Explanation of Surgical Procedure at Southwestern Women’s Options

Determination of Pregnancy and Gestation

Pregnancy Test – Before having this procedure, you should have a positive pregnancy test.

Ultrasound – All patients will have the pregnancy sized by sonogram.

Medical Records

Medical History – You will be asked to complete a medical history form so that we may know of any previous or current illness and/or health problems.

Informed Consent – You must sign your consent to have this procedure performed. It is your right to be informed of any and all possible risks and/or complications knows to be associated with this procedure.

Medical Reports – All lab reports, surgery records, and examination records will be kept in your file. All medical records are strictly confidential and will be released ONLY with your written authorization.

Counseling

You will have an opportunity to talk with one of our counselors. They are available to answer any questions or concerns you have about the procedure. They will also help you with any concerns about birth control, pregnancy, and sexuality that you may have. Each counselor is experienced in helping with feelings of conflict and will be glad to discuss any feelings with you. You are in control of the counseling session. You are under no obligation to discuss anything you do not wish to discuss. We are here to help in any way we can. Only you can know what information, counseling and help you want or need.

Medication – After the counseling session, you will be given prophylactic antibiotics to help guard against infection. You will take this dose before your procedure. Some people experience diarrhea while on antibiotics. If you develop a rash and/or swelling and itching please notify us.

Laboratory Testing

We will test your for Rh factor and anemia. We will also examine the tissue extracted from your uterus for evidence of pregnancy and any abnormality. We will notify you if any irregularity is present.

Procedure – Dilation, Aspiration, and Evacuation

A licensed physician will perform your procedure by dilating your cervix and cleaning the contents of your uterus with a suction tube and/or forceps. This procedure will take from 5 to 30 minutes. In early pregnancy, the uterus is very small and easy to evacuate. As the pregnancy advances, the uterus becomes more enlarged and will take longer to perform the procedure.
The procedure will be done with three different types of medication: (1) Fentanyl (a synthetic form of morphine), (2) Versed (an anti-anxiety medication), and (3) a cervical block. Before the procedure, you will receive an injection of Fentanyl and Versed through an IV catheter. These medications take effect very quickly and help to minimize discomfort. You should feel a calming effect from these medications and may become drowsy. It is our belief that Fentanyl and Versed are the best and safest relaxants for most people; however, if you prefer not to have them, please discuss with your counselor any other options that are available to you.
Your cervix will be anesthetized by a numbing medication. You may experience some discomfort during the procedure, or you may not. It should not be more discomfort than you can tolerate. Some people feel a slight cramp or stinging sensation as the anesthetic is administered on the cervix, though it tends to pass quickly. Some people experience cramping during and/or after the procedure as the uterus contracts. These cramps are similar to strong menstrual cramps or mild labor cramps. They will not last long and we have pain medication available if you need it.

Recovery

After the procedure, you will walk to the recovery room. It is necessary that you are observed in our recovery room for at least 30 minutes. There you may have something to eat and drink while we complete your records, take your vitals, provide you with your after-care instructions, and remove your IV catheter. Our staff will be available to answer any questions and make you as comfortable as possible during this time.

Post-Operative Care

Preventing Infection – Nothing should enter your vagina for at least one week. DO NOT: have intercourse, use tampons, take tub baths, douche, go swimming or insert anything into your vagina for one week. If you think you have a fever, take your temperature and call us if it is 100.4o.
Bleeding – Bleeding typically is light to moderate. It may start and stop for the next two weeks. You may notice some clotting. It should not be heavier than a heavy menstrual period, and usually does not last longer than two weeks. If you continue to bleed heavily after 2 weeks, call us.
Menstrual Cycle – You should begin your next menstrual period in 4-8 weeks after the procedure. If you have not had a normal period after 8 weeks, it is important that you notify us.
If you have any other concerns, please call us. We are available by phone 24 hours a day, 7 days a week. A nurse, counselor, and doctor are on call at all times.

Office Policies

We work by appointment only. This gives us the opportunity to allocate the needed time for each patient. Unfortunately patients do not become ill on schedule, operations do not always run on time, and emergencies do occur; hence, delays are inevitable. But a sincere attempt is made to adhere to the schedule and we request your patience if occasionally you are forced to wait. When possible we will let you know if we are running unduly behind so that you can plan accordingly. Likewise, if you cannot keep an appointment please call and let us know so that we may reschedule your appointment. This will also make that time available for someone else in need.
As a new patient, do not be disturbed to see patients who have arrived after you being called before you.
These are patients who the nurse takes care of under the doctor’s supervision.

If you have any questions, please ask them. If you have suggestions, we encourage you to make them! We are constantly trying to improve our services and communications with our patients. Thank you for selecting us to help with your medical care.