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Abortion & Termination of Pregnancy (TOP)

What is “termination of pregnancy”?

Termination of pregnancy or TOP is a term used to describe the ending of a pregnancy.

Can anyone have a TOP?

TOP is a special procedure that can only be carried out by a trained health worker in a government approved clinic or hospital. Any woman can ask for a TOP in the first three months (12 weeks) of pregnancy. It is important to act quickly if you think you are pregnant and don’t want to go through with the pregnancy. If a woman is three to five months pregnant the TOP is much more complicated. The doctor will only carry out the TOP if:

  • There is a risk to the physical or mental health of the woman or foetus
  • Having the baby will cause major social or economic problems for the mother
  • If the pregnancy is a result of rape or incest

What happens if I ask for a TOP?

Your health worker will give you further information. Counselling is available if you want to talk about your feelings and concerns. Feel free to ask about other choices such as adoption and/or fostering.

Where can I go for a TOP?

Not all clinics and hospitals can offer a TOP. Your health worker may refer you to a clinic or hospital that offers the service. You may have to wait some time before the procedure can be done. You will be asked to sign an informed consent form to give permission for the TOP to be done. You do not need your parents’ or partner’s consent.

Can I become pregnant after a TOP?

Yes, you can become pregnant after a TOP. Your health worker will advise you about pregnancy prevention
methods such as condoms, contraceptive pills, contraceptive injections, the intra-uterine device (IUD), sterilisation or vasectomy for your partner. Condoms are the only contraceptive method that also protects you from sexually transmitted infections such as HIV.

How does TOP work? 

A TOP that is carried out in the first three months (12 weeks) of pregnancy is a procedure that can be done while the woman is awake. An injection may be given at the opening of the womb to prevent pain. Sometimes pills are given instead of the injection. A tube is inserted into the womb and the contents of the womb are removed through the tube, using a suction. If a woman is more than three months (12 weeks) pregnant, the TOP is more complicated. She will have to stay in the hospital for a day or two where she will be given medication to bring on labour. Some women might need to have a general anaesthetic.

What happens after the TOP? 

  • Many woman are able to go home an hour or two after the procedure. Others may need to stay longer.
  • After the procedure there is a risk of infection. You should not use tampons or have sex until the bleeding has stopped.
  • Some bleeding after the TOP is normal. Bleeding should get lighter over time and should not last more than ten days.
  • If you have severe pain or very heavy bleeding after the TOP contact your health worker immediately for advice.

Do I need to tell my parents or my partner?

No. You can decide for yourself if you want to have a TOP, even if you are a teenager. Most girls and women find it is better to discuss their decision with a person they trust.

Is a TOP safe? 

Yes. A TOP is safe if it is carried out by a trained health worker in an approved clinic or hospital. As with any medical procedure, there is a small risk. A TOP is much safer if it is done in the first few weeks of pregnancy.

Will TOP make me infertile?

No. A TOP that is carried out correctly in an approved clinic or hospital should not affect your chances of having children in the future. Remember, it is possible to become pregnant very soon after a TOP.

What is a “backstreet” abortion? 

Before TOP was legal in South Africa, many women had abortions which were carried out by untrained people using unsafe methods. These were called “backstreet” abortions and often resulted in serious  infections, infertility and even death. One of the main reasons for making TOP legal was to provide a safe alternative to “backstreet” abortions.

Do all clinics and hospitals carry out TOP?

No. Although the law has made it possible for a woman to go to a doctor, clinic or hospital and ask for a TOP, not all health workers can offer the procedure and related counselling. Ask your health worker to refer you to a doctor, clinic or hospital where a TOP can be done. TOP is free at government hospitals and clinics. It is also available at some private clinics and hospitals, at a cost.

What is emergency contraception? 

Emergency contraception can prevent pregnancy if you act soon after having unprotected sex. You can get emergency contraceptive pills (‘morning after’ pills) from your health worker or pharmacy. These can be taken up to three days (72 hours) after unprotected sex. It is important to remember that the ‘morning after’ pills are used only in cases of an emergency and thus should not be used as a replacement for contraception. You are encouraged to discuss contraceptive methods with a health care worker.

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