Abortion procedures

What is the gestational age limit at most clinics that provide abortion services?
It may vary from 8-16 weeks. Abortions cannot be performed after 22 weeks gestation, and under Syariah law after 120 days (16 weeks).

In order to have an abortion must a woman have an overnight stay in the hospital?
If the procedure performed is a manual vacuum aspiration (MVA), electrical vacuum aspiration (EVA) or medical/medication abortion (MA), it is treated as an outpatient procedure and no overnight stay is required. If the procedure performed is a D&C (dilatation and currettage) as is done in most public hospitals, an overnight stay is usually required.

Is there any follow-up after post-abortion counseling? What is your network for counseling and follow-up services?
The clinic meets the client again two weeks after the abortion to check up on complications. The nurses in the clinic are trained to do counseling. Pre-abortion counseling involves informing them of contraceptive choices, the risk of infertility through infection, and the process of the procedure itself. Post-abortion counseling involves contraceptive choices and sexually-transmitted infections. There is a high rate of contraceptive use after abortion, but also a high dropout rate.

If the procedure is simple, are you moving towards a state where trained paramedics can perform abortions?
Under the law, paramedics are not registered medical practitioners and cannot perform abortions. However, in the case of medical/medication abortions (using misoprostol), there are several stages:
i) scan, in part to assess if it’s an ectopic pregnancy;
ii) information on medication, which can be done by nurses;
iii) post-abortion follow-up.

By demedicalizing abortion, doctors need not be involved at every stage. Supervision by them would be sufficient. Studies abroad have shown trained nurses and midwives after training are equally competent to perform these procedures under remote medical supervision.

These are questions asked at state seminars held by RRAAM from 2007 thru to the present, primarily for health care providers serving in hospitals and clinics. The answers provided are by RRAAM presenters at these seminars. Some questions were asked only once but they are deemed important enough to be published here. Since laws, policies and guidelines evolve with time and changing social conditions, the answers provided here are necessarily time-bound. Wherever and whenever possible, we will strive to keep these answers accurate and updated. However, we cannot assume liability for the veracity of information provided.