Abortion

Abortion Services
We operate a confidential Unplanned Pregnancy & Abortion Service and SAFETY is top priority.

There are 3 main types of abortion services, including medical abortion and abortion pill:

Medical Abortion (Abortion pill) - ( Under 7 weeks pregnancy).  Latest abortion pill update 19th Jan 2018.  The abortion pill is now available.

 

In medical abortion during early 1st trimester, no instruments or suction will be used, so women will not be exposed to the chance of cervical injury and uterine perforation that rarely occur with surgical abortion.  Anaesthesia is not required.  Medical abortion can be performed as soon as a woman knows she is pregnant (BUT AFTER MANDATORY COUNSELLING AND AT LEAST 48 HOURS OF CAREFUL DELIBERATION). It is more effective and leads to less bleeding at earlier gestations (five to seven weeks compared to eight to nine weeks). Common side effects include bleeding, pain, strong abdominal cramping, nausea, vomiting, diarrhea  and headache.  Women usually have heavy bleeding for several hours and bleed like a period for an average of two weeks.  Even in sucessful medical abortion, light bleeding may persist for up to 45 days.  Since women will be at home during the actual abortion process, they take on more responsibility for their care.  The clinic emergency care plan is provided for women who may need after office hour care.

There is a 10-25% chance that women will need a suction curettage abortion due to continued pregnancy, prolonged or excessive bleeding, or patient choice. 

Patients can choose for the abortion pill to be adminstered in two ways.  The first option is for the pill to be taken by mouth (abortion pills melt under the tongue for 30 minutes).  The second option is for the abortion pill to be inserted vaginally.  Both methods are equally effective.  However, taking the abortion pill by mouth is associated with increased rates of side effects.

Women need to return to the clinic for scan to ensure that abortion is sucessful.

 

Vacuum aspiration – (up to 14 weeks of pregnancy)

All women who choose to use our one day abortion services will have to fast for at least 6 hours before the procedure as general anaesthesia is administered by a consultant anaesthetist. (you will be asleep for around 10 minutes). A small tube will then be placed into the womb through the vagina. A vacuum attached to the tube will then remove the pregnancy and the abortion is complete. Women are generally ready for home 2 to 4 hours later.

 

As this procedure is performed in hospital with strict infection control measures, and use of general anaesthesia administered by a consultant anaesthetist, the cost of the procedure is on the higher range.
 
Mid Trimester Pregnancy Termination – (14 to 24 weeks of pregnancy)
This process is more complicated and hospitalization is generally required, sometimes requiring repeated admissions. A prescribed dose of medication is inserted into the vagina to stimulate natural discharge of the pregnancy. Following the abortion of the fetus and placenta, evacuation of uterus is performed in surgical theatre, usually under general anaesthesia.

Information About Unplanned Pregnancy & Abortion In Singapore
Abortion may be legally performed in Singapore
The residency/travel documents and/or work permit/pass will be verified prior to performing the abortion and a copy of the documents is kept in the medical records for verification.

The doctor will ensure that the woman requesting the abortion has to comply with the residency requirements stipulated under the TOP Act by verifying the relevant documents.

Under the Termination of Pregnancy Act, an authorized medical practitioner shall not carry out abortion for any pregnant woman unless she is:

• a citizen of Singapore or the wife of a citizen of Singapore;
• is the holder, or is the wife of a holder, of a work pass issued under the Employment of Foreign Manpower Act; or
• a person who has been resident in Singapore for at least 4 months immediately preceding the date of abortion.

Abortion is not performed on tourists visiting Singapore. The exception would be only if the abortion is required to save the life of the pregnant woman, which shall be supported by documentary evidence.

The minimum residency requirement of four months stay in Singapore prior to the abortion does not apply to holders or the wife of holders of permits/passes (e.g. work permit) issued under the Employment of Foreign Manpower Act.

However, it is compulsory to bring all the relevant documentation e.g. employment pass, work permit or marriage certificate (in English)

Holders of passes issued under the Immigration Act such as the student pass and long term visit pass are required to be resident in Singapore for four months prior to the abortion.

Under the TOP Act, no treatment for abortion of more than 24 weeks can be carried out unless the treatment is immediately necessary to save the life or to prevent grave permanent injury to the physical or mental health of the pregnant woman. There shall be documentary evidence to support that the treatment was immediately necessary
 
The abortion must be carried out only at the request of the pregnant woman and with her consent. While her husband or partner can offer support, the final decision and consent for the abortion rest solely on the pregnant woman

An ultrasound scan is performed at the first consultation to determine

• confirm pregnancy
• confirm single, twins triplets
• exclude ectopic pregnancy (pregnancy is outside the womb)
• confirm the viability (exclude miscarriage)
• exclude molar pregnancy

Abortion counselling is offered and all concerns and worries should be discussed.  This involves watching a video.

Abortion counselling and watching of the video is mandatory and any issue of medication or surgery can only take place at least 48hours after the counselling is complete.

It is also mandatory to have post abortion counselling which is provided on the day of the procedure.  The main focus will be on effective contraception in the future.  This is to avoid future unwanted pregnancies because repeated abortions may exponentially increase the risk of infertility and uterine scarring.


Abortion via suction is performed up to the 12th week of pregnancy.

Dilatation and evacuation may be performed up to 14 weeks, however, this is associated with higher risk of complications.

Mid-trimester abortion is performed after 14 weeks and requires admission into hospital. Our hospital partners include Thomson Medical Center, Mt Elizabeth (Orchard and Novena) and Gleneagles. Do note that for your privacy, patients are advised to book into a single bed.

For suction abortion, the cervix (entrance to the uterus) is gently stretched and opened until it is wide enough for the contents of the uterus to be removed with a suction tube. The extent to which the cervix needs to be opened depends on the size of the pregnancy. To make this safer, misoprostol tablets will be consumed by mouth prior to the abortion.

You need to fast at least six hours before the abortion.

In order to minimize complications, all suction abortions are done strictly in an operating theatres with short general anesthetic administered by a consultant anesthesiologist.

This avoids the patient from involuntary movements when sedation is used.

Complications of abortion may include:

All methods of early abortion carry a small risk of failure to end the pregnancy and therefore a need to have another procedure. This is uncommon, occurring in fewer than 1 in 100 women.

Abortion, at any time in pregnancy, is a safe procedure for which serious
complications are uncommon. The earlier in the pregnancy you have an abortion, the safer it is. However it is critically important that the decision is deliberated very carefully before proceeding with the abortion.

Risk during the abortion include:

• Excessive vaginal bleeding, such that you may need a blood transfusion, happens in around 1 in every 1000 abortions. It occurs in 4 in 1000 abortions per formed after 20 weeks of pregnancy.
• Damage to the cervix happens in no more than 1 in every 100 surgical abortions.
• Damage to the uterus happens in between 1 and 4 in every 1000 surgical abortions.
• Damage to the uterus happens in fewer than 1 in every 1000 medical abortions done between 12 and 24 weeks of gestation

Should complications occur, treatment – including surgery – may be required

Risk after the abortion may include:

You are more likely to get problems in the 2 weeks after the abortion than at the time of the procedure itself:

Up to 1 in 10 women will get an infection after an abortion. Taking antibiotics at the time of the abortion helps to reduce this risk. If you are not treated, it can lead to a more severe infection known as pelvic inflammatory disease or PID

The uterus may not be completely emptied of its contents and further treatment may be needed. This happens in fewer than 6 in 100 women having a medical abortion and in 1 to 2 in 100 women having a surgical abortion. An operation may be needed to remove the pregnancy tissue within the uterus.

A blood grouping is needed before the abortion if the status is not documented.
If you are RhD-negative, you should usually be offered an anti-D injection after your abortion.

 

Cost of procedure:

 

All women require doctor's consultation and ultrasound scan to determine medical fitness, gestation of pregnancy and exclude ectopic, twin pregnancy etc.  For low risk healthy women, the initial cost excluding mandatory counselling is about $220.  For women requiring more medical care, the clinic extended consultation fees apply.

The fee for mandatory counselling for eligible women is about $32.

 

After paying the above, further payment is dependent on the patient's choice of type of abortion.

 

Abortion procedure is charged based on the weeks of gestation at the performance of the procedure, patients medical condition and  any special requests.  As stopping a more advanced pregnancy is more complex, the fee increases.

For medical abortion package, the cost is about $1070 (clinic extended consultation fees apply at each follow up visit) for healthy medically suitable women and includes related medications (painkillers, antibiotics and abortion pills), scans and consultations during clinic operating hours till the medical abortion is reviewed as successful.  In the event of 10-25% chance that women will need a suction curettage abortion due to continued pregnancy, prolonged or excessive bleeding, or patient choice, **Additional standard charges for vacuum aspiration in a hospital apply.  In case of any requirement for after office hours medical care, **Additional standard charges for hospital attendance and hospital charges apply.

 

The medical abortion package starts once medicine is issued.

 

The following tests are not included in the medical abortion package:

1) Blood group

2) All blood tests

3) Iron pills

 

The current estimated total fee for vacuum aspiration procedure below 11 weeks in Mt Elizabeth Novena hospital and with senior anaesthetist is about $3500, at Thomson Medical Center is about $3300

THERE IS NO MEDISAVE USE FOR MEDICAL ABORTION AS THIS PROCEDURE DOES NOT REQUIRE HOSPITALISATION.

FOR HOSPITALISATION, use of medisave in facilitated by the chosen hospital.

Saturday consultation surchage of $30 applies.