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Tshwane Women Clinic

Pregnancy termination in Pretoria,Gauteng

Is abortion legal?
Yes.However, after the first trimester of pregnancy, each state has the right to regulate how a woman can access abortion care and states can choose to restrict access to abortion care after the second trimester.  In Pretoria, a woman can access an abortion through 24 weeks in her pregnancy based on her last menstrual period (LMP).  At Tshwane Women Center, abortion services are offered through 23 weeks and 6 days from the first day of the last menstrual period

What are the risks of abortion?
Though all medical procedures carry some risks, abortion is considered one of the safest procedures a woman have.  Having an abortion at any stage in pregnancy is considered to be 5 -10 times safer than going through childbirth.  If you choose to have an abortion at Tshwane Women’s Center, our staff will be available to answer any questions or concerns that you have regarding specific risks before your procedure.  Risks vary, depending on the type of abortion you choose

What is the difference between surgical abortion and medical abortion?

A surgical abortion occurs when a doctor (or other qualified health care provider) removes a pregnancy from the uterus.  The doctor numbs the cervix (opening of the uterus), then dilates (opens) the cervix a little bit to put in a small tube and removes the pregnancy with suction.  A surgical abortion may take anywhere from 5 – 20 minutes depending on where you are in your pregnancy.

For additional information about a first trimester abortion click here (go to Surgical 1st trimester abortion page) and for additional information about a second trimester abortion

Medical abortion involves the use of medications that induce abortion. For most women, the medical abortion process is similar to having a miscarriage.  This option is only available early in pregnancy.  The Tshwane Women’s Center uses the FDA approved medications mifepristone and misoprostol for medical abortions.  Mifepristone is also known as RU-486 or Mifeprex®.  In the small percentage of cases in which medical abortions fail, surgical abortion procedures are often required to complete the abortion process.

How can it be too early to have an abortion?
In order to have an abortion, your physician must be able to confirm that there is a pregnancy in your uterus. At Tshwane Women’s Center, we use an ultrasound to confirm pregnancy. If you are very early in your pregnancy, it may be too small to be detected or seen on the ultrasound. At this early stage, the likelihood of missing all or part of the pregnancy tissue (resulting in an incomplete abortion) is increased. In order to avoid this complication, we ask that you wait until your pregnancy is at least 4 or 5 weeks, when it will be clearly visible with ultrasoundIn addition, we will need to confirm that the pregnancy is in the uterus before attempting an abortion. In rare cases, the pregnancy may be developing outside of the uterus or in one of the fallopian tubes. This is called an ectopic pregnancy, and may require immediate emergency care. Using an ultrasound before your procedure will help us to rule out the possibility of an ectopic pregnancy before starting your procedure

When is it too late to have an abortion?

In general, an abortion is legal in the South Africa through the second trimester, or 24 weeks from the first day of the last menstrual period (LMP). In Pretoria, you can access abortion care through 24 weeks LMP, and Tshwane Women’s Center offers abortions in Gauteng up to 24 weeks and 6 days LMP. In some situations, usually involving severe fetal defects or abnormalities, third trimester abortions may be performed, but these are extremely rare and cannot be performed in all provinces.

Because both the risks of abortion and the costs increase as a pregnancy progresses, we recommend that you make the decision to end your pregnancy as early as possible. However, an abortion at any time during pregnancy is still a very safe procedure.


How long does the procedure take?

A first trimester surgical abortion will usually take about 5 minutes. Second trimester abortions can be longer, taking anywhere from 10 – 20 minutes for the surgical procedure. Some second trimester abortions also require additional time to dilate the cervix before the surgery is performed. The dilation process can take anywhere from 30 minutes up to 24 hours (overnight) prior to the surgery.

While the surgery itself is not long, it is important to remember that there are several pre-operative assessments that are required to ensure your comfort and safety prior to the surgery, so your appointment may take several hours to complete. Be prepared for some waiting time in between your assessments – we believe that your health is our priority so if you need extra time at any point in the process, please be assured that we will take time to address your needs. We extend that same courtesy to all of our patients, which at times may affect your wait.


Is an abortion painful? How long will I feel pain after an abortion?

Every woman experiences pain differently and what seems very painful to one person may not seem painful at all to another. The physical experience that you have during an abortion will vary depending on the type of abortion you choose to have (surgical vs. medical abortion) and the type of anesthetic you choose (local vs. IV sedation).

Women who choose to have a surgical abortion with a local anesthetic will often tell us that they experienced strong cramping and a feeling of pressure during the procedure. How intense the cramps are will vary from person to person. Mild cramping (like menstrual cramps) after a surgical abortion will usually last for one or two days, though it is normal to have cramping on and off for a few weeks. This cramping should be alleviated with over the counter pain medication.

Women who choose to have a medical abortion will often tell us that they experienced very strong cramping and heavy bleeding that subsides within several hours. Mild cramping (like menstrual cramps) after a medical abortion will usually last for one or two days, though it is normal to have cramping on and off for a few weeks. This cramping should be alleviated with over the counter pain medication.

Severe, intense pain is not normal after an abortion and could be an indication that something is not OK. If you are experiencing extreme pain after your procedure, please call us immediately at (012) 772-3033!


Do my parents have to know about my abortion?
 No. Your partner or parents does not need to know. Your services are completely confidential.

What is the difference between a medical abortion (abortion pill) and emergency contraception pills (morning after pill)?

A lot of people are confused about the difference between medical abortion (also known as “medication abortion”) and emergency contraceptive pills (also known as “morning-after pills”)! Emergency contraception pills help to prevent pregnancy; medical abortion terminates an established pregnancy.

According to the best scientific evidence available, all FDA-approved emergency contraception pills work by interfering with ovulation or fertilization before pregnancy begins and are not able to terminate an established pregnancy An excellent fact sheet explaining the differences can be found here and more information can be found here.

Be careful when you search for information online about this topic, as there are many anti-abortion websites that contain misleading statements and misinformation.


What is medical abortion?
Medical abortion involves the use of medications that induce abortion.  For most women, the medical abortion process is similar to having a miscarriage. This option is only available early in the pregnancy.  The Atlanta Women’s Center uses the FDA approved medications mifepristone and misoprostol for medical abortions.  Mifepristone is also known as RU-486 or Mifeprex®.  In the small percentage of cases in which medical abortions fail, surgical abortion procedures are often required to complete the abortion process.

What are emergency contraceptive pills (ECPs)?

ECPs are used to prevent pregnancy immediately after sex. They can be up to 95% effective when taken immediately after sex. You might choose to use ECPs if you have unprotected sex, have a problem with your contraception use (condom breaks, skipped a day of your birth control pill, etc.) or if you are sexually assaulted. ECPs are available without a doctor’s prescription for women 17 and older. If you are under 17, you will need a doctor’s prescription in order to obtain ECPs.

Plan B®, Next Choice®, Levonorgestrel, and ella® are currently the only products marketed specifically as emergency contraceptive pills in the United States. ECPs are most effective when taken immediately after unprotected sex, but can be used up to 5 days after

Can I have a support person with me during the procedure?

You may have your partner, parent or friend with you doing your session with your patient advocate, but due to various protocols and regulations, support persons are not permitted to accompany you during your surgical procedure or during your stay in the recovery room. Your support person is welcome to wait in our waiting room, or leave and return to pick you up. Generally we recommend that your support person wait inside the clinic so that he or she can be easily contacted in case of an emergency.

You will have a team of highly qualified, compassionate medical personnel to guide you through the process. If you feel that you would like additional support during your surgical procedure, please talk with one of our patient advocates. Our advocacy staff is there to support you and is able to be with you throughout your procedure

Is it safe to have more than one abortion?

Having an abortion is very safe.  An abortion procedure is up to 10 ten times safer than childbirth.  While there are risks associated with an abortion procedure every time you have one, there is no definitive research that shows that having more than one abortion procedure will cause increased risks to you, your future health or your fertility.

Yet pregnancy in general does carry risks and having many pregnancies – regardless of whether the pregnancies end in abortion or not – may increase some of these risks.  Because of this, it is extremely important that you share your health history and a detailed pregnancy history with your medical provider to ensure that you are receiving the highest quality of care for your individual needs.


How can I choose a provider?

When choosing an abortion provider, it is important to find one that meets your needs, both physically and emotionally.  There are many different types of healthcare facilities that provide abortion care, such as private doctor’s offices, clinics, surgery centers, and hospitals.  When looking for an abortion provider, try to get as much information as you can about the facility.  The more you know about your provider, the better your experience will be.

A good abortion provider will answer all your questions.  If you are unsure of your decision, they should provide you with unbiased counseling and referrals for all of your pregnancy options. The provider should be able to provide accurate medical information about abortion procedures, the procedure’s safety and possible risks, pre- and post-operative instructions, and information about any state mandated abortion laws that you need to follow.  Most importantly, you should be treated with respect and compassion, and be offered access to supportive services after the procedure such as counseling and birth control.  You deserve the best treatment and services available, and you deserve to be treated with dignity and kindness

Can I choose to have IV sedation on the day of my appointment?

Yes. You have the option of choosing either local anesthesia or IV sedation for your surgical abortion.  However, we need to review your current and past medical health history and do a brief physical exam, to determine whether or not general anesthesia is a safe option for you in an out-patient facility.  Also, because you will need a ride home and not eat or drink after midnight on the night before your surgery, you must have an escort to bring you to and from your appointment if you would like IV sedation.

Please see more information about our anesthesia services

Is receiving IV sedation in the office safe?

In the hands of a qualified professional, such as our Certified Registered Nurse Anesthetist (CRNA), IV sedation is a safe option for most women during an abortion procedure.

Sedation care doesn’t stop when your surgery is over. The process also includes specialized care that takes place before and after the anesthesia is given. In addition to our surgical staff, you will be cared for by our CRNA who will provide the anesthesia, and experienced Registered Nurses (RN) in the recovery room.

How will I feel after anesthesia? When will I feel normal?

Everyone responds differently to anesthesia.  Some women feel wide awake immediately after surgery, while some women will feel sleepy for several hours after and some women will experience some dizziness or nausea afterwards.  Because the anesthesia medicines stay in your body up to 24 hours after your procedure, it is important that you have someone to escort you home safely.

Please see more information about our anesthesia services

Why do i need a ride?

It’s all about your safety!

If you have chosen to have IV sedation, the medications used during general anesthesia can remain in your body for up to 24 hours and can cause side effects such as feeling drowsy, light-headed, dizziness and nausea.  It is extremely important that you do not drive, make important decisions or care for small children immediately after your procedure.

If you choose to have local anesthesia or if you choose to have a medical abortion with medication, you are able to drive yourself.  But we always recommend that you bring a supportive person with you to aid in your comfort throughout the process.

When will I get my next menstrual period?
You can expect to get a normal period about 4 to 8 weeks after the abortion. Often the first menstrual period after an abortion is heavier than normal.
How soon can I have sex?
Generally, you can start having sexual intercourse about 2 weeks after your abortion.  We recommend waiting to have sex until after you have a follow-up exam 2 -3 weeks after your procedure.  You can get pregnant immediately after an abortion, before your next period starts, so be prepared with a method of contraception before you resume having sexual relations.

What will I feel emotionally after the procedure?

Women express a wide range of feelings after an abortion. From sadness to relief and from anger to grief, a mix of emotions is normal.  There is no right or wrong way to feel after an abortion.  It is important that you consider your feelings carefully and try not to ignore them.

If you find that you would like help in coping with any emotions that you are experiencing after your abortion, the counselors at Tshwane Women’s Center are available to meet with you at no additional cost after your procedure to discuss any feelings that you are experiencing.

If you feel it would be helpful to speak with a counselor or therapist outside of our Center, we are also able to provide you with supportive referrals.  You can also go online or call organizations that offer free telephone counseling before and after abortion.  We recommend organizations listed here.

For more information about TWC’s counseling services

How much does an abortion cost?

The cost of an abortion procedure varies depending on where you are in your pregnancy and the type of procedure you choose.  Generally speaking, the cost of the abortion increases after the first trimester, and sometimes increases with each week of pregnancy.  This is because the procedure requires more medication and time to perform as the pregnancy becomes more advanced.

When asking about the cost of a procedure, be sure to ask what that price includes so that you are not surprised by fees on the day of your appointment.  For example, you should ask if the cost includes screening tests, ultrasound, medications during and/or after surgery, and follow up visits.
Will my insurance cover an abortion?

We do not take any insurance or medicaid to cover abortion procedure.

Is there any funding to help me pay for my abortion?

There is some limited funding available for women in Gauteng who fit certain eligibility requirements.  If you are having difficulty obtaining your fee, please inquire when you schedule your appointment to see if you qualify for any funding options.  It is not guaranteed that funding will be available for your services.

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