At the Cleveland Surgi-Center, our first trimester surgical abortions are provided for women who are between 4 weeks and 12 weeks pregnant. There are several steps that you will take to ensure your safety and well-being . Ohio law requires a woman to meet with the physician at least 24 hours before an abortion procedure. So on day one, the pregnancy verification, pre-operative evaluation and counseling are performed and you speak with the physician. The abortion procedure can be scheduled the next day or as soon after as possible . PREGNANCY VERIFICATION Every patient will have an ultrasound. This advanced diagnostic technique is used 3 weeks or more after the last menstrual period to determine the correct length of the pregnancy. It is an important procedure that improves the accuracy of the physician's pre-operative diagnosis and further assures the safety of the patient and the procedure. If necessary, a urine pregnancy test will also be performed. PRE-OPERATIVE EVALUATION Further laboratory work is completed to screen all potential patients. Routine laboratory analysis includes hematocrit testing, urinalysis, Rh typing and tissue pathology. Patients with Rh-negative blood type will receive an injection of Rhogam at an additional charge. After the laboratory testing, a registered nurse will evaluate your health. This includes a review of your medical history, a physical exam and a pre-screening for anesthesia risks. Our facility is concerned with the success of your termination and we want to make sure that your current health and size of your pregnancy will allow the safest of procedures. COUNSELING Individual counseling supplies important information and support for patients scheduled for a pregnancy termination. Each woman receives personal confidential attention and care throughout her visit. All counseling, under the direction of our MSW social worker, is private and confidential. Detailed information is provided about the abortion procedure and birth control. Counselors are there to help with feelings and concerns and each patient is treated with warmth, understanding and sensitivity. Whenever appropriate, patient’s family and friends can receive our counseling services. VACUUM ASPIRATION PROCEDURE Cleveland Surgi-Center performs abortions up to 12 weeks of pregnancy by the vacuum aspiration method, the most common method of abortion available today. The procedure involves the gradual widening of the cervix followed by the insertion of a thin flexible tube attached to a vacuum aspirator, which gently removes the uterine contents. A patient who is eligible and chooses to be totally asleep is given a general anesthetic given through an IV. You will not remember, see or hear anything during the abortion procedure. A patient who chooses to have twilight anesthesia will also have medications given through an IV. Twilight anesthesia is conscious (“awake”) sedation. Patients are relatively pain-free and tranquil and yet still aware of their surroundings. Most of the time, a patient doesn’t remember what happened during the abortion procedure. A patient choosing a local anesthetic is given an injection that numbs the cervix. A Medical Assistant is present during the procedure and the doctor explains what he/she is doing so that there are "no surprises". After the procedure, patients with Rh-negative blood type will receive an injection of Rhogam which is administered for an additional charge. (See Fee Schedule) WHAT TO EXPECT AFTERWARDS Your aftercare in the three weeks following an abortion is very important. Please carefully read the information below; it will help to insure an easy and worry-free recovery. You will receive additional information at the time of your visit. Bleeding It is perfectly normal to experience some bleeding after a pregnancy termination. Some women have bleeding similar to a normal period and others bleed very little or not at all. After your procedure, you will be taking a medication called methergine/ergonovine for a few days. This medication helps to control bleeding and contract the uterus. Your first normal period following the abortion should come in four to six weeks. We ask that you monitor your bleeding for three days after your abortion. If your bleeding becomes excessive and you begin to saturate a full size pad within one hour or if you are passing clots of blood larger than the size of a quarter, you should contact us by calling our emergency telephone number. This number will be given to you during your visit and provides twenty-four hour emergency access. Cramping It is not unusual to experience cramping after your procedure. You may take any non-aspirin pain reliever or a pain reliever that is prescribed by us to relieve your discomfort. Avoid aspirin as it may thin the blood and cause heavier bleeding. Breast Soreness and Mood Changes As your hormones shift to the non-pregnant state, you may feel a slight "down" or "blue" period. These feelings should subside in a few days. A small percentage of women experience some increased breast tenderness for a few days after the procedure and some women produce milk. This is best remedied by wearing a tight-fitting bra for 24-48 hours, applying ice to the breasts, refrain from touching the breasts and taking hot showers. Milk production should diminish in a few days. Restrictions In order to avoid infection and to ensure a healthy recovery, it is most important that you completely take your antibiotic prescription. Also, there are some restrictions that you must stick to for three weeks after your abortion and until you have received a follow-up exam: 1. Abstain from sexual intercourse 2. Do not use tampons 3. No douching, tub baths or swimming 4. Avoid strenuous activities such as heavy lifting (lifting anything over fifteen pounds) and all exercise.       Copyrighted © 2005-2009 Cleveland Women's Medical Group All Rights Reserved. Home | Early Surgical Abortion | Early Medical Abortion | Late Surgical Abortion | Anesthesia Options | Pre-Op Instructions Informed Consent | Privacy Information | Emergency Contraception | Fee Schedule | Staff & Facility | Well Women Services | FAQ Make An Appointment |Map / Directions | Contact Us | En Español Cleveland Surgi-Center Inc. | Pearl Road Health Center, 4269 Pearl Road, Suite 406, Cleveland, OH 4109 | 216-912-0676 | 866-837-9213