. Your next period should come in four to six weeks.

Ovulation can return within two weeks, so contraception is worth starting immediately and most methods can be begun the same day. A follow-up is arranged to check the bleeding has settled and to go through contraception properly. Feelings afterwards vary widely and there is no right way to have them; if low mood lasts more than a few weeks, go back and say so, because support is available and it helps.