When making an appointment, make sure to:

• Have your valid Quebec health insurance card (RAMQ), a transitional certificate from the RAMQ or your PFSI paper. This will ensure that you receive our services free of charge. If you do not have a RAMQ card, you will have to pay a fee.
• Have the report from your referring physician.
• Let us know if you are diabetic and take insulin.

Before your appointment, make sure to:

• Fast for 3 hours before your appointment (no liquid or solid food).
• Do not drink alcohol or take drugs 24 hours before and after your appointment.
• Take your prescription medication, if you have any, at the usual time.
• Complete the online questionnaire.

Once you arrive, after reading the pre- and post-intervention information documents, you will be called by the counselor for a preparatory interview. This is an opportunity to validate your medical questionnaire and answer your questions.

Shortly after the interview with the counselor, the nurse from the rest room will call you to prepare you for the procedure. She will give you a gown and you will be able to use our private bathroom to change. A urine sample will be required to perform the test to detect chlamydia and
gonorrhea (STIs). Then, she will show you a place to put your clothes and a comfortable bed to lie down while waiting to be called.

The dilation-aspiration procedure is one of the least risky surgical procedures. A nurse will be by your side at all times to take care of you, check your blood pressure, heart and respiratory rate, the amount of oxygen in your blood and thus ensure your well-being. While explaining the
different steps of the procedure, she will be a warm and human presence throughout the procedure.

In the operating room, an ultrasound will first be performed. Once the ultrasound is finished, you will be asked to get into the gynecological position. In addition, a plastic tube (catheter) will be placed in a vein in your arm to administer medications adapted to the needs of each patient. This catheter will be left in place until you leave the clinic. All this to ensure that the procedure takes place in the safest possible conditions. It is with the help of this catheter that the nurse will take a few drops of blood to determine part of your blood group, called the Rhesus factor (Rh) if you are more than 8 weeks pregnant. About 15% of the population does not have this factor. If this is your case, you are Rh negative and the nurse will administer an immunoglobulin solution (which is similar to a vaccine) to prevent you from producing antibodies that could harm a future pregnancy.

The vast majority of patients receive, through the tube installed in the vein, a dose of powerful analgesic in order to reduce as much as possible the pain and/or anxiety that may occur during the procedure. Each patient has specific needs and we are very attentive to them. Again, rest assured that we use the safest medications at doses that we adapt according to the situations. After preparing his instruments, the doctor will begin the procedure by inserting a warmed speculum into the vagina. Then comes the local anesthesia which will numb the cervix. The
technique used, dilation and aspiration, is the one that is recognized as being the safest. The surgical procedure lasts approximately 8 to 10 minutes.

Once the procedure is complete, you will be taken to your bed where you can rest until you feel ready to leave (minimum one hour). We will make sure that you are comfortable, that your bleeding is light and we will offer you drinks and biscuits if you wish. During this time, we will review the post-procedure information sheet with you and give you all the explanations you will need. When you leave, we will make sure that you are in good condition and that you have received the necessary information, prescriptions and/or medications.

After an intervention following a missed pregnancy, it is important to take care of yourself physically, but also emotionally. It is normal to experience and feel various emotions such as sadness, anger, incomprehension, etc. It is also possible that you do not feel like having sex, it is important to respect your rhythm. Each woman reacts differently. Physically, we suggest that you rest well the same day. The majority of women are ready to resume their normal activities the next day. It is better to wait a week for very intense physical activities. If you feel that you need additional support, you can contact us or refer to our “Resources” section.