Fetal anomaly treatment options
If you have been booked for same-day treatment you will proceed to treatment on your first clinic attendance. If you have been booked for treatment on another day, we will tell you the time, date and place of your treatment.
Note: Surgical procedure – currently BPAS only provides surgical management. For medical induction please discuss with your antenatal care provider.
Vacuum aspiration
- This method is used up to 14 weeks of gestation
- Plan to be at the clinic for 3 to 4 hours
- You will need cervical preparation
- Can be performed with local anaesthetic or sedation (conscious sedation or general anaesthesia). You will have an opportunity to speak to your clinician about which option is best for you.
Vacuum aspiration uses gentle suction to remove the pregnancy and takes about 5-10 minutes from start to finish. Afterwards, you will need to rest in the recovery area for about 30-60 minutes.
A healthcare professional will show you into the treatment area. You will meet your doctor at this stage and can ask any remaining questions. Any sedation will be given to you before the procedure begins. A nurse will stay with you throughout for support and comfort.
You will be asked to lie on a couch with supports for your legs. After examining you and placing a speculum into your vagina, the doctor may need to open the cervix using thin rods called dilators. A tube will then be inserted through the cervix into the uterus. Either a handheld suction device or a suction machine gently empties your uterus. If you are awake for your procedure, you will feel cramping, like period pains.
After your treatment you will be taken to the recovery area where you will be monitored until staff consider that you are ready for discharge. You will have a light snack before going home.
Anaesthesia options:
Significant, unavoidable or frequently occurring risks
These are usually easy to treat and rarely have any long-term health effects:
-
Retained products of conception - where the pregnancy has been successfully ended but some of the pregnancy tissue is left behind in the womb (1 in 600)
-
Infection (1 in 6,500 as reported to BPAS but may be higher)
-
Unpredictable bleeding after the procedure (variable)
-
Pain during the procedure (variable)
-
Injury to the cervix (1 in 11,000)
-
Psychological problems (variable)
-
Continuing pregnancy (1 in 1,500)
These may require transfer to hospital or surgical procedures, and may have serious long-term health effects:
-
Perforation of the uterus/womb (1 in 6,500)
-
Haemorrhage - very heavy bleeding (1 in 8,000)
-
Injury to bowel, bladder or serious injury to cervix (very rare)
Extra procedures that may be necessary
-
Repeat surgical procedure or uterine aspiration
-
Blood transfusion
-
Laparoscopy or laparotomy – operation to look inside the abdomen
-
Repair of damage to cervix, uterus, bladder, bowel or blood vessels
-
Hysterectomy – surgical removal of the womb (1 in 35,000)
Death is very rarely linked to treatment - less than 1 in 100,000 for all terminations of pregnancies.
Dilatation and evacuation with general anaesthetic or conscious sedation
-
This method is used from 14 to 23 weeks and 6 days of gestation
-
Duration of visit varies on gestation and cervical preparation method, plan to be at the clinic for the whole day
-
You will need cervical preparation, either on the day or the day before surgery
-
Always performed under sedation (conscious sedation or general anaesthetic)
This method can be used from 14 weeks’ gestation up to 23+6 weeks gestation. Up to 18 weeks it may be under general anaesthetic or conscious sedation. At 18 weeks or above the procedure is done under general anaesthetic.
This method uses instruments and suction to remove the pregnancy. A healthcare professional will show you into the treatment area. You will meet your surgeon, and if appropriate your anaesthetist, who can answer any remaining questions. Any sedation or anaesthesia will be given before the procedure begins. A nurse will stay with you to support and monitor you throughout.
The surgeon will examine you and place a speculum into your vagina. The opening of your cervix may be stretched with thin rods called dilators. The pregnancy is removed using instruments and gentle suction.
You will not feel pain during this procedure under general anaesthetic but may feel some discomfort if you have your treatment under conscious sedation. The treatment takes about 10-20 minutes. Afterwards you will be taken to the recovery area and monitored until we consider you are ready for discharge. You will have a light snack before going home.
Anaesthesia options:
Significant, unavoidable or frequently occurring risks
These are usually easy to treat and rarely have any long-term health effects:
-
Retained products of conception - where the pregnancy has been successfully ended but some of the pregnancy tissue is left behind in the womb (1 in 800)
-
Infection (1 in 2,500 as reported to BPAS but may be higher)
-
Unpredictable bleeding after the procedure (variable)
-
Pain during the procedure (variable)
-
Injury to the cervix (1 in 5,000)
-
Psychological problems (variable)
These may require transfer to hospital or surgical procedures, and may have serious long-term health effects:
-
Haemorrhage - very heavy bleeding (1 in 800)
-
Perforation of the uterus/womb (1 in 2,500)
-
Injury to bowel, bladder, or serious injury to cervix (very rare)
Extra procedures that may be necessary
-
Repeat surgical procedure or uterine aspiration
-
Blood transfusion
-
Laparoscopy or laparotomy - operation to look inside the abdomen
-
Repair of damage to cervix, uterus, bladder, bowel or blood vessels
-
Hysterectomy - surgical removal of the womb (1 in 5,000)
What to expect on the day
Can my partner come with me?
Yes. We welcome the involvement of partners or other support people.
We will do as much as we can to make your time with us as comfortable as possible for both of you. Please let us know your preferences for partner or support person involvement. Your partner can stay with you right up to going into theatre and possibly into theatre too depending on treatment and anaesthetic type. This can be discussed on admission. Otherwise they will be reunited with you as soon as possible after surgery.
Where possible, we will provide some separate space away from other clients while waiting for and recovering from the procedure.
Information for women having a surgical procedure
Glasses and contact lenses
Many people now sleep in soft contact lenses and this may be acceptable for short procedures. Please ask the nurse or the anaesthetist. You may keep your glasses on until the last moment.
Dentures
False or loose teeth can interfere with the anaesthetist's oral equipment. If you have dentures please discuss this with the anaesthetist.
Jewellery, make-up and nail polish
You must remove all jewellery and decorative piercings (including tongue piercings). If you can’t remove it then we will cover it with tape to prevent accidental damage to your skin.
Please remove all make-up. You do not need to remove false nails or nail varnish.
Essential things to bring:
- Any prescribed medicines or inhalers
- Stick-on sanitary towels
- Extra underwear
- Slippers and a nightshirt or t-shirt if you are having treatment under general anaesthetic (asleep)
Fetal anomaly treatment: Frequently Asked Questions
Some questions you may have.
-
Will the baby feel pain?
-
Current research shows that the necessary sensory structures are not developed enough for a fetus to feel pain before 28 weeks' gestation.
-
Can I know the sex of the baby?
-
BPAS staff are not trained to identify the sex of a baby on ultrasound. Sometimes it is possible to identify the sex after the procedure but there is no guarantee. Speak to your clinician on the day about what is possible.
-
I would like to have a funeral for my baby, how do I go about it?
-
You will need to contact a funeral director. There is more information about this here.
-
When can I get pregnant again?
-
You can try and conceive again whenever you feel ready. If you do not want to get pregnant in the near future it is important to understand that your fertility can return within 2 weeks of a termination, so you may want to discuss starting a method of contraception at the time of your treatment.
The next step
If you have been booked for same-day treatment you will proceed to treatment on your first clinic attendance. If you have been booked for treatment on another day, we will tell you the time, date and place of your treatment.
