An unwanted pregnancy is a pregnancy that is not accepted by the person concerned. There can be various reasons why you do not want or cannot be pregnant:
- you do not have a partner with whom you can raise the child
- you do not (yet) feel able to raise/raise a child
- it is not wise to be pregnant for your physical or mental condition
- your family was already completed
- you do not have the financial means or home to support the child
- you are pregnant because of sexual contact that you have been forced to do
- you are pregnant with a disabled child and you cannot and/or do not want to cope with that situation
- your contraception has failed
Unwanted pregnancy symptoms
You may suspect that you are pregnant because you have had sexual contact with a man without using contraception.
Physical symptoms that occur during pregnancy, such as morning sickness, vomiting and breast tenderness, can also make you feel pregnant. This suspicion can be strengthened because menstruation does not occur on and after the expected menstrual date.
A pregnancy test, which you can buy at the drug store or get it from your doctor, can tell if you are pregnant. If the test is negative but you still have strong suspicions that you are pregnant, you can repeat the test a few days later.
You can read more information about this in the information leaflet ‘The first signs of pregnancy’.
How does an unwanted pregnancy develop?
There are several reasons why you could be pregnant when you actually don’t want to:
- you forgot to use contraception: because of the romantic mood or embarrassment to bring up the topic of contraception, you have not used contraception but have made love
- you have not used contraception correctly
- you have forgotten to take the pill every day
- you have used a condom twice
- you are taking medicines in addition to the pill, including antibiotics that make the pill no longer work optimally. If you are unsure whether you are using (or have used) the contraception properly, you can read more about this in the information leaflet ‘Contraception’
- the contraception has not worked properly: no contraceptives exclude pregnancy 100%. The pill and sterilization are very reliable, but nevertheless there are four to ten pregnancies per 1000 women, despite good intake of the pill, and five pregnancies after sterilization. When the condom is used alone, this is twelve pregnancies per 100 women per year. More information can be found in the information leaflets ‘Reliability of contraception’ and ‘Contraception’
- someone forced you into sexual contact without you wanting to: pregnancy can occur after rape
- you did not think you could become pregnant because you have never had a period or because you thought you were already in the menopause: before the very first menstrual period you will ovulate and you can therefore also become pregnant. During the menopause, ovulation and menstruation can occur very irregularly and sometimes stay away for a long time, but then suddenly return. Then you can get pregnant
- you thought you could not get pregnant because your periods have stopped temporarily for another reason: if you are breast-feeding, are underweight or sick, your periods may stop temporarily. However, you never know when the first ovulation will occur, so you can get pregnant
You run the greatest risk of becoming pregnant in the week in which ovulation takes place. Ovulation usually occurs fourteen days before the expected menstrual date.
Unwanted pregnancy and then what?
If you turn out to be pregnant when you don’t want to at all, you will be faced with a lot. Feelings of all kinds can arise: you are surprised, angry why this is happening to you, you think it is all not true, you are sad because you do not know what to do, you are afraid that your whole life will change, afraid of the reactions from other people and/or many more feelings.
Some feel gloomy and listless, others feel irritated and irritated. If you realize that you are indeed pregnant, there will also be questions about how to proceed with this pregnancy. After all, it has important consequences for yourself and your further life, and for the baby in your womb.
You will have to decide what the future will look like. In some countries, it is possible to choose whether you want to keep this pregnancy or end the pregnancy.
Whatever choice you make, it is often a difficult decision that involves all kinds of feelings. Often not only your own feelings but also those of your partner, your parents, or other people in the environment. Your doctor or professional people who work at abortion clinics, Rutgers Foundation, or FIOM (see below) can also help you list the various possibilities and feelings, in order to make a choice that suits you and your situation. The various options are discussed below.
Work with people you trust to clarify what is important to you and what choices you are going to make. You don’t have to make this choice in one day, take the time you think you need.
- Maintaining the pregnancy
You can choose to accept and carry on the pregnancy. Problems you saw at first are sometimes less serious than you initially thought. Think of feelings such as shame for the environment, the inability of yourself to raise a child, and/or fear of responsibility.
Your partner, parents, and friends can support you during pregnancy and in raising your child. All kinds of arrangements can be made for financial problems. Special measures can often be taken at school; there may be the possibility to follow an evening course. Various arrangements are also possible at work, making it possible to combine raising a child and working.
If you want to carry on with the pregnancy but do not want to take responsibility for raising a child, you may want to consider adoption. You can also choose this option if you are not allowed to have an abortion due to your religious beliefs. Your general practitioner or other organizations such as FIOM and the association for the protection of the unborn child (VBOK) can help you get in touch with an organization that arranges adoption. They can also guide you through all the emotions that may arise in you when you give up your child.
- Terminating the pregnancy
In some countries, it is legally permitted to perform an abortion up to a gestational age of 22 weeks. You can go to an abortion clinic or a general hospital for termination. Your doctor can refer you to this. You can also make an appointment at the abortion clinic.
You will first be interviewed there to discuss your motives for terminating the pregnancy again and to make a final decision. An ultrasound will also be made to confirm the gestational age. If you are still in doubt, you can also have some interviews with a psychosocial worker.
If you are less than sixteen days late, you can immediately receive treatment. Otherwise, a statutory reflection period of five days applies. The costs for terminating the pregnancy are reimbursed by the Exceptional Medical Expenses Act (AWBZ) if you live in the Netherlands. If you can show an extract from the population register or proof of registration of your health insurance, you do not have to pay anything.
Women who do not officially live in the Netherlands are helped but must pay the costs of the treatment themselves. If you are under the age of 16, you must have parental consent to have the treatment carried out.
There are various methods of terminating a pregnancy. The choice of a particular method depends on the gestational age. The gestational age is the number of weeks that have passed from the date of the first day of your last period. By the time you are overdue, the pregnancy is already at least four weeks.
Options for terminating the pregnancy
The options for terminating the pregnancy are:
- the morning after pill: up to three days after inadequately protected sexual intercourse
- the abortion pill: up to a gestational age of seven weeks, suction curettage: up to a gestation period of twelve weeks
- the suction curettage + reduction of the fetus and placenta: from a gestation period of 12 to 22 weeks
- induction of childbirth: from a gestational age of 12 to 22 weeks
- The morning after pill
Although the morning after pill is not strictly speaking a method of ending an unwanted pregnancy, it can prevent an unwanted pregnancy if you have had insufficiently protected sexual intercourse.
You can get a prescription from your doctor up to three days after insufficiently protected sexual intercourse for tablets, of which you must take two times two twelve hours apart. These tablets contain hormones that prevent fertilization or the implantation of a fertilized egg.
Proper use can prevent pregnancy in 98 out of 100 women. In spite of correct use, 2 out of 100 women do have a pregnancy. If the fruit has already established itself when you use the morning-after pill, the morning after pill is not suitable for terminating the pregnancy and will therefore not work.
You may experience nausea, breast tenderness, headaches, or dizziness on the first day after taking the medication. These complaints disappear spontaneously. If you vomit within two hours of taking the tablets because of nausea, the tablets will lose their effect. In that case, ask your doctor for advice. Sometimes drugs to prevent vomiting are prescribed. You can read more about this in the information leaflet ‘Morning-after pill’.
- The abortion pill
If you are not more than seven weeks pregnant, counted from the first day of your last menstrual period, there is the possibility of terminating the pregnancy by taking the so-called abortion pill. This treatment takes place in an abortion clinic. You will usually need to come to the clinic three times for treatment. During the first visit, you will have an interview in which you will discuss the arguments for choosing to terminate the pregnancy and make a decision.
The pregnancy duration is checked with an ultrasound examination. You will then be given three tablets with hormones that counteract the pregnancy hormone progesterone. This prevents the pregnancy from developing further and the fetus dies. You are expected to return to the abortion clinic two days later. You will then be given other tablets that cause the uterus to contract in order to expel the fruit from the body.
This works within a few hours for three out of five women. They experience blood loss and cramping in the abdomen comparable to a heavy period. If you do not have blood loss after four hours, you can have the same tablets again. In most women, blood loss occurs within twelve hours with the expulsion of the fetus.
The blood loss can last well over a week after the treatment. You may also suffer from abdominal pain, nausea, and/or vomiting. That is quite normal. If it disturbs you a lot, you can contact the doctor. Sometimes these drugs can be prescribed to relieve symptoms.
The abortion pill does not work in one in twenty women. In that case, a suction curettage will still have to be done. It is wise to start contraception immediately. You should not have sexual intercourse during the first three weeks after treatment. You run an increased risk of infection.
The last visit to the abortion clinic consists of a follow-up. An ultrasound is used to check whether the abortion pill has worked properly. There is also room to talk about your experiences and feelings about the treatment.
- The suction curettage
Another method of terminating the pregnancy if it has not progressed beyond twelve weeks is suction curettage. This treatment can be performed in an abortion clinic. The cervix is stretched and the uterus is sucked empty with a thin tube through which the fruit and the amniotic sac come out. The procedure takes five to ten minutes.
Usually, the procedure is performed under local anesthesia of the vagina and cervix. A combination of a strong analgesic and sedative medicine or a general anesthetic is also possible.
You can go home a few hours after the procedure. It is wise if you do not drive home yourself, but ask someone to pick you up. After the procedure, you may still feel menstrual-like pain for a few days. If this pain is very severe, you can take one or two tablets of paracetamol for this. You can do this up to four times a day.
When the suction curettage is performed if you are less than sixteen days late, this is also referred to as an overdue treatment. However, the procedure is exactly the same.
The curettage gives a small chance of complications. An infection of the uterus may develop. You will also receive instructions on what to do if you develop a fever. Another risk consists of severe bleeding that does not stop after a week. Usually, this is caused by tissue left behind. This will have to be removed by a new curettage or treatment with drugs.
In addition, adhesions can develop on the inside of the uterus, very rarely the tube or spoon accidentally passes through the uterine wall. This can easily be remedied. You will have to be admitted to a hospital for the treatment of these complications.
- Suction curettage and reduction of the fruit
If you are more than 12 weeks pregnant, the fetus containing the placenta is too large to be removed with a suction curettage alone. That is why the fruit and placenta are first made smaller with special tongs. Above sixteen weeks, the cervix must also be stretched considerably, otherwise, the fetus and placenta cannot come out.
Then a suction curettage is applied. This procedure also takes place under local anesthesia of the cervix by means of injections. In addition, you will also receive pain relief via an IV. This procedure is only performed in abortion clinics.
If you are less than eighteen weeks pregnant, you can go home a few hours after the procedure. Because the procedure is more difficult after eighteen weeks of pregnancy and there is a slightly higher risk of complications, you will have to stay overnight in the abortion clinic afterward. The next day, if no problems have occurred, you can go home. After the procedure, you can still suffer from blood loss and/or cramps in the lower abdomen for more than a week. The complications of this procedure are the same as with suction curettage alone.
- Induce labor
This treatment is only applied in the hospital. Contractions can be induced by means of an IV with hormones. For example, the delivery will start within 24 to 48 hours and your baby will be born.
Another method is to break the membranes and let some of the amniotic fluid run-offs. After that, a saline solution is introduced into the uterine cavity. This stimulates the development of contractions. Labor will start after approximately 36 hours. Usually, the child dies during delivery, sometimes only after it is born. There is a chance that the placenta will not be born spontaneously. If so, it will need to be removed under anesthesia.
One risk of inducing labor is excessive blood loss because tissue remains in the uterus. A follow-up treatment in the form of a curettage must then follow. Another important risk is infection. You will therefore be instructed what to do if you develop a fever. Very rarely does a hole appear in the womb. This must be treated in a hospital afterwards.
Fortunately, the risk of complications is small in a registered abortion clinic. A complication occurs in one in 2,000 abortions.
After termination of pregnancy
Despite choosing carefully and deliberately to terminate the pregnancy, you may feel sad for a time. It is important to talk about your feelings with someone you trust.
Some people also keep a diary. That can help process your feelings. You can also talk to the general practitioner, the abortion clinic or the FIOM. Some women feel guilty because they don’t feel guilty or are not sad. Talking about that too is often good for yourself.
If you find yourself struggling to accommodate the abortion, it may be important to seek counseling that can help you process the abortion.
- feel guilty about the abortion
- feel ashamed that you have had an abortion
- continues to feel down
- avoid maternity visits
- has difficulty with sexual contact
- feel very alone, and no one understands you This is especially the case if you live in an environment that disapproves of abortion, if you found it very difficult to make a choice or if you would have liked to keep the pregnancy, but still has opted for an abortion.
- Looking up to a new pregnancy Your mind and your feelings are not in harmony. Don’t be ashamed of this. It is very important to seek guidance and not keep walking around with these feelings for months to years.
Several people may be eligible to give you the guidance you need. Choose someone you trust and feel comfortable with. You can get guidance from your general practitioner, psychosocial workers in the abortion clinic, the FIOM foundation, the VBOK and the Rutgers Foundation.
It is also possible to communicate by e-mail with a doctor from the Dutch association of abortion doctors (NGvA). FIOM has processing groups where you can talk about your feelings and experiences with women who have been through a similar situation.
- Message to the doctor
In principle, the general practitioner will be informed by the abortion clinic that you have had an abortion. In the unlikely event that problems arise, your doctor will be aware that you have had an abortion.
He can also guide you if you have difficulty coping with the abortion. If you object to the doctor being informed, you can indicate this. In that case, the doctor will not be notified.
A follow-up is done two to three weeks after the abortion. During this check-up, the treatment is discussed, an ultrasound is made to see whether the treatment has been successful and there is room to talk about your feelings about the abortion.
- Birth control
To prevent unwanted pregnancy again, it is important to use good contraception. It is wise to start with this on the day of the surgery. You can opt for the contraceptive pill, the contraceptive injection or having an IUD inserted.
If you have an IUD inserted after the procedure, you will generally suffer more from abdominal cramps and blood loss.
- Resumption of work
If you feel well, you can, in principle, resume work one day after the abortion.
- New pregnancy
Due to the risk of infection, you should not have sexual intercourse during the first three weeks after the abortion. The abortion has no consequences for a possible pregnancy at a later date.
When to go to the doctor?
If you do not want to continue the pregnancy, you can contact your doctor. Together with the doctor, you can see what is possible in view of your personal circumstances.
Your doctor can refer you to authorities if you need to discuss your feelings and motives regarding whether or not to keep the pregnancy. He can also help you or refer you to authorities (such as FIOM, VBOK, social workers) that can support you if you decide to continue your pregnancy.
If you decide to have an abortion, the doctor can refer you to an abortion clinic or a hospital where an abortion is performed. You can then go there after the reflection period of five days. This reflection period does not apply if you are less than sixteen days late.
You can also go to your doctor to discuss the abortion after the abortion has been performed. If you have great difficulty processing the abortion, your doctor can refer you to an abortion clinic or the FIOM for more intensive guidance.
What can you do about it yourself?
Once you have an unwanted pregnancy, there is nothing you can do to end the pregnancy yourself. It is also not wise or even dangerous to follow any advice on how to end the pregnancy yourself.
If you think you want to terminate the pregnancy, you can make an appointment at an abortion clinic yourself or through your doctor.
General advice and precautions
Although abortion is legally possible in some countries, it of course remains an emergency measure. It is always better to avoid becoming pregnant if you do not want a child. It is important to use good contraception at least if you have sexual intercourse, even if you have never had a period or if you have not had your period for a while.
There are several methods of birth control so you can find one that is right for you. You can think of the contraceptive pill, the condom, an IUD, a diaphragm, or sterilization. No method is able to prevent pregnancy 100 percent. One method is more reliable than the other. You can read various information leaflets about contraception at Edexme.com. Sometimes it is wise to combine two methods, such as the pill and the condom.
Even though it is sometimes difficult to talk and think about contraception, it is a very important and actually quite normal topic. By discussing it in time you can avoid a lot of tension and sadness due to an unwanted pregnancy.
In addition, it is important to use the contraceptive in the prescribed way. For example, you must take the pill at a fixed time every day. If you forget, vomit or take antibiotics, the pill is no longer reliable. You can read more about this in the information folder ‘The Pill’.