There are two techniques to perform a voluntary termination of pregnancy (abortion): the chemical method, using drugs, and surgical method by aspiration. If the first takes precedence over the second, it is nevertheless widely practiced, with 101,021 procedures performed in 2010, nearly half of abortions (46%).
According to the General Inspectorate of Social Affairs (IGAS), 40% of women in France will one day have recourse to abortion. Zoom on abortion by suction.
Surgical abortion: where, when, how?
The surgical abortion, also called suction abortion, is necessarily practiced in health care institutions, whether public or private. It lasts only ten minutes and requires mostly a hospital a few hours, allowing the patient to go home the same day. Technically, this method involves dilating the cervix with drugs (the same as those used in the medical abortion), then aspirate the contents using a probe. Prof. Nisand stresses that while "the gesture has no particular technical difficulty, it must be done slowly and can be done either under local anesthesia or under general anesthesia." This choice only depends on the patient.
In France, the surgical abortion can be performed until the end of the 12th week of pregnancy (SG), ie before the end of the 14th week of amenorrhea (absence of menstruation or SA). Women have the choice between surgical abortion and medical abortion, but beyond 7 SG / 9 SA, the High Authority for Health (HAS) recommends to favor the surgical approach. A position that openly criticizes Israel Nisand Professor, Head of Gynaecology Obstetrics Division at the University Hospital of Strasbourg, who questions this specific trend the Hexagon "This recourse to surgical abortion from 7 weeks of pregnancy a recommendation, not a legal requirement. It is important to remind women that they have the choice of abortion, even beyond this period, no offense to a small lobby doctors who would keep the monopoly surgical abortion, much better paid. "
A tip: make an appointment early, wait times in certain cities or regions are such that it is sometimes necessary to go beyond the famous 7 day cooling off period for an appointment on time.The surgical abortion under local anesthesia
Nadege, 28, has experienced an unwanted pregnancy 10 years ago, while taking birth control pills for a specific hormonal and adrenal problems. She preferred to local anesthesia, "for fear of likely general" but does not remember seeing the anesthesiologist before surgery. An aberration since according to the recommendations of the National College of Obstetricians Gynecologists French (CNGOF), "a pre-anesthetic consultation should be carried out systematically before any intervention if a method by aspiration has been decided, even if under local anesthetic action." For Professor Nisand, local anesthesia, "generating less complications," is preferable. In any case, this technique requires two qualities from the obstetrician: experience and empathy. It can thus be experienced quite satisfactory, both by the patient, who condones living in real time the "mourning" of the unwanted pregnancy by the doctor, who only has the feeling of being the " dirty work "instead of his patient. If Nadège has in fact felt no physical pain, nor during surgery, nor in the hours and days that followed, however it retains a very bad memory of its trade with the doctor that "[it] was felt that it was not in agreement with [her] choice and [he] spoke to [him] yelling. "The surgical abortion under general anesthesia
Mathilde, 26, has meanwhile undergone an abortion under general anesthesia last year. Even though she said he did not remember being asked his preference, she thinks "it was probably better that way." An opinion shared by the majority of patients Professor Nisand since almost 100% of surgical abortions performed in the University Hospital where he works are done under general anesthesia. This choice is one of the patients, usually HEALTH RESEARCH BULLETIN who wish to see nothing, hear nothing, not living "that time" in full consciousness.
For Professor Nisand, it is essential to systematically leave the choice to the women: "There are a lot of places where general anesthesia is necessary because, basically, it's the easy way: we did not to listen, reassure, you sleep ... It is more comfortable and easier for the medical profession. " Before choosing the best is always yet to really think and feel confident with the doctor. This was the case for Mathilde, who has the memory of a medical team "adorable and dédramatisante, not in judgment, always joking."The benefits of surgical abortion compared to medical abortion
Women who choose surgical abortion generally exceeded the seven weeks of pregnancy or do not wish to live the trauma of medical abortion in the solitude of their toilets or their bathroom, as is often the case for those opting for chemical abortions outside health facility (the tablets of Mifegyne ® ® Gymiso and then being in the presence of a physician during a consultation).
Surgical abortion is most appropriate for women who wish to be supported in less than 24 hours and painlessly, either for personal or professional reasons. The chemical abortion, often over several days and causes pain similar to those of childbirth, can be a source of anxiety and a real discomfort, especially for primiparas and have chosen the Option "home".Prices and management of surgical abortion
Since March 31, abortion is supported 100% by the health insurance for all women as part of a package. On the official website Ameli.fr, we read that "the surgical abortion is reimbursed by insurance at 100% disease on the basis of a variable flat rate (from € 437.03 to € 644.71) depending the health facility (hospital or clinic), the type of anesthesia (local or general) and duration of hospitalization. This price includes the preliminary analyzes to abortion, local or general anesthesia, the act of abortion and monitoring, reception and accommodation. It does not include two preliminary medical consultations and medical consultation control, chargeable extra and supported under the usual conditions. Note that the package Daily is not billable. " Some complementary health contracts provide total or partial support for not reimbursed by social security costs.What about the risks and consequences of surgical abortion?
Like any surgery, abortion Aspiration presents risks (plus the risk of potential complications of general anesthesia). The main ones are uterine perforation (rare but serious) or infection due to the introduction of instruments into the uterus. The failure rate of the method being almost zero (0.3% against 5% for medical abortion), it is important to remember that certain drug abortion "incomplete" will be "completed" surgically. As after delivery, bleeding can be expected in the days following the intervention.
Regarding the follow-up to contraception of women, the obstetrician advises to enjoy the action in proposing the IUD (intrauterine device or IUD), where the situation of women s 'are ready.
As for the cons-indications to surgical abortion, "the only one I would see a uterine malformation," the specialist adds that there are no painful sequelae or incompatibility with one or more subsequent pregnancies and the number of abortions is not limited in the life of a woman.
Whatever the method used, a monitoring and verification of consultation is carried out between the 14th day and the 21th day following the intervention.
If Nadège has never seen a psychologist in this event and that Mathilde ignores postoperative consultation, neither of today questions the choices she has always considered to be good. None not to be excluded mom ... when it's time!
According to the General Inspectorate of Social Affairs (IGAS), 40% of women in France will one day have recourse to abortion. Zoom on abortion by suction.
Surgical abortion: where, when, how?
The surgical abortion, also called suction abortion, is necessarily practiced in health care institutions, whether public or private. It lasts only ten minutes and requires mostly a hospital a few hours, allowing the patient to go home the same day. Technically, this method involves dilating the cervix with drugs (the same as those used in the medical abortion), then aspirate the contents using a probe. Prof. Nisand stresses that while "the gesture has no particular technical difficulty, it must be done slowly and can be done either under local anesthesia or under general anesthesia." This choice only depends on the patient.
In France, the surgical abortion can be performed until the end of the 12th week of pregnancy (SG), ie before the end of the 14th week of amenorrhea (absence of menstruation or SA). Women have the choice between surgical abortion and medical abortion, but beyond 7 SG / 9 SA, the High Authority for Health (HAS) recommends to favor the surgical approach. A position that openly criticizes Israel Nisand Professor, Head of Gynaecology Obstetrics Division at the University Hospital of Strasbourg, who questions this specific trend the Hexagon "This recourse to surgical abortion from 7 weeks of pregnancy a recommendation, not a legal requirement. It is important to remind women that they have the choice of abortion, even beyond this period, no offense to a small lobby doctors who would keep the monopoly surgical abortion, much better paid. "
A tip: make an appointment early, wait times in certain cities or regions are such that it is sometimes necessary to go beyond the famous 7 day cooling off period for an appointment on time.The surgical abortion under local anesthesia
Nadege, 28, has experienced an unwanted pregnancy 10 years ago, while taking birth control pills for a specific hormonal and adrenal problems. She preferred to local anesthesia, "for fear of likely general" but does not remember seeing the anesthesiologist before surgery. An aberration since according to the recommendations of the National College of Obstetricians Gynecologists French (CNGOF), "a pre-anesthetic consultation should be carried out systematically before any intervention if a method by aspiration has been decided, even if under local anesthetic action." For Professor Nisand, local anesthesia, "generating less complications," is preferable. In any case, this technique requires two qualities from the obstetrician: experience and empathy. It can thus be experienced quite satisfactory, both by the patient, who condones living in real time the "mourning" of the unwanted pregnancy by the doctor, who only has the feeling of being the " dirty work "instead of his patient. If Nadège has in fact felt no physical pain, nor during surgery, nor in the hours and days that followed, however it retains a very bad memory of its trade with the doctor that "[it] was felt that it was not in agreement with [her] choice and [he] spoke to [him] yelling. "The surgical abortion under general anesthesia
Mathilde, 26, has meanwhile undergone an abortion under general anesthesia last year. Even though she said he did not remember being asked his preference, she thinks "it was probably better that way." An opinion shared by the majority of patients Professor Nisand since almost 100% of surgical abortions performed in the University Hospital where he works are done under general anesthesia. This choice is one of the patients, usually HEALTH RESEARCH BULLETIN who wish to see nothing, hear nothing, not living "that time" in full consciousness.
For Professor Nisand, it is essential to systematically leave the choice to the women: "There are a lot of places where general anesthesia is necessary because, basically, it's the easy way: we did not to listen, reassure, you sleep ... It is more comfortable and easier for the medical profession. " Before choosing the best is always yet to really think and feel confident with the doctor. This was the case for Mathilde, who has the memory of a medical team "adorable and dédramatisante, not in judgment, always joking."The benefits of surgical abortion compared to medical abortion
Women who choose surgical abortion generally exceeded the seven weeks of pregnancy or do not wish to live the trauma of medical abortion in the solitude of their toilets or their bathroom, as is often the case for those opting for chemical abortions outside health facility (the tablets of Mifegyne ® ® Gymiso and then being in the presence of a physician during a consultation).
Surgical abortion is most appropriate for women who wish to be supported in less than 24 hours and painlessly, either for personal or professional reasons. The chemical abortion, often over several days and causes pain similar to those of childbirth, can be a source of anxiety and a real discomfort, especially for primiparas and have chosen the Option "home".Prices and management of surgical abortion
Since March 31, abortion is supported 100% by the health insurance for all women as part of a package. On the official website Ameli.fr, we read that "the surgical abortion is reimbursed by insurance at 100% disease on the basis of a variable flat rate (from € 437.03 to € 644.71) depending the health facility (hospital or clinic), the type of anesthesia (local or general) and duration of hospitalization. This price includes the preliminary analyzes to abortion, local or general anesthesia, the act of abortion and monitoring, reception and accommodation. It does not include two preliminary medical consultations and medical consultation control, chargeable extra and supported under the usual conditions. Note that the package Daily is not billable. " Some complementary health contracts provide total or partial support for not reimbursed by social security costs.What about the risks and consequences of surgical abortion?
Like any surgery, abortion Aspiration presents risks (plus the risk of potential complications of general anesthesia). The main ones are uterine perforation (rare but serious) or infection due to the introduction of instruments into the uterus. The failure rate of the method being almost zero (0.3% against 5% for medical abortion), it is important to remember that certain drug abortion "incomplete" will be "completed" surgically. As after delivery, bleeding can be expected in the days following the intervention.
Regarding the follow-up to contraception of women, the obstetrician advises to enjoy the action in proposing the IUD (intrauterine device or IUD), where the situation of women s 'are ready.
As for the cons-indications to surgical abortion, "the only one I would see a uterine malformation," the specialist adds that there are no painful sequelae or incompatibility with one or more subsequent pregnancies and the number of abortions is not limited in the life of a woman.
Whatever the method used, a monitoring and verification of consultation is carried out between the 14th day and the 21th day following the intervention.
If Nadège has never seen a psychologist in this event and that Mathilde ignores postoperative consultation, neither of today questions the choices she has always considered to be good. None not to be excluded mom ... when it's time!
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