PREPARATION
Scheduling an appointment
You can make an appointment at Gynaikon Clinics directly if you are facing an unintended pregnancy.
Appointment without referral letter
You can make an appointment directly for abortion at Gynaikon Clinics and don’t need a doctor’s referral letter. You can discuss with the doctor how must time you need to think about your decision to terminate the pregnancy.
Minors
If you are 16 or older, you may legally decide to have an abortion without the consent of your parents.
If you are 15 or younger, you need your parents’ consent.
If this is not possible, please contact us by telephone on +31 (0)88 8884444.
Period of pregnancy
The period of pregnancy is calculated from the first day of the last monthly period or based on ultrasound scans. If you do not know how far along you are in your pregnancy, you can make an appointment for an ultrasound scan at short notice.
Birth control products and methods
The pill, the IUD and the condom are well-known birth-control products. Other reliable birth control products include the contraceptive injection, the contraceptive implant, the vaginal ring and the contraceptive patch. Sterilisation is an option that you can choose if you are certain that you do not want to have (any more) children.
A condom protects you against STDs (sexually transmitted diseases) and HIV (AIDS).
Fees
Patients who live in the Netherlands
If you live in the Netherlands and have a Dutch health insurance, you will not be charged for the abortion procedure and the costs will be reimbursed via funding provided by the Ministry of Health, Welfare and Sport. Complete anonymity is guaranteed in this process. Your health insurer will not be informed and you do not pay any deductible access (unlike treatment in hospital).
In order to determine whether you are eligible for reimbursement, we require your insurance card or a copy of your health insurance policy. In addition, we request you to bring an identity document, such as a passport or driving licence, with you.
Patients who do not live in the Netherlands
If you do not live in the Netherlands, you must pay for the costs of treatment yourself. The maximum fees for treatment are set by the government. The fees must be paid prior to your treatment. Please contact the clinic for details of the fees.
The video ‘scheduling an appointment’ will explain how to make an appointment with Gynaikon Clinics Watch the video >
Intake
Once you arrive in the clinic, you will check-in with our receptionist. After you have completed a digital health questionnaire in the waiting room (if you have not yet completed it at home) you will have an initial assessment and pre-exam. We will do an ultrasound to determine the length of the pregnancy. During this part of the process, no one else may be present. This is because we want to have a moment alone with you. During the assessment the nurse also talks about the use of contraception and will answer all your questions. Up to about 15 weeks pregnant, you can have an IUD inserted immediately after the procedure.
If you do not know your blood type and Rhesus factor, we will perform the necessary tests. The Rhesus factor is particularly important when terminating a pregnancy, so we need to know whether it is positive or negative. If you have a negative Rhesus factor, we will give you an antibody injection immediately after the procedure.
Depending on how many weeks pregnant you are will vary the treatment options and the observation period after treatment.
The video ‘INTAKE’ will explain what happens during the intake. Watch the video >
The treatment options are depending on the number of pregnancy weeks.
You may take 1 accompanying person to the clinic.
Children are not allowed in the clinic.
Medication-based treatment - abortion Pill
(up to 9 weeks pregnant)
The abortion pill can be used up to 9 weeks after the first day of your last period. The medication-based treatment consists of multiple medicines, namely mifepriston (Mifegyne®) and misoprostol (Cytotec®), that you take on different days. The Mifegyne® will stop the pregnancy and will be taken into the clinic. You get 4 tablets Cytotec® to take home. You insert these tablets into your vagina 2 days later. They cause the uterus to contract and induce a miscarriage. This is painful and causes blood loss. Both the blood loss and pain may last longer and be more intense than in the case of a normal monthly period. You may also pass clots. So you are advised to also take a painkiller immediately. An adult who is aware of the abortion should remain with you during the day.
We advise you not to use tampons for the blood loss; use normal sanitary towels. You can expect your next monthly period 4 to 6 weeks after the abortion.
Sometimes, the use of the abortion pill is not possible for medical reasons, so-called contraindications, for example, in the case of anaemia, high blood pressure or asthma.
In addition, you or your companion must have sufficient command of the Dutch or English language.
The video ‘Medication-based treatment’ will explain the process of this treatment. Watch the video >
Surgical treatment in the first trimester
(5-13 weeks)
During this procedure, your uterus will be carefully emptied using a thin tub and is possible up to approximately 13 weeks. You can choose between a local anaesthetic or general anaesthetic. You will be given 2 tablets of misoprostol that cause the cervix to soften and open slightly. This is called priming and from this point, the treatment has started.
Local anaesthetic
If you have chosen a local anaesthetic, you will mainly feel the needle as the anaesthetic is administered and possibly experience spasms similar to menstrual cramps. The procedure takes 5 to 10 minutes.
The video ‘SURGICAL TREATMENT UNDER LOCAL ANESTHETIC’ will explain the process of this treatment. Watch the video >
General anaesthetic (sedation)
If you have chosen a general anaesthetic make sure you have fasted before the appointment at the clinic (also check the text ‘treatment under sedation’). Before the treatment you are put to sleep first. The doctor will wake you up again immediately after the procedure has finished. After treatment, you will remain in the clinic for observation for approximately 1 hour.
The video ‘SURGICAL TREATMENT UNDER SEDATION’ will explain the process of this treatment. Watch the video >
TREATMENT
Second trimester treatment
(13-18 weeks)
From approximately 13 weeks, you undergo a second trimester treatment under sedation (go to sleep). If you have chosen a general anaesthetic make sure you have fasted before the appointment at the clinic (also check the text ‘treatment under sedation’).
You will be given 2 tablets of misoprostol that cause the cervix to soften and open slightly. This is called priming and from this point, the treatment has started. Before the treatment you are put to sleep first. During this treatment, the pregnancy is removed with instruments and the uterus is cleaned. Depending on how many weeks pregnant you are, the procedure takes from 10 to 20 minutes. The doctor will wake you up again immediately after the procedure has finished and you will remain in the clinic for approximately 1 hour after treatment for observation purposes.
The video ‘SECOND TRIMESTER TREATMENT UNDER SEDATION’ will explain the process of this treatment. Watch the video >
Treatment under sedation
When you opt for treatment under sedation, make sure you have fasted before the appointment at the clinic. This means that your stomach must be empty.
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Eating: is allowed up to 6 hours before the appointment, but you cannot eat anything after that.
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Drinking: do NOT drink ANYTHING from 2 hours before the appointment. Drinking water, tea, or coffee without milk is allowed between 6 to 2 hours before the appointment.
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Medication: you can take your usual medication with water up to 1 hour before your appointment. EXCEPTIONS to these rules: blood thinners and diabetes medication. If you are on this kind of medication, please let the clinic know.
You will be given a prescription for antibiotics after the procedure. You will soon feel physically fit again. However, you may experience breast tenderness, blood loss or abdominal pain for a few days. If necessary, you can take a painkiller. You can expect your next monthly period 4 to 6 weeks after the abortion.
If your breasts feel tender and painful after the procedure, or they become congested, your best course of action is to wear a tight bra. Do NOT massage the breasts. Ice packs can also help. If you experience pain, you may also take a painkiller. If you experience lactation, medication can be prescribed to stop milk secretion. We do not prescribe this medication as standard because of the high incidence of side-effects. You should contact your own doctor if you require a prescription.
During the first two weeks after the procedure, you may not use tampons, go swimming, take a bath (obviously you may shower) and have sexual intercourse.
Risk of complications
The risk of a complication during or after the procedure is extremely small. Possible complications include excessive blood loss or damage to the uterus. Additional treatment in a general hospital may be necessary in that case (< 0.2%).
In addition, the intervention may have been unsuccessful in the case of an early pregnancy, or residual tissue may have been left behind in the uterus. In that case, the doctor may decide that additional medication or a curettage is required.
In general, the procedure does not have an adverse effect on subsequent pregnancies.
Emotional reactions
In some cases, you may experience unexpected emotional responses during a period of days or weeks due to hormonal changes in your body. If you have difficulty in coming to terms with the abortion, we will be happy to help you find suitable psychological counselling. You can also contact FIOM, an institute which offers abortion support and counselling.
www.fiom.nl for more information.
The video ‘RECOMMENDATIONS AFTER TREATMENT IN THE FIRST AND SECOND TRIMESTER’ will explain what happens after the treatment. Watch the video >
Follow-up appointment
Three weeks after the procedure you can do a pregnancy test and make an appointment for a follow-up. You can come to Gynaikon Clinics or you can also go to your own doctor for this.
You can have an IUD inserted immediately after the procedure. You can find more information about contraceptives on the websites zanzu.nl and sense.info. There are costs associated with inserting the IUD and the clinic can inform you about the current rates.
The video ‘FOLLOW-UP AND CONTRACENTION’ will explain what happens when you come to Gynaikon Clinics for the follow-up appointment. Watch the video >
IMPORTANT !
Treatment under sedation:
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If you have not fasted, you will not be sedated.
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After sedation, you are not allowed to drive a car or ride a motorcycle or bike for 24 hours, so bear that in mind!
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Please arrange for someone to take your home.
FOLLOW UP
The page PRACTICAL INFORMATION informs you about the day of treatment, procedure, what you have to bring with you and things you need to consider.
Cancellations
If you cannot keep an appointment, we kindly but firmly request you to notify us by telephone at least 24 hours beforehand!
The vacant appointment can then be assigned to somebody else. If you wish, you can arrange a new date for treatment with the receptionist.
Abortion services
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Abortion pill up to 9 weeks pregnant
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Suction curettage from 5 to 13 weeks pregnant
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Abortion from 13 to 18 weeks pregnant
An abortion is an intervention which is designed to terminate the pregnancy. Gynaikon Clinics offers the following treatment options:
Questions & Answers
1. What are my options if I am unintentionally pregnant?
Depending on how many days or weeks pregnant you are, you have the following options:
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Allow the pregnancy to come to term and raise your child yourself
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Have the child placed in a foster family
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Give your child up for adoption
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Abortion
Many women are able to come to a decision very quickly, however others are tormented by indecision. The best approach is to carefully review your plans and analyse your feelings, before taking the decision which seems best in your circumstances. Even though this is a decision which you must take yourself, being able to discuss your problem with somebody else is often helpful. If you are unable to decide on your own, you can make an appointment with your GP or with our clinic.
2. I think that I may be pregnant after having unprotected sex
Have you had unprotected sex, or did the condom tear?
If this occurred less than 3 days ago, you can buy a morning-after pill from a pharmacy or chemist without a prescription. The morning-after pill does not offer 100% protection. If your monthly period does not come at approximately the normal time, take a pregnancy test to be sure.
If you had unsafe sex less than 5 days ago, you can have a copper IUD inserted into your uterus. This prevents pregnancy. (If you wish, you can leave the IUD in place as a contraceptive.)
3. What can I do when my monthly period is overdue?
If your monthly period is more than a week overdue, take a pregnancy test. This test can be purchased from a pharmacy or chemist. If the result is inconclusive, take another pregnancy test after a week. You can also make an appointment at our clinic for a pregnancy test and/or ultrasound scan.
4. At how many weeks into my pregnancy can I still get an abortion?
At Gynaikon Clinics, you can get an abortion up to 18 weeks of pregnancy, calculated from the 1st day of your last monthly period. (In the Netherlands, treatment is possible up to approximately 22 weeks of pregnancy.)
5. How long does the complete treatment procedure last, including pre-procedure and post-procedure care?
In the case of a pregnancy up to 18 weeks, you can return home during the course of the afternoon on the same day. In general, you will spend 3 to 6 hours at the clinic.
6. To what extent does my weight affect treatment?
An increased risk is associated with anaesthesia if you are obese or seriously underweight. If you are obese or seriously underweight, please contact us.
7. Are there any problems if you have had an abortion previously?
A previous abortion does not cause physical problems that might affect treatment.
8. How is an abortion procedure performed?
Up to 9 weeks, you can opt to take the abortion pill. You will be given medication that contains a 'contraceptive hormone', which, in most cases, prevents the pregnancy from developing further. Two days later, either at the clinic or at home, you are given prostaglandin tablets, which cause the uterus to contract, resulting in rejection of the embryo. You can also opt for a suction curettage.
Up to approximately 13 weeks, a suction curettage can be performed under local anaesthetic or general anaesthesia. The cervix is anaesthetised via the vagina and expanded slightly. Next, a thin tube is inserted and tissue is removed by suction. Sometimes you are given prostaglandin tablets a few hours before the procedure in order to soften the cervix.
From approximately 13 weeks, the cervix has to be expanded further and the embryo removed with instruments. After removal of the embryo, the uterus is cleaned by curettage. You are given prostaglandin tablets one hour to a few hours before the procedure in order to soften the cervix.
9. Am I given a general anaesthetic, an epidural anaesthetic or a local anaesthetic?
We do not administer an epidural anaesthetic. Up to 18 weeks into your pregnancy, you can choose between a local anaesthetic or general anaesthesia. If a general anaesthetic is administered, you may not operate a vehicle (including riding a bicycle or moped) for 24 hours after the procedure.
10. Is the procedure painful?
If the procedure is performed under local anaesthetic, you are not put to sleep and you can feel what happens. The degree of pain experienced differs depending on the individual in question. You will generally feel some cramping after treatment. This feeling is very similar to strong menstrual cramps.
If the procedure is performed under general anaesthetic, a sedative and a painkiller are administered through a needle in your arm. Under a general anaesthetic, you will not feel anything during the procedure. You are woken up immediately after the procedure. You will feel a little sleepy afterwards and may experience some dizziness.
11. Is my partner or companion allowed to be present during the procedure?
Your partner or companion may not be present during the intake interview and preliminary examination performed by the doctor. This is because the doctor will want to speak to you privately. Your partner or companion is allowed to be present when the procedure is performed under local anaesthetic up to 13 weeks of pregnancy.
12. What complications may arise?
The risk of a complication during or after the procedure is extremely small, but increases proportionately to the duration of your pregnancy. Possible complications include excessive blood loss or damage to the uterus. Additional treatment in a general hospital in our region, with which we have a partnership agreement, may be necessary in that case (< 0.2%).
In addition, the intervention may have been unsuccessful in the case of an early pregnancy, or residual tissue may have been left behind in the uterus. In that case, the doctor may decide that additional medication or a curettage is required.
13. What should I look out for during the first few days after treatment?
You will be given antibiotics as a precautionary measure. If you have a temperature of more than 38ºC after the third day, please contact us.
If your breasts are tender and painful after the procedure, you may take a painkiller. If you experience lactation, medication can be prescribed to stop milk secretion. We do not prescribe this medication as standard because of the high incidence of side-effects. You should contact your own doctor if you require a prescription.
You may not have intercourse during the first two weeks after the procedure. During this period, you may also not use tampons, go swimming and take a bath. You are allowed to shower.
14. I find the abortion to be overpowering emotionally. Can I share my feelings with anybody?
If you feel uncertain or have difficulty taking a decision, you can contact FIOM, an institute which offers support and counselling for unplanned pregnancies. For an address in your area, please refer to the website: www.fiom.nl. On the day of the procedure, you can discuss all aspects of the treatment with one of our nurses.
15. Does an abortion have an adverse effect on future pregnancies?
In general, the procedure does not have an adverse effect on subsequent pregnancies. You can expect your next monthly period 4 to 6 weeks after the abortion.
16. For how long after the abortion should I refrain from having sexual intercourse?
To prevent infection, you may not have intercourse during the first two weeks after treatment. During this period, you may also not use tampons, go swimming and take a bath. You are allowed to shower.
17. Can I have an IUD inserted after the abortion procedure?
Up to about 15 weeks pregnant, you can have an IUD inserted immediately after the procedure. Please contact us for details of the current charge for inserting an IUD. A number of health insurance policies (partially) cover the cost of the IUD itself and/or (partially) cover the insertion charge. Please contact your insurer to request reimbursement.