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Abortion

Abortion: different types of abortion, where and how can you get help

Abortion is a process in which a pregnancy is terminated before the full 22 weeks. This happens either by the body itself, or by the pregnant woman choosing to terminate the pregnancy.

In this article you can read more about the abortion law in Norway, the difference between spontaneous and provoked abortion, where you apply and how an abortion takes place, and how we can help you in the situation you are in.

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The Abortion Act in Norway - how does it work?

In Norway, women have the right to self-determined abortion by the end of the 18th week of pregnancy (17 weeks and 6 days), unless there are strong medical reasons against it. If the woman wants an abortion, she must be given thorough information about how this is done and what risks it entails.

After week 18 of pregnancy, one must apply to a tribunal for approval for abortion, and according to the law, a provoked abortion can only be performed after week 18 if:

  • The pregnancy, birth or care of the child can lead to unreasonable strain on the woman's physical or mental health
  • If it puts the woman in a difficult life situation
  • There is a high risk of serious illness in the child (as a result of hereditary disease or harmful influences during pregnancy)
  • If the woman became pregnant under conditions mentioned in the Penal Code (eg abuse)
  • If the woman is severely mentally ill or significantly mentally retarded.

Miscarriage

A miscarriage is when the body itself rejects the fetus before the full 22 weeks (if the baby comes out after week 22 it is referred to as birth, and then either stillbirth if the child can not be saved or live birth if it survives). Early in pregnancy, this usually happens because there is something seriously wrong with the fetus, and it would not have developed into a viable child. Later in pregnancy, it is more often due to defects in the placenta, infections or serious illness in the mother.

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Provoked abortion

A provoked abortion is when you do not want to keep the baby, and you terminate the pregnancy either medically (using tablets) or surgically (using scraping from the uterus). Whether it will be a medical or surgical abortion is determined by how far in the pregnancy you have come. This is assessed by the gynecologists at the hospital.

The length is calculated from the first day of the last menstrual period, ie the last time you had your period and not the time of intercourse. If you are unsure when the first day of the last menstrual period was, the length of pregnancy can also be estimated from ultrasound and the size of the fetus. An abortion can be performed at the earliest in week 6 of the pregnancy.

If more than 18 weeks have passed, you must apply via a tribunal. The abortion committee consists of two doctors, a man and a woman, one of whom must be employed at the ward where the abortion may take place and the other doctor has been appointed the county doctor.

Missed period - what do I do now?

If you have not had your period by the time you usually do, it is a good idea to take a pregnancy test. You can either buy home tests at the pharmacy, or have a test taken by a doctor. Both are equally safe, and detect pregnancy just as early.

At the pharmacy, there are several types to choose from. There is a package with 8 test strips, which costs around NOK 200. This test can be taken from the day you expect menstruation, where you have to collect urine in a container. With other types of tests you can pee straight on the stick, also these are most safe from the day you expect menstruation, but some can be taken 5-6 days before the expected menstruation. If it is then negative and you still have a strong suspicion of pregnancy, it is a good idea to test once more a week later.

Abortion - where to go and how does it work?

If you have tested positive (you are pregnant), but you do not want to keep the child, you have the right in Norway to self-determined abortion until the end of the 17th week of pregnancy. If you are over 16 years of age, you can call the optional hospital directly to arrange an appointment for an abortion without a referral from a doctor or health nurse. Abortion is free to perform in a hospital and there are also free public services for guidance if you are unsure. Amathea.no is a free service for you who are unsure of your pregnancy.

Once you have contacted the hospital, you will receive an appointment for a consultation. Here you get thorough information about how a provoked abortion is performed, as well as an ultrasound that determines how far the pregnancy has come. If it is less than 9 weeks, most people are offered a medical abortion. This takes place either at home or in a hospital, where most people choose to do it at home.

Medical abortion
You first get a pill, and then another pill 1-3 days later. These pills work so that they initiate a "birth" where the uterus repels the fetus. Most people will abort within 4-6 hours after pill number two. This causes pain, and most people find the paracetamol together with an ibux-like preparation relieves well. It is common with a little subsequent pain and about two days with heavy bleeding after the abortion.

Surgical abortion
If a surgical abortion is decided, it takes place in the hospital, usually in a light anesthesia, where the gynecologist uses a vacuum suction to empty the uterine cavity. If the pregnancy has lasted longer than 17 weeks, an abortion can only be performed when it has been approved by the tribunal. This is then a medical abortion performed at the hospital.

Complications
Complications after an abortion are rare, and in most cases these are due to an incomplete emptying of the uterus. The woman will then experience persistent heavy bleeding and sometimes pain. It is then important to contact the hospital again as soon as possible.

The chance of getting pregnant after an abortion
An abortion does not reduce the chance of getting pregnant again at a later date, but some studies have shown a slightly increased risk of premature birth in a later pregnancy.

Sick leave
After an abortion performed in 1 trimester, you usually need 3 days of sick leave after the abortion. In 2 trimesters, the need for sick leave is assessed individually.

Abortion
When can you have an abortion?

An abortion can be performed at the earliest in week 6, and no later than in week 12 of pregnancy. After week 12, you must apply for an abortion.

Do I have to go to my GP for help with an abortion?

If you are under 12 weeks on the road, you can call your local hospital and get help for an abortion there. If you are 12 weeks or more, you must go to the GP to get help to apply to the abortion board for approval of an abortion. Many people also think it's nice to have a chat with their GP before they decide on an abortion or not. If you are under 16 years of age, you must see your GP first.

Will an abortion make it harder to get pregnant later?

No, an abortion does not reduce the chance of getting pregnant later.

Is medical and surgical abortion equally safe?

Both methods are safe, but with medical abortion, there is less risk of infection and complications that can damage the uterus during a surgical abortion.

I just had an abortion and I'm having a hard time, where can I get help?

Unfortunately, there are not many support groups after an abortion (neither miscarriage nor provoked abortion). The GP can be a good person to contact for a chat and guidance. The municipality may have low-threshold services that you can take advantage of. These vary slightly from municipality to municipality, so it would be best to go to the website of the municipality where you live, and see what they have to offer in terms of support.

Sources

Norsk elektronisk legehåndbok, (2020), Provosert abort, (online), tilgjengelig fra: https://legehandboka.no/handboken/kliniske-kapitler/gynekologi/tilstander-og-sykdommer/abort/abort-provosert/, hentet: 12.06.2020

Lovdata, (2020), Lov om svangerskapsavbrudd, (online), tilgjengelig fra: https://lovdata.no/dokument/NL/lov/1975-06-13-50, hentet: 23.06.2020