Sometimes a pregnancy will need to be terminated for various reasons. According to the law in Hong Kong, a pregnancy can be terminated before 24 weeks under the following conditions:
1) If continuation of pregnancy would involve risk to the life, physical or mental health of the pregnant woman greater than if the pregnancy were terminated.
2) If the child to be born would be severely handicapped as a result of physical or mental abnormality.
Terminating a pregnancy is a serious decision. The woman will have an appointment with a doctor to assess her condition and the pregnancy, and to discuss various options. She should take time to reconsider her choices carefully after the first visit. If she thinks that termination of pregnancy is the right choice for her, she will see a second doctor who will discuss with her the options again. This second medical consultation is required by law, and it also serves to ensure that the woman has made the correct decision for herself.
What are the options other than termination of pregnancy?
If termination of pregnancy is considered for a pregnancy with an abnormal fetus, the woman can choose to continue with the pregnancy if it will not pose health issues. If termination of pregnancy is considered for an unexpected pregnancy, the woman can choose to keep the pregnancy, adoption or to end the pregnancy.
What are the methods for termination of pregnancy?
There are two methods to end a pregnancy: medical termination of pregnancy, or surgical termination of pregnancy by suction evacuation of uterus if the pregnancy is still in the early stage.
Medical Termination of Pregnancy
Medical termination of pregnancy can be done in both the first and the second trimesters, up to 24 weeks. The woman will be admitted to hospital and will take two types of medications. Most women will pass the pregnancy around 6 hours after taking the second medication. But some may need repeated doses especially if the pregnancy is more than 10 weeks. She will be able to go home after the pregnancy tissue has been passed out and bleeding is not heavy. She will continue to experience vaginal bleeding after discharge from the hospital. It may take a few weeks for the remaining pregnancy tissues in the womb to be expelled completely, then the bleeding stops.
The advantages of medical over surgical termination of pregnancy are its non-invasive nature and there is no need for anaesthesia.
However, the woman will need to go through the entire termination process. She may experience medication side effects which include nausea, vomiting, diarrhoea, abdominal cramps, bleeding, fever and possible allergy. The duration of vaginal bleeding is usually longer when compared to surgical termination of pregnancy. She may need repeated follow-ups to confirm the completeness of termination. If there is retained pregnancy tissues, she may need to repeat the medications or to undergo surgery.
Surgical Termination of Pregnancy (Suction evacuation of uterus)
Suction evacuation of uterus can be performed in the first trimester before 12 weeks, usually before 10 weeks. The woman will be given a medication to loosen the cervix after admission to hospital. Then the operation will be performed in an operating theatre under monitored anaesthesia, regional or general anaesthesia. A suction catheter is inserted through the cervix to empty the womb by vacuum aspiration. She can go home on the same day.
The chance of completely clearing the womb after surgery is higher than medical termination of pregnancy, although there is still a 5% chance of retained pregnancy tissue after the operation. There will be some bleeding but the duration of bleeding should be shorter than after medical termination.
The drawbacks of surgical termination are its invasive nature, risk of anaesthesia and risks of the operation including bleeding, pelvic infection, uterine perforation, injury to cervix and scarring inside the womb cavity which may affect future fertility.