Abortion, or termination of pregnancy
Specialist in the article
Revised 9/1/2023
An abortion refers to terminating a pregnancy either medically or surgically by suction scraping at the request of the pregnant woman. In Mehiläinen, abortions are only carried out in certain units by designated physicians.
Abortion, or termination of pregnancy, in brief
- The Abortion Act defines the limits of abortion.
- According to the new act, an abortion can be performed at the pregnant woman's own request before the end of the 12th week of gestation (≤ 12+0 weeks of gestation) without separate justifications.
- In Finland, more than 98% of abortions are currently carried out medically.
- The majority of medical abortions can be carried out at home.
- Abortions are carried out in public and private healthcare in Finland.
Abortion at Mehiläinen (Helsinki and Oulu)
In Mehiläinen, abortions are carried out only in certain units by designated physicians. In Mehiläinen, abortions are performed only in single pregnancies of less than 12 weeks of gestation (≤ 12+0 weeks of gestation).
Multiple pregnancies and longer-term pregnancies are always referred to public health care. Serious underlying diseases of the pregnant woman, an increased risk of bleeding (e.g. blood-thinning medication) or severe language barriers are also obstacles to an abortion being performed in Mehiläinen.
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Termination of pregnancy at one’s own request
The Abortion Act was amended as of 1 September 2023. According to the new abortion act, an abortion can be performed at the pregnant woman's own request before the end of the 12th week of gestation (≤ 12+0 weeks of gestation) without separate justifications. Abortions after 12 weeks of pregnancy are not covered by the amendment and their regulation remains unchanged.
The Act on Abortions in brief:
- Gestational length less than 12 weeks. A woman who is less than 12 weeks pregnant and wants to have an abortion can directly contact a unit performing abortions and make an appointment for an abortion, and a separate referral by a physician is no longer needed.
- Gestational length over 12 weeks. When the length of pregnancy is more than 12 weeks, the abortion may be carried out by a decision of the National Supervisory Authority for Welfare and Health (Valvira). For pregnancies over 12 weeks of gestation, the opinion of two physicians is still required.
- Medical justification regardless of the duration of pregnancy. Pregnancy can be terminated by a decision of two physicians on medical grounds, regardless of the length of the pregnancy, if the continuation of the pregnancy or giving birth to the child would endanger the life or health of the woman seeking an abortion.
How to get an abortion?
The pregnancy termination process depends on the length of the pregnancy. In early pregnancy and when the person is certain that she wishes to terminate the pregnancy, action must be taken without delay.
Gestational length less than 12 weeks:
When the length of a pregnancy is less than 12 weeks (≤ 12+0 weeks of gestation), a physician's referral and special justifications are no longer needed for an abortion, but the pregnant woman can directly book an appointment with the unit performing abortions. Currently, almost all abortions are performed medically.
In Mehiläinen, abortions are carried out only in certain units by designated physicians. The physician who performs abortions in Mehiläinen, together with an expert nurse, plans and carries out the abortion, the necessary laboratory tests and follow-up monitoring. The physician also assists in the planning of future pregnancy prevention.
Gestational length over 12 weeks:
When the length of a pregnancy is over 12 weeks, permission for an abortion is required from the supervisory authority, Valvira. These abortions are always performed in a public hospital. The pregnant woman must contact the unit that performs abortions in the public hospital in her area without delay. In addition, an appointment can be made with a Mehiläinen gynaecologist, who can assess the pregnancy situation with an ultrasound scan, plan subsequent pregnancy prevention can be and provide psychological support.
Uncertain situation:
If the length of a pregnancy is unclear or the person is uncertain about their decision to terminate the pregnancy, it is advisable to make an appointment with a gynaecologist. An ultrasound examination at the appointment can be used to determine the state of a pregnancy. Assistance with psychological coping can also be offered during the appointment, as the abortion decision can be mentally burdensome. After an abortion, it is important to take care of reliable contraception, which can be planned at the appointment even before the pregnancy is terminated.
Medical abortion
A medical abortion is carried out with the help of two different medications. A medical abortion is possible from week 5 (5+0 week of gestation) of pregnancy. The medications used in the termination of pregnancy are taken every 1–3 days. The medications used in an abortion can cause birth defects, so after taking them, the termination of a pregnancy should no longer be cancelled.
- In the first stage of the abortion, mifepristone is taken orally at the appointment. It prepares the uterus for the abortion. The medication can sometimes cause nausea, lower abdominal pain and bleeding.
- Another medication, misoprostol, is administered either vaginally or orally and results in the actual termination of a pregnancy; the uterus begins to contract and empty, producing a bloody discharge. The contractions feel like menstrual pain. The bloody discharge typically lasts 1–2 weeks.
After a medical abortion, it is sometimes necessary to perform additional scraping due to bleeding or an incomplete emptying of the uterus.
Contraception is started immediately after the abortion procedure. An IUD can be inserted after a medical abortion as soon as the uterus has emptied or in connection with a follow-up examination.
Surgical abortion
A surgical abortion is carried out by means of suction scraping of the uterus under anesthesia in the operating room. A surgical abortion is possible between the 7th and the 12th week of pregnancy. The uterine orifice is dilated and the uterus is emptied with a suction device. The scraping is carried out as a day surgery procedure, which does not usually require an overnight stay in a hospital.
The insertion of an IUD or a contraceptive capsule is usually possible during the procedure. Other contraception is started immediately after the abortion procedure.
Follow-up appointment
Nowadays a follow-up examination at the physician's office is usually no longer scheduled right away, but the situation should be reassessed if the bleeding is prolonged or other abnormalities occur. In that case, an ultrasound examination may be performed. Contraception is started immediately after the abortion procedure. An IUD can usually be inserted during the follow-up appointment if no issues have emerged in the abortion and recovery.
Sources:
TerveysporttiExternal link
TerveyskirjastoExternal link
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Gynaecology-related problems
Endometriosis
A gynaecological disease in which tissue that resembles the endometrial mucosa exists outside the uterus.
Lower abdominal pain in women
The most common causes for lower abdominal pain are either intestinal or gynaecological.
Ovarian cyst
An ovarian fluid-filled sac is often harmless and asymptomatic, but may sometimes require surgery.
Pelvic inflammatory disease
Abdominal pain, foul-smelling vaginal discharge and fever.
Urinary tract infection
A need to urinate frequently and a burning sensation or pain when urinating.
human papilloma virus (HPV)
a good tendency to heal, but it should be monitored so that the infection does not persist and progress to cancer.
Frequently asked questions about abortion
An abortion refers to terminating a pregnancy either medically or surgically by suction scraping at the request of a pregnant woman.
According to the new act, as of 1 September 2023 an abortion can be performed at the pregnant woman's own request before the end of the 12th week of pregnancy (≤ 12+0 weeks of gestation) without separate justifications. A woman who is less than 12 weeks pregnant and wants to have an abortion can directly contact a unit performing abortions and make an appointment for an abortion, and a separate referral by a physician is no longer needed. Abortions after 12 weeks of pregnancy are not covered by the amendment and their regulation remains unchanged.
According to the new act, a woman who is less than 12 weeks pregnant and wants to have an abortion can directly contact a unit performing abortions and make an appointment for an abortion. If the length of a pregnancy is unclear or the person is uncertain about their decision to terminate the pregnancy, it is advisable to make an appointment with a gynaecologist.
In Mehiläinen, abortions are carried out only in certain units by designated physicians.
A medical abortion is carried out with the help of two different medications. A medical abortion is possible from week 5 of pregnancy. The medications are taken every 1–3 days. In the first stage of the abortion, mifepristone is taken orally at the appointment. It prepares the uterus for the abortion. Another medication, misoprostol, is administered either vaginally or orally and results in the actual termination of pregnancy; the uterus begins to contract and empty, producing bloody discharge.
In a medical abortion, the rate of heavy bleeding as a complication is less than 1%. These cases may require a blood transfusion or uterine scraping. In approximately 5% of abortions, the uterus does not empty properly with medication, and uterine endoscopy or scraping is required.
A surgical abortion is associated with the risk of bleeding related to the operation and, as a rare risk, uterine perforation with a scraper instrument, which requires endoscopic surgery. After a surgical abortion, scraping or endoscopy must be performed on approximately 4% of patients. An infection requiring antibiotic treatment or a suspected infection occurs after a medical abortion in 3–5% of patients and after a surgical abortion in 4–9% of patients.
An uncomplicated abortion will not affect subsequent fertility. The effect of repeated abortions on fertility is not fully known. It is very important to ensure reliable contraception after an abortion in order to avoid the need for repeated abortions.