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Clinique médicale Fémina
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Important message

[ MESSAGE TO PATIENTS COMING FOR A PREGNANCY TERMINATION ]
[ MESSAGE TO PEOPLE COMING WITH A WOMAN UNDERGOING A PREGNANCY TERMINATION ]
[ POST-SURGERY INSTRUCTIONS ]

Message to patients coming for a pregnancy termination

Welcome to our clinic,

Your decision to have an abortion instead of continuing with your pregnancy may have been difficult for you, but be assured that it will be respected by the members of our staff. You will be treated with understanding and empathy. Our goal is to provide you with a safe abortion in the best possible conditions.

The purpose of this message is to inform you about the procedure and to answer some questions which people often ask.

We would like to remind you that on the day of your appointment:

  • you need to bring your Quebec Medicare card with a valid expiration date in order to receive free services. If not, the fee you will have to pay for your abortion will be given to you when you will call for your appointment.
  • you need to be fasting for 3 hours (no liquid or food) before your appointment time. If you are diabetic on insulin, please call us for specific instructions.
  • you should avoid taking drugs and alcohol 24 hours prior to and 24 hours after the procedure. If you are on any prescription medication, you should take it on schedule and at the usual dose.
  • you should not drive any motor vehicle until 24 hours after the procedure.
  • you should be accompanied for your return home.
  • Please call us 2 days prior to your appointment to confirm. Call us on Friday to confirm an appointment on Monday or Tuesday.

Once the formalities are completed at the reception desk and after you have read the documents about the procedure and the postabortion instructions, you will be called by the counsellor for an interview in order to prepare you for the intervention. This is NOT a psychosocial evaluation about your choice and its reasons; it is an informal meeting to answer your questions, alleviate your fears and set you at ease. The counsellor will review with you the medical questionnaire which you have completed; then, if you wish, you may discuss with her the subject of birth control. If, after the interview, you have other questions or worries, feel free to ask the doctor about these. You have the right to know exactly what to expect, and our medical staff will be happy to answer your questions.

As we suggested, you are probably accompanied. People close to you are very important before and after the abortion. At the clinic, their role will be limited but nevertheless essential. You will meet with the counsellor on your own at least for the first part of the interview. If then you wish to have somebody with you, you will allowed to. The access to the operation room will be limited to you only, but the person with you will be allowed to visit you for a short period of time in the recovery room. During the procedure itself, experience has shown us that you will be better supported if you are accompanied by an experienced professional.

Soon after the interview with the counsellor, you will be called by the nurse; she will guide you to our private washroom in order to get changed into a gown and empty your bladder, saving some urine for further analysis to detect chlamydia and gonorrhea. Then, you will be assigned a comfortable bed for you to relax while waiting for the doctor.

In the operating room, an ultrasound examination will be done first; this is a simple and painless procedure done on an empty bladder; we put a small device on your stomach or in your vagina, coated with jelly, which transmits a picture of your internal organs. This way, we can tell more precisely how many weeks pregnant you are. Consequently, we can use the smallest instruments possible with full knowledge of your anatomy to proceed with the abortion with greater comfort and safety.

After this, the nurse will set you up on the operating table, and the doctor will do a gentle vaginal examination. Then, a small mask will be put on your nose for you to inhale nitrous oxide (laughing gas); this will help you to relax, will numb feelings and might even bring you into a light sleep if you want to let yourself go. This gas is harmless to your health, even if you suffer from asthma.

Then, before the operation begins, a plastic catheter will be inserted in a vein in your arm and you will be given an intravenous medication through it. This catheter will remain in your vein as long as you are in the clinic. This way, we can administrate any medication you may need during or after the procedure without any more manipulation.

From the same catheter, the nurse will draw a few drops of blood in order to check your blood type. If you don’t have the Rhesus factor in your blood (Rh negative), we will give you an injection to prevent you from producing antibodies in order to protect your future pregnancies. You will not feel the injection because we will inject directly in the catheter already in place. We will also put a small device (pulse oximeter) on one of your fingers to measure the level of oxygen in your blood and to read your pulse. All of this is for your safety.

Most of the patients are given, by the catheter in their arm, a strong painkiller that will prevent most of the pain and anxiety you could suffer from, during the intervention. Each patient has different needs and we respect that. Again, be assured that we use safe medications and that the dosage is adapted to each and every patient.

The nurse will remain at your side all the time to look after you, to hold your hand and to explain what is happening. In short, you will have a warm human contact at all times.

You will begin to breathe the laughing gas. The doctor will start by inserting a warm speculum in your vagina. Then, he or she will proceed with the local anesthesia. This may cause numbness around the mouth and buzzing in the ears. The technique that will be used to do the abortion is dilatation and suction with curettage. This is the safest technique.

If the ultrasound revealed that you are more than twelve weeks pregnant, the doctor may suggest that you use a medication called misoprostol vaginally or orally for about 3 hours in order to dilate and soften your cervix and make the procedure easier and safer.

The whole procedure will last about fifteen minutes. Right after, we will take you to the recovery room where you will rest for as long as you like (one hour at least). We will make sure that you are comfortable, that you are bleeding normally and we will serve you a light snack.

We will also review with you the written postabortion instructions that you received at the front desk. Before you leave the clinic, we will make sure that you do not have any unanswered questions, that you received the necessary prescriptions or medication.

HERE ARE A FEW FREQUENTLY ASKED QUESTIONS:

What are the risks in undergoing the procedure?

The most frequent complication (about 2% of cases) is “tissue retention” also called incomplete abortion. Some tissues, not the pregnancy itself, are always left in the uterus after an abortion, even if your doctor did the suction and curettage with a state of the art technique. The uterus will usually get rid of those tissues during the normal bleeding that occurs during the first week following the abortion. In some cases, the uterus will not do his job correctly and/or for reasons related to uterine anatomy, more tissue than average was left in the uterus. This is the phenomenon called incomplete abortion. The signs and symptoms of that will be abnormal bleeding and cramping usually more than one week after the procedure. The solution is an aspiration and curettage of the content of the uterus that will be done here at the clinic without any after-effect for you. It does not mean that your abortion was not well done, it is a risk related to the procedure itself that is, sometimes, unavoidable. You will have, on hand, our emergency phone number to use after business hours of the clinic if you think you have an urgent problem. Try to avoid going to hospital emergency room without calling us first.

Screening of patients with particular risks (uterine anomaly, previous incomplete abortion) helps us reducing the rate of complications.

Other possible complications are:

+ Hemorrhage;
+ Infection;
+ Laceration of the cervix;
+ Perforation of the uterus;

These complications are very rare and the clinic uses strict protocols to deal with it.

Will I have a lot of pain?

Probably not at all or only mild pain. Many patients are amazed because they did not feel any pain at all. Our goal is to provide a safe and painless abortion. Our doctors are gentle and they work with delicate care while being attentive to your needs. They care a lot about the comfort of our patients.

Is there any chance for me to become sterile after this?

The possibility of sterility is extremely low. We use a technique which is recognised as being the safest and instruments that are sterilised the same way as in a hospital operating room. We, therefore, minimize the risk of any complication which could affect future fertility. Studies of women who have several abortions show that their fertility remained unaffected.

Finally, we want you to know that we are pleased that you put your confidence in us. We wish that your stay at the clinic will be as pleasant as possible. If you have any questions, comments or suggestions, feel free to tell us.

L'équipe de la Clinique médicale Fémina

Message to people who have come with a woman undergoing a procedure
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When a woman makes appointment, we always suggest that she does not come alone. A procedure like that is not an easy thing to go through. Empathy, attention and warm contact of the people around her are very important. Women are given medications to make the intervention as easy as possible; it is preferable for them to be accompanied home afterward.

Experience has shown us that the presence of a partner or friend in the operating room is rarely helpful to the woman. An experienced nurse can assure a close follow-up of what is going on and knows what kind of sensations the woman could expect. Her presence will be a warm and supportive one.

When the intervention is finished and the woman is resting in the recovery room, you may visit her. We will ask you then to stay at her side for just a short period of time in order to let her rest.

She will stay in the recovery room for at least 60 minutes or more if she needs it. Instead of waiting here, you may want to leave. Let us know that you are going and we will tell you approximatively when she will be ready to leave. If you wait at the clinic feel free to inquire about her to the nurses who come in and out of the recovery room.

You may find that the waiting time is relatively long. Women go through the intervention their own way and it is necessary to give them the time they may need.

All the information about the intervention and the post-abortion cares are available on request. By reading it, you will be more comfortable in helping the person you have come here with. We hope this waiting time will be as pleasant as possible.

The Clinique médicale Fémina staff

POST-SURGERY INSTRUCTIONS
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After an abortion, it is important to take care of yourself both physically and emotionally. It is normal to have various feelings such as sadness or anger. You may also feel relieved. It may happen that you don’t feel like having sexual intercourse; respect your own rhythm. Each woman reacts in her own way.

Physically, we suggest that you rest the day of abortion. Most women are back to their usual activities the day following the procedure and their pregnancy symptoms fade away over a few days. For strenuous exercise, we recommend that you wait a week.

Recommendations

  • Do not drive a car for 24 hours.
  • Do not drink alcohol or use street drugs for 24 hours.

TO AVOID INFECTIONS ,for the following week:

  • Do not put anything in your vagina such as:
    • tampons
    • suppositories
    • vaginal douches
    • fingers
    • intercourse with penetration
  • Use only sanitary pads

AFTER THE PROCEDURE, IT IS NORMAL:

  • Not to bleed
  • To bleed immediately after
  • To bleed a few days after
  • To bleed more or less heavily with or without blood clots, during the first week
  • To pass blood clots
  • To bleed for 3 weeks
  • To have a positive pregnancy test for the first 3 weeks

N.B. The fact that you bleed after an abortion does not mean that you are having your period. Your real period will appear within 4 to 7 weeks from now. However, you can get pregnant immediately after an abortion, even while you are bleeding.

IT IS ALSO NORMAL:

  • to have cramps
  • to feel pain in your lower abdomen, for a few hours or even for a few days

N.B. to relieve the pain, use Ibuprofen, 200mg (Advil or Motrin) 3 tablets in one dose every 4-6 hrs. If you have prescription of Anaprox or Ponstan, you can use it as prescribed. Avoid these medications if you are allergic to Asprin. In this case, you should take acetaminophen 500 mg, (Tylenol or Atasol) 2 tablets every 4 to 6 hours. If that does not work, use Tylenol 1 or Atasol 8, 2 or 3 pills every 4 to 6 hours except if you are allergic or codeine.

About 3 or 5 days after an abortion many women have heavier bleeding with blood clots sometimes accompanied with a low grade fever. These symptoms last between 24 to 48 hours and are NORMAL. We recommend: rest, a hot water bottle and analgesics, either Advil or Motrin, 200 mg, 3 tabs in one dose every 4-6 hours. If you have a prescription of Anaprox or Ponstan, you can use it as prescribed.

WHAT IS << NOT NORMAL>> AFTER THE PROCEDURE:

  • heavy bleeding that occurs more than one week after the abortion.
  • bleeding that makes you change your pad every half-hour for 6 hours in a row
  • non-stop acute pain which is not relieved with Advil, Mortin, Ponstan or Anaprox
  • fever higher than 38◦ C
  • pregnancy symptoms still present after one week (however your breasts may remain swollen and sensitive for more than one week)
  • to have a positive pregnancy test more than 4 weeks after the abortion.

If you have any of these symptoms, call us at the clinic. If the clinic is closed and your bleeding is very heavy, if your pain is unbearable or your fewer is higher than 38◦ C, call us at the emergency phone number.

SCREENING:
A test was done before the procedure to detect sexually transmitted diseases (gonorrhea and chlamydia).If a result comes back positive, we will contact you at the phone number you have given us. Please note the cervical cytology (Pap test) was not done during your abortion.

ANTIBIOTICS:
If the antibiotics have been prescribed or given to you, it is very important that you start taking them today and that you read carefully the instructions that came with it.

Hormonal contraception:
If you choose to take the pill or the patch (EVRA), you must start the coming Sunday.
If you choose the ring NUVARING, follow the instructions given to you by the nurse before your departure.
N.B. You are not well protected before you have used your method for 7 days.

If you have any questions or if you feel there is something wrong, contact us at the clinic Monday through Friday from 8 a.m. to 5 p.m. at 514 843-7904.

If the clinic is closed and you consider that your problem is really an emergency, use the EMERGENCY PHONE NUMBER that was given to you and leave your name and phone number. A qualified member of the clinic is available to answer your call. Between 11 pm and 7 am, call 811 (info santé).

Take care!

The staff of Clinique médicale Fémina

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