Complete abortion manual

page views:1 Publication date:2023-02-27 08:11:07

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For some, prior knowledge can positively reduce anxiety; the more they know, the more confident they feel, and the better they can control their emotions. I happen to be one of those people, so before the surgery, I really wanted to know what would happen, what the doctor would do, and what would be used to ensure the success of the surgery. For others, knowing more might make them more nervous, because it all has to happen to them. If you are one of those people (for example, if you get particularly nervous when you see instruments at the dentist), then I suggest you skip this part and go directly to the second part of the surgery section.
Pregnancy test for miscarriage
"Am I pregnant?" The first sign should be your period. Don't believe the vomiting or fainting scenarios often seen in movies or novels. The most important thing is whether your period is late. If you've recently had active sexual activity and your period is more than a week late, please buy a pregnancy test at a pharmacy. Don't assume it's just irregular periods; the sooner you know you're pregnant, the better.
The most common pregnancy test kit is about the length of a toothbrush and looks a bit like a thermometer. It's called a pregnancy test kit and costs around ten dollars.
These pregnancy tests typically use urine. Remove the cap from the test; inside is a small stick, about the size of a toothpick, which is the urine sampling stick. Urine on the stick, being careful not to urinate on the test window, and do not immerse the stick in any liquid (especially toilet water). Then close the cap.
Lay the pregnancy test flat
There are usually two small holes on the test window, one large and one small. A horizontal line will slowly appear in the smaller round hole; on the one I bought, it's a red line. This only indicates that urine has been collected and the test is in progress. If there is no red line, it means that not enough urine has dripped onto the test stick, the test has failed, and you need to try again. (One pregnancy test can only be used once and cannot be reused.)
The other large round hole may or may not show a blue line. If a blue line appears, it indicates a positive result, meaning you are pregnant; if not, it indicates a negative result, meaning you are not pregnant. Wait three to ten minutes. If nothing appears, it's likely a false alarm. If a blue line does appear, it usually appears very quickly, almost within a minute, simultaneously with the red line. Even a dotted blue line strongly suggests pregnancy.
Urine tests are highly accurate. If you see a blue line, don't assume it's a mistake; 99% of the time it means you are indeed pregnant.
The decision to have an abortion
Finding out you're pregnant for the first time is a very complex experience (of course, planned pregnancies are mainly about joy, but we're talking about accidental pregnancies here). Everyone feels this way. Even though you might be alone, and even though a lot of thoughts might be running through your mind, remember that you're not isolated and helpless, and you're not the only one carrying the biggest secret in the world. Your reaction isn't unusual, so don't scare yourself, and try not to cry.
If you can consider who to discuss pregnancy with, you've already passed the hardest hurdle. Indeed, there are many people you can talk to: your mother, your boyfriend/husband, your best female friend, your family doctor, your online friends… When you talk to these people, you're actually helping yourself decide whether to have an abortion or keep the baby, and this consideration is essential.
Getting emotional won't solve the problem, and the solutions may vary. Whether to have the child or not is indeed a difficult decision, but you must think about it and not run away from it.
If you don't want to tell anyone, you can check the Yellow Pages or find the local abortion helpline online. Their conversations are confidential, and they are quite experienced.
There are several situations in which abortion is more appropriate:
1. You are taking birth control pills, perhaps because you missed one or started them a little late, but you haven't stopped taking them. In this situation, the child conceived may be born with birth defects. Due to residual effects from the medication, a miscarriage is the best option.
2. You are particularly afraid of miscarriage and the pain. Then it's best to have a miscarriage. The pain of childbirth is many times greater than the pain of a miscarriage. In early pregnancy, your uterus and other organs haven't changed shape. In late pregnancy, your spine curves, your heart shifts out of position, your internal organs push upwards, your breasts enlarge, and your entire body has to adjust to accommodate the baby. Labor contractions often last for more than ten hours. Compared to these changes and discomforts, miscarriage is indeed mild. Delaying childbirth until you have no choice but to have a baby in order to avoid a miscarriage is a terrible decision.
3. Your financial situation or your boyfriend is extremely unsupportive. Being a single mother is very difficult; it's not impossible, but it certainly carries a significant responsibility.
4. The so-called alternative of not having an abortion is being born and adopted by someone else. At this time, the child is a living, breathing, fully capable person with their own thoughts (the one in your womb is not yet). If you think you can take responsibility for having such a child and can convince yourself that he/she doesn't need to know the birth mother, then perhaps you will like this alternative. Personally, I would rather know for certain that my child is dead than that he/she is in some place in the world I don't understand, and I don't know if he/she is doing well.
Whatever your decision is, don't worry. First, you have a choice; second, you have carefully considered all other options. We can only choose the best possibility from the less desirable ones. A mother who does this is not derelict in her duty.
Abortion appointment
One thing that might surprise you when you call an abortion clinic is that the date you book your appointment is the same day you'll have your procedure; you only need to go once. Therefore, it's best to research the risks of abortion, the principles of the procedure, and the doctor's experience before you call.
The risks of miscarriage are mainly twofold: physical and psychological.
The main adverse effects of miscarriage on the body include:
Post-hemorrhage bleeding is normal; some people will experience bleeding or blood clots after the surgery, while others may not bleed much. If you experience bleeding requiring four or five sanitary pad changes within an hour, or if you feel continuous dripping of blood, it's hemorrhage and you should call emergency services immediately. Sometimes, a second hemostatic surgery may be necessary.
The uterus is more sensitive after an abortion. If you have a history of vaginitis, gonorrhea, or other infections, you should be especially careful. The main symptoms of an infection are sharp lower abdominal pain, accompanied by fever. Your doctor will usually prescribe antibiotics after the procedure.
Uterine perforation occurs when a doctor uses improper force during examination or surgery, causing the uterus to perforate. If it occurs, major surgery is required for repair, which may lead to future infertility.
If a continued pregnancy is not completely aborted, part of the fetus may remain or migrate to the fallopian tube to continue developing. This is dangerous and can cause severe bleeding in the future.
Complications with anesthesia: If you know you are allergic to narcotics, or if there is a family history of narcotics allergies, be careful. This can be fatal.
These adverse consequences seem terrifying. I know my first reaction upon seeing these potential outcomes was to refuse the procedure. But think about it: heavy bleeding, infections, and complications from anesthesia aren't unique to abortion; childbirth carries the same risks. Furthermore, it's crucial to look at the statistics to see the probability of these events occurring.
In Canada, only one in a thousand legal abortion procedures result in severe bleeding, diarrhea, uterine perforation, or incomplete abortion. Approximately seven in a thousand women experience pregnancy phobia, or relative sexual apathy. A total of 1.1% of women experience significantly more negative than positive reactions after an abortion.
另外一方面就是精神折磨。如果你去clinic，在必要的身份证检验之后，一般有一张调查表，这张表会问你知道怀孕之后和决定流产时主要的情绪包括什么，９９％的人说悲痛、伤心、失落感，９２％的人感觉压抑、有负罪感、生气，而８９％的人对两性关系表示失望，８１％的人不断地哭，６５％的人闪过自杀的念头。因此，无论你的反应如何剧烈，从统计数据上来说，你最大可能还是落在壳形曲线的中间，也就是说，多数有类似经历的人有与你类似的体会，你不是世界上最不幸的那个。
这里我还得说明一点，也许因为我们从中国来，而中国的特殊国情使得中国女性在流产率上长期为世界第一，也许你知道你的朋友、你的妈妈、你的奶奶都有过流产的经历，甚至是想流而没有流掉。这对中国女人总体而言可能是悲剧性的，而对你个人而言，也许是好事，你不像外国的一些女人一样，还有宗教、家庭，社区等等更大的压力。我在clinic听到最哭笑不得的一句话是︰
“don’t worry. all chinese women are the best patients.”
造成情绪压抑的一些因素是可以workout的。如果你要流产的是头一胎，likeme，我最大的压力是对未来再生育有无影响，而如果你是在怀孕的头三个月（firsttrimester or within 12 weeks）流产，这种几率是很小的。习惯性流产是在多次进行流产手术以后子宫不再能承担胎盘和妊娠的压力而出现的情况，第一次进行流产手术除非出现穿孔，否则不大可能就丧失生育能力。
在了解了手术大概的风险之后，也许你对流产的决定有了新的变化。如果你最终决定打电话预约，那么，现在就要看一看当地的abortion clinic的情况，选择一个比较有经验的医师。
在选择医师和决定流产的时候有一个重要的因素，就是你已经怀孕几个星期了。自己推测的方法是距离上次正常月经的时间还要加上两个星期，如果在十二个星期以内，也就是我前面提到的first trimester，那么需要担心的要少一些，因为这时婴儿只有三英吋长，大概和两个quarter差不多重，没有性别，没有人的五种知觉，没有痛感，但是隐约可见手和小脚，有眼睛，尾巴基本消失。在此之前的手术是相对更安全的，无需对子宫作人为扩张。
如果在十二到二十个星期以内，你可能需要子宫扩张以确保手术的安全，这时对医师的要求要更高，你可以询问医师的经验。超过二十周的流产相当危险，几乎没有医院可以做。也许只有等婴儿长大一些做催生，那就相当于一次完整的生产了。
在预约的时候还可以问关于出血和感泄的防治，即使接电话的只是一般护理者，可能连护士执照都没有，但是如果她回答得耐心、详细，值得信赖，那么整个clinic的气氛相对比较体贴，也说明经验比较久。虽然在医院里也可以做流产手术，但是如果到专门的abortion clinic，还会有安抚医师，让你在手术前进入比较放松的情绪状态，一般护理都只针对流产者，比较专业。
最后，如果你对男医师做流产手术自然地感觉紧张，可以找从护理到手术都是女性的clinic.
abortion clinic的地址和电话在黄页分类的第一类，或者，可以在yahoo!上找，如果你在多伦多，大多地区只有五个abortion clinic.
the morgentaler clinic可能是最有名的，因为曾经有激进的反堕胎组织袭击过这个诊所，以dr. morgentaler为起诉人的官司一直打到最高法院，最后判定他胜诉，彻底将流产从犯罪法中解除出来。
另外一个women’s care clinic，从医师到护理都是女性，而且预约迅速，通常可以约到一星期以内的手术日，这对接近十二个星期孕期的流产者很有用，但是有一些费用，其他诊所都是完全免费的。
（下）
人工流产手术最常见的作法是这样的︰
如果你怀孕超过十二个星期或者在超声波（ultrasound）检查时发现胎儿比较大，大过三英吋，前面提到，为了保证手术的安全，更重要的，为了减少对子宫的伤害，不影响以后的生育，你需要扩张子宫。
子宫扩张是先用一些很类似牙签的小棒塞进子宫中，与牙签不同，而这些小棒并不尖锐，是干海草（dried seaweed）做成的。干海草有很强的吸附力，在子宫中它们会涨大，这样子宫的容积会增加，子宫壁相对变薄，这些都是你的身体可以容纳的，因为到怀孕的后期子宫自然扩张程度要远远大于此时的膨胀。小棒（it’s called laminaria tent）放进去几个小时以后，正式的手术才开始。
正式手术时，护士会通过你手背上的血管注入麻醉剂，这只是局部麻醉。不过前面我们提到手术的一项风险就是对麻醉剂过敏引起急性反应，所以你可能有必要向父母询问，你是否绝对对麻醉剂免疫。
然后医师慢慢地轻轻地把海草棒取出，并且此时子宫和阴道都比较张大，适合手术。
然后医师慢慢伸进一个小管，这个小管和一种吸出器（aspirator machine）联在一起，很类似于牙医清除唾液的装置，当吸出器打开的时候，医师在很短的时间内完全吸收子宫内的胎儿，因为预先用超声波看过胎儿的位置，吸收应该是非常准确干净的。
最后医师用一种圆形的小器具（called curette）轻轻地刮过子宫壁，以保证没有残留的胎盘或胎儿，防止出现不完全流产。
虽然多数的介绍上说流产手术不会超过十分钟，这是非常保险的说法。实际上，有经验的医师做上述动作不会超过三到四分钟，甚至更短。在吸出和刮宫的时候都没有很多感觉，（但是有知觉，部份原因是因为麻醉剂的作用），而阴道扩张的开始可能是最不舒服的。
手术结束后你会到一个休息室里放松，背枕起半躺的姿势休息，另外一个医师询问你感觉如何，是否有大出血的迹像，如果没有，医师会给你开药，讲术后的注意事项。
前面有人提到在怀孕早期可以用药物流产，也是中国比较多见的“早早孕”早期流产药，叫ｒｕ４８６，这里顺便也说一下。
ｒｕ４８６可以在怀孕的早期，也就是怀孕七个星期，最多九个星期的时候终止妊娠。对前七个星期，有效率可以达到９５．５％，对前九个星期，综合可以达到８８％，现在在中国，法国，瑞士和英国都是合法的。在美国刚刚完成药检，没有拿到商用执照，在加拿大正在争论是否进行ｒｕ４８６的药检，所以在美国和加拿大的药店里还没有出售。
注意，ｒｕ４８６不是自己吃了就可以完成流产的，它也会有副作用，必须有其他的配合治疗，必须有医生的同意，所以不要考虑到中国托人买了回来自己流产，千万不要！要么就回国去看医生，更多的关于ｒｕ４８６的信息可以查这个网站︰
http︰//www２.cbctrust.com/cbctrust/ru４８６.９６.html
以上都是人工流产手术的原理部份，如果你决定流产的话，这些还不是最重要的，最重要的是我下面要提到的，自己调节你的情绪，配合医师，保证手术的成功。
如果你决定流产的话，一定要记住，做人工流产不是世界上最恐怖的事情，比这更惨的是，一次手术不成功或手术出现大的失误。所以，你的所有恐惧、悲伤、负罪感都要转化成让手术成功的愿望，在不大有利的条件下为你自己和你的下一个孩子创造最好的条件。如果任由情绪控制理智的话，可能会留下更大的终身遗憾。下面我要讲到的是在手术的当天可能会引起你心理紧张的一些细节和对策，希望可以有所帮助。
首先，你要牢牢记住，你在手术中是很关键的。而你最关键的配合动作，就是不要有任何特殊的动作。也就是说，你在手术台上一定不要移动，不要收紧阴道，绝对不要做任何突然的上抬翻转，这样手术才可能进行得顺利和迅速。
当然，任何人都会紧张，而紧张的时候，人的本能反应就是退缩和夹紧，这是自然的保护性的反应，可是在手术中，就是这些反应是真正会伤害你的，一定要控制你的情绪，强迫自己放松，从肌肉到神经都尽量放松，坚持过这三到四分钟。
实际上，从走进诊所开始，已经有很多周到的考虑希望你可以渐渐进入放松的状态。
到手术日的时候，建议你带一本平时比较喜欢看的书，以便在等待的时候阅读。一般诊所里有轻音乐，你也可以闭上眼睛欣赏。不要想性或者关于孩子的事情。如果有人陪你同去是最好的。
在手术之前一般会有一个安抚医师（consulor）告诉你关于流产的知识，多数不会比我已经写的更详细。但是如果你有什么特别的要求，可以向她提出来，比如你觉得自己紧张的话，可以要一些辅助药物，一种口服，一种含服的，都是起放松神经作用。你特别的担心，比如以前曾经有过感泄，有对某种药物过敏的历史，希望将来可以生育等等，都可以向安抚医师提出。
此外，安抚医师也许会给你看一种器具，是手术开始扩张阴道用的，外表有点像夹胡桃的坚果钳加上一个突出的鸭嘴型工具，这个东西看起来比较恐怖，但是只有鸭嘴型小片会真正深入到阴道中。“鸭嘴”张开的时候直径不会比稍大一点的阴茎更大，这是用来辅助阴道的扩张，你可以摸一摸，消除一些恐惧。
而在真正开始手术的时候，这个工具是凉的，不要忘了，所以你最可能在它刚刚接触你的下体的时候移动。而移动是医师最不愿看见的。因为你紧张，她就会比你更紧张，她不知道你会怎么动，而她的手里有器具，她要承担医疗风险。所以，记住︰在手术刚开始，可能会凉一下，然后阴道不自觉扩张。
和性交不同，性交因为有刺激作用，扩张是不自觉的，而且感觉比较热，而此时是有点想收缩，那么，一定要记住不要自然收缩，不要移动，这其实就是最困难的一关了。只要扩张时你没有突然动作，余下的吸取和刮宫反而都比较容易适应。
安抚医师还会测血压，在指尖取你的血样作血型测试，这些都是为了防止可能的大出血急救。不用紧张。
在更衣的时候，多数流产诊所允许你穿自带的睡衣或长t-shirt，你可以准备最家常的，一定要穿袜子，可以不穿鞋行走。
如果你有近视，不要带眼镜或隐性眼镜进入手术室，这些都让你的神经有进入睡眠的错觉，有助于放松自己。
手术床是一般的单人床大小，唯一特别的是有两个马镫（stirrup）一样的翘脚垫，你需要把脚或膝盖放上去，这样下体会自然张开。如果你以前作过例行的妇科检查，也许对这个姿势比较熟悉，如果没有，你可以在家里自己练习一下，双腿曲起，自然张开成略大于九十度的钝角，盆骨尽量下压，深吸气，然后保持这个姿势大约五分钟不要动。这样在真正手术的时候就容易适应一些。
然后护士会在你的肚子上涂一些凉的药膏，这是为了进行超声波检测，可以准确定位胎儿，即使你可以看见屏幕，相信我，你根本看不出那是胎儿。我在手术前看过一些资料，对几个星期应该是多大的胎儿图片都记忆深刻，就是这样，我也无法把屏幕上的白影和胎儿对应起来，看不出哪边是头，总之，也许不看更好，不过，对我来说，那是唯一一次看见这个婴儿的机会，所以我还是看了。
然后护士会给你注射麻醉剂，可能还会给你乙醚气罩，就是急救室里经常看见罩在鼻子上的一个塑料罩，然后有乙醚气喷出，这也是帮你放松的。有这个罩子的好处是你可以说话或者唱歌，出声音也可以。不要笑，我一直在唱歌，而且我觉得唱歌很有效，建议你也想几支歌唱一唱，当然不要唱情歌之类的，我唱的是《少年先锋队队歌》，所以我也知道全部手术时间跟大致唱完一支队歌差不多长，也就是三分钟左右。
阴道首先感觉的是医师的手，因为她要检查一下你的阴道的松紧度，然后，前面讲到，会稍微凉一下，不要动；然后你基本上只能感觉有什么东西在里面，但是不痛，有些不大自然，还是不要动，眼睛可以看悬挂的图片，可以闭上专心唱歌，不要想什么其他的，然后，手术就结束了。
从手术床上下来的时候还有一个细节，就是从床的侧面下，不要从前面，因为从前面你可能会不经意瞥见吸出器或者里面的内容。believe me, you just don’twanna see it.
然后你可能感觉头晕眼花，这是那些药物的作用。有的人会有呕吐反应，这些都是药物的问题，不说明手术不成功。
当你在手术室里休息的时候，护士会给你盖毯子，从这时起，要注意腰部的保暖。从你的情绪理智慢慢开始恢复的时候，你可能会感到莫大的轻松，许多天来萦绕的问题像一块大石头，现在拿掉了。
这种轻松感是流产手术后最大的正反应，超过８５％的人认为这让她们感觉做了一个正确的决定，使她们可以moveon。记住这种正反应，因为下一篇，我会提到术后的调养和术后常见的负反应，希望你也可以顺利度过这一劫。
流产之术后
手术后你至少应该拿到四钟口服药。
一是tylenol，这是止痛药。手术之后你可能会感觉痉挛性疼痛，和痛经的感觉非常想像，如果比较厉害的话，服这种药；
二是antibiotics（抗生素），这是防止感泄的，前面提到过；
三是gravol，这是因为术后某些人会有呕吐现象，如果感觉心，头晕，可以服这种药，这种药不需医生处方，也很便宜，建议你也买了备用；
四是birthcontrolpills（避孕药），术后很快就应该服，因为这主要是调节荷尔蒙，刺激卵巢，促进卵巢持续排卵，这样大约一个月的时间你可以恢复正常的月经。但是要注意，因为避孕药是和抗生素同时服用，避孕药的避孕作用会被抵销，所以术后至少两个星期不可性交。在诊所你可能会听说有人术后马上又怀孕的，真是不走运，或者她性要求也太多了点儿。
术后你不能开车，前面忘了提醒一下，手术的当天要安排出租或别人送你回家。
中医认为“小产”，无论是人工的还是自然流产，都有伤气，失血的症状，表现为腰痛，不可劳累，身体虚弱。所以中医的补养都以补血补气为主，也就是饮食上要多吃枣补血，喝鸡汤、蜂王精、鸡精都可以服用，不要吃过多生冷的食品，房间注意不要持续通风，注意保暖，否则可能留下慢性腰痛，风湿等毛病。
在术后的精神调养也非常重要。长期以来，我们以为身体好就是身体没有毛病，实际上很多疾病还包括对精神的刺激，也应该当认真调整防治。人工流产后最常见的精神负反应叫flash back，也称回想，就是由于场景或者特别的语言刺激而强烈地回忆起怀孕时候的往事，比较严重的会发生角色错位，有的人会恍忽中认为已经有一个孩子了而举止都很像母亲，比如抱着枕头当婴儿、晚上会出现幻听、认为有婴儿的啼哭声，这些精神创伤可能会是终身的。如果你知道你的母亲辈女人有过流产的经历，可能曾经听过她感叹道︰“当年如果……现在都这么大了。”这就是典型的回想。尤其是流产后因为种种原因不孕的女人容易深刻地被回想伤害。
另外一种错位是误以为自己就是那个孩子，有的人会在梦中感觉被莫名地杀死、逃跑，但是最亲近的人成为最恐怖的人等等，出现角色错位的时候，家人、伴侣的抚慰是最重要的，许多反应持续到你有下一个健康的婴儿的时候会基本痊愈。另外如果你感觉非常压抑，经常有错位或回想的话，应该考虑看心理医生。
The last common negative reaction after an abortion is decreased libido. This is due to lingering fear of pregnancy caused by the psychological stress before and after the abortion, or strong psychological resistance during the procedure. The pain of losing a child may lead her to see sexual activity or her partner as the culprit, or as an object of her venting, resulting in a complete lack of sexual interest. At this time, the male partner must not force her, otherwise she may become permanently sexually apathetic and may not recover. With considerate care, patient waiting, and shared responsibility during the period of emotional fluctuation, the woman's sexual desire will usually gradually recover after one to six months, and may even be stronger, because her subconscious desire to reproduce may be stronger than before.
Although I expressed my hope in the preface that this article would not be reprinted, it now appears to have circulated outside this forum. Therefore, I feel it's necessary to clarify that this article discusses five aspects: pregnancy testing, decision-making, scheduling, surgery, and post-operative care. These five aspects are all crucial for pregnant women, not just the few minutes of surgery. If you truly care about your child and your partner, please compile the entire article and repost it or print it out for her reference.
Furthermore, if you are a man and discover your partner is pregnant, please do not force her to make any decisions she does not want to make. You do not have that right, otherwise she may suffer lifelong psychological trauma. Abortion is a woman's decision, and until a substitute for the uterus is invented, please respect that.
Finally, to help you communicate with doctors abroad or call abortion hotlines, here are some commonly used English terms and translations. Those already mentioned in the article will not be repeated.
Fetus before seven weeks of gestation, placenta, early fetus
Fetus is a fetus that is seven weeks old. The main difference between fetus and embryo is that the former is still a fertilized egg, while the latter has already developed into a human-shaped fetus.
cramps are abdominal spasms, especially used to describe the cramping pains of menstrual cramps.
clot blood clots
conception pregnancy
ovary
uterus
Cervix cervix
vagina
sexual dysfunction (sexual frigidity)
hallucination
diagnose, detect
Contraceptive pills, contraceptive methods
mortality rate
suction
scraper
dilation (expansion, expansion)
Saline solution is used to induce labor in cases of miscarriage after 20 weeks of gestation.
laceration cut
hormonal hormones
(End of article)

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