The first line of defense against unplanned pregnancy is contraception, but in case of failed contraception, termination of pregnancy is one of the remedial options. Since 1979, the Family Planning Association of Hong Kong (FPAHK) has been providing surgical termination of pregnancy in accordance with the Hong Kong abortion law. Last November, FPAHK introduced the first “Medical Termination of Early Pregnancy” service in Hong Kong to provide another safe and effective choice for women with unwanted pregnancy.
Dr Sue Lo, FPAHK’s Senior Doctor, said, “Numerous research studies around the world have shown that medical termination of early pregnancy is safe and effective, and the drug has been registered in over 45 countries or localities. In Hong Kong, since 1987, FPAHK has been recruiting suitable subjects for various research studies on medical termination of pregnancy conducted by the Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, University of Hong Kong (HKU). During the renovation of our Operation Theatre in 2010, FPAHK collaborated with HKU on a clinical study on medical termination of early pregnancy at our own premises. The satisfactory outcome led to the official launch of this service last year.”
Dr Lo shared the results of the first 100 cases performed: the complete abortion rate was 96.8%. No serious side effects were noted. Only five women experienced mild drug allergy and one suffered from abdominal pain, all were subsequently well. The advantages of medical abortion include avoidance of anesthesia and surgery, the process feels more natural as it resembles a menstrual period, it offers more privacy and greater control over one’s own body. The drawbacks are that it involves more clinical visits and the process takes longer to complete, around 2 to 3 weeks on average.
Not all women are suitable for medical termination of pregnancy, for example, those whose gestation is more than 9 weeks, have suspected ectopic pregnancy or multiple pregnancy, are allergic to the drugs, smoke heavily, are breastfeeding, or have certain health conditions or chronic illnesses, etc. Therefore doctor’s examination and assessment are essential. Even for those suitable for medical abortion, monitoring and follow-up by healthcare professionals are needed to ensure effectiveness and safety. Commonly reported side effects are vaginal bleeding, abdominal pain, nausea, vomiting, diarrhea and drug allergy, etc. Reports of fatal adverse reactions such as severe bleeding and septicemia are rare.
FPAHK’s aim in providing termination of pregnancy service is not only to help women deal with the current unwanted pregnancy, but more importantly to enable them to avoid future recurrence by emphasizing the importance of informed choice, counseling and education. According to Ms Maggie Lau, FPAHK’s Clinic Manager, women seeking abortion are required to undergo counseling which: (i) reviews the reasons for contraceptive failure and offers contraceptive advice; (ii) explains her other choices such as giving birth to the child and raising it herself or giving it up for adoption; (iii) relieves emotional stress.
If a woman decides to abort, two doctors must affirm that legal requirements are fulfilled and that she is suitable for the procedure. She must be informed about the procedures for medical and surgical abortion, their advantages and disadvantages, side effects, risks and measures in case of emergencies, so that she can freely choose whether or not to have an abortion and which method to use, and agree to comply with all necessary procedures. At the post-abortion follow-up, the woman is assisted to choose a regular contraceptive method which suits her needs and instructed on its use so as to prevent repeated unplanned pregnancy.