Abortion

This option is chosen when the pregnancy is under 9 weeks or after the 12th week. Treatment can begin from the 6th week if a living embryo has been confirmed via ultrasound. In most cases, the treatment can begin immediately after a medical examination. Medical abortion is a 3-day treatment:

• Day 1: A medication is given that stops the pregnancy.
• Day 2: Bleeding may begin, possibly with period-like cramps — this is normal.
• Day 3: Four tablets are inserted into the vagina early in the morning, and the person must lie down for 2 hours while the medicine dissolves. This medication causes uterine contractions, bleeding, and pain. Bleeding usually begins 3–4 hours later. The amount of bleeding varies by individual but is often similar to a heavy period. It's important to take pain medication before inserting the tablets.

On this day, it's important to have a responsible adult at home in case any complications arise, as can happen with any medical treatment.

The treatment is followed up by a nurse from the Gynecology Department, and you’ll be given a phone number to call 6 hours after the vaginal tablets have been inserted (or earlier, if needed). During the call, your symptoms, bleeding, and pain will be assessed.

After 5 weeks, it's important to take a home pregnancy test and call the gynecology department to report the result.

While bleeding after an abortion it is not recommended to have intercourse (vaginal sex) or to lie in a bath/hot tub. You should only use menstrual pads, not tampons or menstrual cups. 

From the 9th to 22nd week of pregnancy, surgery is recommended. After a medical exam, a procedure date will be set a few days later.

On the morning of the procedure, tablets must be taken to prepare the cervix. You must arrive fasting early in the morning at the Gynecology Department, and the procedure is done the same day. It is performed under light general anesthesia and takes about 5–10 minutes, with the entire process lasting around 1 hour.

Usually, no follow-up is needed after a surgical abortion.

All procedures — whether abortion, appendix removal, or joint replacement — come with some risk of complications, such as bleeding and infection. However, complications from abortion are generally very rare.

The further along the pregnancy, the higher the risk of complications — but they are still uncommon.

Complications differ depending on whether the abortion is surgical or medical:

Surgical abortion:

• Uterine wall injury is very rare (0.1–0.4% of cases) and usually heals well.
• Uterine infection may occur (0.9–1.7%) but is treatable with medication.
• Average bleeding lasts around 10 days after surgery, but heavy bleeding over 500 ml is rare (0.2%).

Medical abortion:

• • Common side effects include nausea, uterine cramps, diarrhea, mild fever, and chills.
  • Rare complications include:
  • • Uterine infection (0.3%)
    • Fallopian tube inflammation (0.03%)
    • Bleeding requiring a surgical abortion (0.35–2%)
    • Need for a blood transfusion due to bleeding (0.1–0.3%)

The decision to have an abortion can sometimes be complex. In such cases, it can be helpful to talk to a neutral party to sort out your thoughts.

An interview with a social worker is available for all those who are considering termination of pregnancy at the Obstetrics & Gynecology Department at Landspitali University Hospital or the Obstetrics & Gynecology Department at Akureyri Hospital. It is not mandatory to talk to a social worker, but an interview can be a great help when making hard decisions.

There is no cost to meet with the social worker, who offers non-judgmental guidance and support. You can request a session before or after the abortion.

The abortion process begins with a consultation with a doctor. This includes a medical assessment, where your health history, allergies, medications, etc., are reviewed — in order to determine which abortion method is best for you.

You will also be informed about how the abortion will be carried out, what to expect during the process, and any potential risks involved. Contraceptive counseling is also offered during this consultation.

You are encouraged to bring up any questions or concerns you might have. You do not have to give a reason for choosing to have an abortion. This decision belongs to you — no one else can make it for you.

Immediately following the consultation, an ultrasound scan is performed to confirm the pregnancy and determine how far along it is. You may choose to view the screen if you wish.

You’ll also be offered screening for chlamydia or gonorrhea.

A large review article on the mental well-being of people undergoing abortion shows that 40–45% experience anxiety and distress while deciding whether to continue or end the pregnancy. However, one month after the abortion, rates of anxiety and distress drop significantly, down to 8–32%, depending on the study.

Making this decision often requires individuals or couples to carefully evaluate their situation and base their decision on their own judgment.

Many also report feeling relieved after the abortion, but some struggle to allow themselves that relief because of social stigma.

Before the Abortion:

• Desperation, panic, and fear
• A sense that life is threatened and future plans are falling apart
• Unexpected emotions, such as everything “working” in terms of conception
• Most people have made up their minds by the time they schedule the appointment
• Still, they may feel anxiety, grief, guilt, worry, and emptiness

After the Abortion

• Relief!
• Few people regret their decision
• Few people are traumatized or feel bad afterward
• One year later, many report feeling they know themselves better and feel more mature

The biggest emotional challenge after an abortion is shame — people often feel guilty for feeling relieved because of society’s opinions. It’s important to remember that the decision you made was the right one for you at the time. No one else can tell you how you should feel, and your body is always yours to control.