Complications during pregnancy
If you have been advised that your baby has a severe fetal anomaly and you are considering ending the pregnancy, the following information may help.
Unfortunately, not all pregnancies go as expected or hoped. You may discover that your baby has medical complications. It may be that your baby will not be the healthy baby you hoped for. It may even be that your baby will not survive.
Learning that your baby has a serious condition is often a shock and you will be faced with difficult decisions.
Before making the decision to end the pregnancy, it is important that you are provided with information on the type and severity of complications your baby has been diagnosed with, and the impact it might have. Your healthcare provider will be able to provide you with this information or refer you to someone who can.
We encourage you to discuss your pregnancy, the diagnosed anomaly, your options, your concerns, the risks and the costs with your healthcare provider as soon as possible.
Please note that the following information does not replace medical advice.
Is an abortion safe?
When performed by a qualified health professional, an abortion is a safe medical procedure. It is one of the most common gynaecological procedures performed in Australia.
The earlier you have an abortion, the safer it is. That is why it is important to discuss your options with a healthcare provider as early as possible.
Your healthcare provider will discuss possible complications of having an abortion or continuing the pregnancy. Although serious complications are not common, all medical and surgical procedures have some risks, and these risks will depend on your specific circumstances.
What happens before an abortion?
Your healthcare provider will ask questions about your medical history and may do some tests and screening.
You will be given information on the types of abortion available to you, what to do after the procedure and pain-relief options, as well as information on relevant support services.
What types of abortion are available?
In WA, there are two types of abortion available: medical abortion (where medicines are used) and surgical abortion (when an operation is performed).
Note, the type of abortion chosen may be impacted by how many weeks pregnant you are and your individual circumstances.
| Medical abortion | Surgical abortion | |
|---|---|---|
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What happens in this type of abortion? |
his procedure uses medication, given in doses over two or more days. Your experience of medical abortion will depend on how many weeks pregnant you are. An early medical abortion can be like a heavy period or miscarriage, whereas at a later stage of pregnancy it has similarities to induced labour. |
This is a procedure to remove the pregnancy from your womb. There are different types of surgical abortion depending on how many weeks pregnant you are. |
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Where will the abortion take place? |
It will take place in a hospital. You may be able to go home on the same day, or you may need to stay overnight. |
It will take place in a clinic or hospital. You can normally go home on the same day, but you will usually need someone to accompany you. |
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Is the abortion painful? |
It may be painful when you deliver the baby. The amount of pain will vary from person to person and will depend how far along you are in your pregnancy. You will be offered pain medication during the procedure. Please speak to your practitioner about pain relief if you are concerned. In the days and week after the procedure pain, and cramping is common. Simple pain-relief medication and a heat pack can assist. |
If you have had sedation, the procedure might feel uncomfortable. If you have had a general anaesthetic, you will not be aware of what is happening and will not feel any pain until you are awake again. Some cramping or mild abdominal pain after the procedure is normal and simple pain-relief medication or a hot pack should help with any discomfort. |
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How much bleeding will there be? |
You will have vaginal bleeding during a medical abortion. This is usually heavier than your normal period. After delivering, bleeding can last for about 12 days but should get lighter day by day. |
You will have vaginal bleeding after a surgical abortion. Bleeding can last for 10-14 days but should get lighter day by day. |
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How likely am I to need another procedure to complete the abortion? |
You are more likely to need another procedure if you choose medical abortion. The majority of people do not need a further procedure but at times a surgical procedure will be required to complete the abortion. |
You are less likely to need another procedure to complete the abortion if you choose surgical abortion. However, a small number of people will need a further surgical procedure. |
Considerations following an abortion
Below are some aspects for you to consider following an abortion.
Seeing your baby
Depending on how many weeks pregnant you are, and the method of abortion used, you may have the option of spending time with your baby. If you have a medical abortion, you can see your baby. However, if you have a surgical abortion this is unlikely to be an option.
It is important for you to understand that the appearance of your baby may be different to how you imagined, in size, skin colour and condition or features. It will depend on how far along your pregnancy was and fetal anomalies may impact on your baby’s appearance. If you would like to discuss the possible appearance of your baby, you can do so with your healthcare provider.
Post-mortem examination
Your healthcare provider may discuss the benefits of a post-mortem and placental examination. This examination will only occur with your consent. A perinatal pathologist (doctor) will examine your baby to identify or confirm any abnormalities. This examination may provide valuable information for you for this pregnancy and future pregnancy planning. Your healthcare provider will discuss a plan with you to receive these results.
Lactation after abortion
You may experience breast changes and milk production. If your breasts are sensitive to touch or uncomfortable, you can apply cold compresses, take cooling and soothing (not hot) showers and wear a firm bra.
Your healthcare provider can provide you with suppression medication and further information on reducing lactation.
When to seek advice following an abortion
You should call the clinic or hospital where you had the abortion, or you may wish to visit your regular healthcare provider if you have:
- a temperature
- a fever
- persistent pain
- bleeding that is not reducing after a few days
- ongoing worry or concerns.
Follow-up care
You will need to arrange a follow-up appointment with your GP between 14 to 21 days after an abortion to make sure there are no problems.
You may need to make an appointment earlier if you experience any problems as listed above.
Specialist follow-up appointments for information sharing and results will be arranged by the clinic or hospital staff. This may include appointments with KEMH’s Genetic Health, Maternal Fetal Medicine Service, Perinatal Loss Service, your obstetrician or GP.
Support services available at KEMH
If you have had an abortion at KEMH for fetal anomaly the following services may be available to you.
Perinatal Loss Service
Provide care for families who have experienced perinatal death and pregnancy loss. This includes clinical care and counselling support. To contact the service, phone (08) 6458 2222 and ask to be put through to the Perinatal Loss Service team.
Social Work Department
Support and short-term counselling to those experiencing a pregnancy loss, including information on grieving, community supports and practical assistance.
Tel: (08) 6458 2777 (weekdays)
Genetic Health WA
Provides information, counselling and support for individuals, couples and families following the diagnosis of a genetic condition in a family member, or when an abnormality is found in an unborn baby. A genetic counsellor / geneticist is available to discuss the possible causes of recurring miscarriages where one partner carries a chromosomal rearrangement.
Tel: (08) 6458 1525 (weekdays)
Psychological Medicine Department
Counselling and psychiatric services for mental health issues that may complicate the experience of a pregnancy loss by clinical psychologists, psychiatrists, medical officers, and mental health nurses. Ask your healthcare provider to arrange a referral or contact the department.
Tel: (08) 6458 1521 (weekdays)
Perinatal Pathology Department
When possible, perinatal pathology staff are responsible for the creation of mementos (photos, hand and footprints) of your baby and, if applicable, post-mortem examination and / or cremation. They can be contacted to arrange the collection of any mementos or request to have a report sent to your doctor by phoning (08) 6458 2730 or through the KEMH switchboard on (08) 6458 2222.
Spiritual care and ceremonies at KEMH
Pastoral Care Services offers an inclusive service for patients experiencing a pregnancy or baby loss, regardless of faith or cultural background. Pastoral Care staff can complete the Consent for Cremation form with you, which includes options for Interment of Ashes, separate ashes and mementos. A representative from Pastoral Care Services can offer support, spiritual care or counselling to patients and their families and advise on the Interment of Ashes Service and other rituals. Contact (08) 6458 1036.
Pastoral Care staff also offer the following ceremonies:
- The Ritual of Remembrance for those experiencing an early pregnancy loss, usually held on the second Monday of the month in the KEMH Chapel
- A service of Naming and Blessing, an acknowledgement of the life of your baby
- The Interment of Ashes Service, a monthly gathering in the KEMH Memorial Garden to intern the ashes of babies who have been born under 28 weeks gestation
- Helping parents with funeral arrangements - assistance with planning what is right for you and your baby.
Registration of a baby
If the gestational age of a baby is over 20 weeks, it is a legal requirement to register the baby with the Registry of Births, Deaths and Marriages. The required forms will be provided to you before leaving hospital.
Counselling and other support
The decision to have an abortion is yours alone. It can be helpful to talk to someone supportive and unbiased. Red Nose Grief and Loss is the primary grief support service in the community for parents who have experienced the loss of a pregnancy, including those who have decided to terminate for medical reasons.
Red Nose Support line: 1300 308 307 (available 24 hours a day, 7 days a week)