Pregnancy Advisory Service
Medical and clinical information about abortion at the Womens
The Royal Womens Hospital Fact Sheet / www.thewomens.org.au
The Pregnancy Advisory Service (PAS) at the Royal Womens
Hospital supports women who have an unplanned or unwanted
pregnancy. The service provides information and advocacy
and can help women to make decisions about their pregnancy.
PAS can make appointments for women to have an abortion
at the Womens, or can refer women to other useful services.
The Womens believes that all women have the right to
accurate and non-judgmental support and information when
they are facing an unplanned or unwanted pregnancy.
We believe that women have the right to choose the
option which is best for their individual circumstances.
This may include:
continuing the pregnancy to have and care for the child
to consider adoption or another care arrangement
having an abortion.
What you can expect from
services at the Womens
Counselling, discussion and support
You may or may not be clear about what you want to do,
or you may want more information and the chance
to discuss your situation further. PAS counsellors are
available to discuss all your options with you in a non-
judgmental way. The aim is to support you to do what you
want to do. PAS counsellors will not attempt to talk you
into any decision.
Confidentiality and privacy
All services at the Womens must protect your confidentiality.
Staff cannot disclose any information about you to others
unless you agree and consent to it.
Patient rights
The Womens has a charter of patient rights, which describes
our commitment to providing patients with caring, professional
and respectful support and care.
Age and consent
If you are under 16 years of age, it is generally necessary
for a parent or guardian to give consent for you to have surgery.
However, if you have any concerns about this, please let us
know so we can discuss this with you and help you consider
all your options.
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Cultural and linguistic diversity
Interpreters are available free of charge to assist any woman
using the public hospital system.
The Womens understands that women from different cultures
have diverse needs and beliefs about abortion and we strive to
be sensitive and responsive to these.
Individual needs and access
PAS wants to ensure that women who have special or individual
needs have access to our services and support in using our
services. Please let staff know if there are particular issues
for you such as a disability, health issues, problems in your life
or circumstances, or difficulties like having to travel a long way.
Confirming you are pregnant
If you are not sure if you are pregnant there are a number
of places where you can have a pregnancy test including:
the Womens Health Information Centre at the
Womens (free of charge if you have a Medicare card)
9.00am4.30pm Monday to Friday
a GP
a womens health service.
If you would like further information or to discuss any of these
issues, please telephone PAS on (03) 8345 3063.
Having an abortion at the Womens
If you wish to have an abortion at the Womens, appointments
are available through the public hospital system, or through
private consultations with doctors who work at the Womens.
For both public and private appointments please telephone
PAS on (03) 8345 3063.
If you attend the clinic or the private doctors rooms,
please bring:
letter or referral from your doctor which confirms
your pregnancy
Medicare Card or number and Health Care Card
if applicable
blood group card, if you have one.
Your visit at the public clinic may take several hours and you
will need to allow sufficient time for this. If you are running late
or cannot attend your public or private appointment, please
telephone our service or telephone the rooms of the doctor you
were to attend as soon as possible.
When you see the doctor you will be examined to safely plan
for your abortion and decide on the method. This check-up will
usually include an internal vaginal examination and blood tests.
After the examination and further discussion, a decision will
made regarding an abortion.
The different options will be discussed in full during your
consultations, so you can make an informed choice.
Your abortion will usually take place within a few days after your
first visit with the doctor.
The doctor or nurse will also talk with you about contraception
and follow up appointments.
Types of abortion
There are two types of abortion, surgical and medication
abortion. Medication abortion (using tablets) may be an option
at the Womens depending on medical factors, your choice and
available bookings.
Abortion using medication
There are medications available to bring about an abortion.
In most cases you would need to be between about 5 and
9 weeks pregnant. There are some exceptions to this but
only where it is recommended by a doctor. An abortion using
medication is done under supervision at the hospital.
An abortion using medication takes place over three days.
You take one tablet (on day one) and then return to the hospital
two days later for further medication. After this, the abortion
will usually happen within four to eight hours. As the abortion
happens you will usually have crampy pains and bleeding
which is heavier than a normal period.
You will be asked to return to the hospital in one to two
weeks after the abortion. Follow up is very important because
sometimes, though it is rare, the abortion will not succeed.
Up to one in twenty women (or 5 out of 100) may need
a curette afterwards for this reason or because of ongoing
pain and bleeding due to retained pregnancy tissue.
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Things to consider about medication abortion
Some women feel this is a more natural approach and
feel more in control of the situation.
Some women may be concerned when the bleeding
gets heavier, especially if they pass blood clots, or even
a recognisable embryo.
Although excessive bleeding and the need for a blood
transfusion are very rare, they are slightly more common
with a medical abortion than with surgery.
With surgical abortion there are risks, both with the surgery
and with general anaesthetic. Though these are rare,
a medical abortion means they can be avoided
The medication has side effects, which usually ease off
after a few hours, but can be unpleasant for some women.
These include nausea, vomiting, diarrhoea, fever and
chills. The tablets can be swallowed or dissolved under
the tongue or they can be placed inside the vagina which
may reduce side effects. This will all depend on your
individual circumstances.
Most women will stay in hospital for a few hours after
medication is given to wait for the pregnancy to pass.
A few women still need to have surgery, sometimes
urgently, if they develop infection, bleed heavily or if the
pregnancy does not pass.
If you are breastfeeding you will need to stop until the
treatment is complete.
Surgical abortion
Most women have a surgical abortion between weeks 712
of pregnancy (Calculated from the first day of your last menstrual
period or measured by ultrasound). The operation usually involves
the use of a suction curette and in most cases is done under
general anaesthetic.
After 12 weeks, the procedure is a little more demanding
physically and, for some women, emotionally. If you are unsure
of the gestation, or you are over 12 weeks pregnant, our service
will discuss the various options with you.
Please refer to our brochure, Medical Information for Women
having an abortion at the Royal Womens Hospital for more
detailed information about having a surgical abortion.
Things to consider about surgical treatment
The risk of a curette are very low, but include:
a risk that the surgery has not removed all of the
pregnancy. This can cause prolonged or heavy bleeding
and occasionally the operation may need to be repeated.
This will happen in up to one in fifty women (or 2 out of 100).
infection needing antibiotics: some studies suggest this
is more common after a surgical abortion than a medical
abortion, while others suggest the rates are similar.
a risk that the cervix or uterus is damaged during
surgery. This is very rare (1 in 1000) and, when it does
happen, it is usually a small hole or tear which will heal itself.
excessive bleeding. This is very rare; in a few cases
(12 in 1000) a blood transfusion will be needed.
anaesthetic risks. These are very low for healthy women,
but no anaesthetic or operation is without risk.
Payment
The cost of an abortion and any tests or prescriptions you need
depends on whether you are a public or private patient, or have
a Medicare or Health Care Card, or private health insurance.
There is no cost for public patients (however public appointments
are limited).
At the time of writing, the private fee is generally around
$295.00. Any costs will be clearly explained when you
contact PAS.
Day surgery and abortion
If you have made a booking for an abortion, we will provide
information sheets which will provide you with further details
of what to expect during and after the procedure.
Feelings about abortion
Most women find that when they have freely made a considered
and informed decision, and have received support and
acceptance, that they cope well in the short and longer term.
Some women may feel mixed emotions such as sadness or loss,
as well as being relieved and positive about their decision. Every
woman is an individual, and will experience an abortion in her
own unique way. If you want to talk with a counsellor about how
you feel before or after an abortion, please ring (03) 8345 3061
to arrange to talk with a counsellor from PAS or for a referral to
another service that can support you.
Disclaimer The Royal Womens Hospital does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided in this fact sheet
or incorporated into it by reference. We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are
encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent
care you should go to the nearest hospital Emergency Department. The Royal Womens Hospital, July 2011
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Contraception
It is possible to get pregnant the first time you have sex after
the operation before your first period. Reliable contraception
should prevent this and methods will be discussed with you
before the operation.
There are many contraceptive options for you to think about.
If you would like more information about types of contraception
you want to use, you can discuss it with the doctor at the
medical consultation or telephone afterwards to make an
appointment with the Royal Womens Hospital Clinic on (03)
8345 3135. There is also information on contraception available
on our website www.thewomens.org.au/Contraception
Contact with PAS
Contact PAS (03) 8345 3063 between 9.15am and 4.30pm
on weekdays if you wish to make an appointment to see a
counsellor or a doctor. You can contact PAS directly, or a health
professional can make a referral on your behalf. However,
we will need to speak to you directly to confirm appointments.
These arrangements can be made over the phone or in person.
Sometimes it can be difficult to get through because the
telephone service is very busy. If you find it hard to get
through try:
calling again later
calling the Womens Health Information Centre (WHIC);
the WHIC can send you written information, give you
information about other abortion providers (public and
private), or talk with you about what else you might need
to do
look in the health information section of our website where
you will find information to help you with decision making
www.thewomens.org.au
look for information on the Better Health Channel website
www.betterhealth.vic.gov.au
More Information
For free and confidential information about any womens
health matters, contact the Womens Health Information Centre
(WHIC) on (03) 8345 3045 or 1800 442 007 (for country
callers), visit the Womens website at: www.thewomens.org.au,
or email whic@thewomens.org.au