The most appropriate method of termination depends on:
• The stage of the pregnancy
• The woman’s particular circumstances, medical history and preference
• The experience, practice and clinical judgment of the practitioner
• The local availability of resources and infrastructure.
Depending on the individual woman’s clinical circumstances, needs and preferences, preparation for termination of pregnancy may then include:
•Confirmation of pregnancy and gestational assessment by clinical history and examination, pregnancy test and/or ultrasound examination:
- To avoid an unnecessary procedure if a woman is not pregnant or miscarriage has already occurred.
- To check for ectopic pregnancy and
- To ensure selection of most appropriate procedure.
•Some studies report routine ultrasound examination: It may be necessary to assess gestation more precisely if medical abortion is to be offered.
•General history and examination to assess medical risk.
•Blood group and Rhesus status.
- To identify Rhesus-negative women for administration of Anti-D, to prevent Rhesus immunization and its sequelae in later pregnancies.
•Prophylactic antibiotics or testing for genital infection.
•Planning ongoing contraception following termination.
-Consideration may be given to opportunistic and/or follow up health screening and advice, for example cervical cytology, rubella titre and smoking cessation advice.
A follow up appointment should be arranged and strongly encouraged, to include:
• Assessment of physical recovery;
• Discussion of ongoing contraception;
• Consideration of emotional issues and arrangements for further review and counseling as necessary.