Abortion in Singapore
Contributed by Dr Ben Choey, Obstetrics & Gynaecology
W GYNAE Women’s Clinic
Block 721 Ang Mo Kio Avenue 8 #01-2807 Singapore 560721
Under the Termination of Pregnancy Act in Singapore, abortion can only be carried out by an authorized gynaecologist in an approved institution.
Termination of pregnancy can only be performed on any pregnant woman who is:
- A citizen / permanent resident of Singapore or the wife of a citizen / permanent resident of Singapore;
- A holder or the wife of a holder of a work pass issued under the Employment of Foreign Manpower Act (Cap. 91A);
- A person who has been resident in Singapore for at least 4 months from the date of termination of pregnancy.
It may also be performed if it is immediately necessary to save the life of the pregnant woman.
According to the Singapore Abortion Act law:
- There is no defined age limit for the abortion procedure
- There is no legal requirement for parental consent for minors
- Abortion is prohibited after 24 weeks (6 months) of pregnancy unless the mother’s life is in danger.
It is against the Termination of Pregnancy Act to perform abortions for foreigners who come into Singapore on a social or tourist pass. Abortion can only be performed for foreigners who have stayed in Singapore for more than 4 months consecutively.
It is mandatory by law to provide pre-abortion counselling for a pregnant woman, regardless of parity, marital status and nationality.
Counselling will be done by a certified abortion counsellor at least 48 hours before the scheduled date of procedure.
At least 48 hours must lapse after pre-abortion counselling before the pregnant woman can give her written consent to treatment.
No parental consent is required, even if the patient is less than 16 years of age (but above 14 years old). However, a patient must be above 16 years of age before an abortion can be performed with her consent alone.
For girls less than 16 years of age, it is mandatory to undergo counselling at the Health Promotion Board Counselling Centre and obtain a Certificate of Attendance before abortion can be carried out. This entire process is strictly confidential and no one will be informed, including parents of the patient.
For girls less than 14 years of age, there is no medical confidentiality to protect them from being reported to the police and to parents, as it is an offence for any male to have sexual intercourse with a girl under 14 years of age (statutory rape).
Generally there are 2 main types of abortion procedure:
a) Vacuum aspiration (up to 14 weeks)
The patient needs to fast for 6 hours. Procedure is usually performed under sedation in day surgery facility at TMC. A small tube is then placed into the womb via the vagina, to remove the pregnancy. The process takes about 10 minutes and it is painless. The patient will be monitored closely for an hour post abortion surgery and should be able to return home within 3 hours.
b) Mid-Trimester Termination of Pregnancy (MTPT) (14-23+6 weeks)
MTPT is a more complicated process and involves hospitalization for a day or two. Medicine is inserted into the vagina at regular intervals to induce expulsion of the pregnancy. The womb is then cleaned by vacuum aspiration and curettage after the foetus and placenta are aborted. As this process is more complicated and costly, early decision is important.
It is normal to expect light bleeding for a few days after an abortion, and normal menses will usually return in 4-5 weeks. However, prolonged and heavy bleeding may occur if the womb has not been emptied completely. It is therefore important to see your gynaecologist for a follow up visit 1-2 weeks after an abortion for an examination.
Incomplete evacuation of womb (2%)
Due to anatomical variations of the womb position, it may not be possible to completely evacuate all the pregnancy contents using the vacuum aspiration method. However, this is uncommon under skilled hands.
It is very common to experience menstrual cramp like pain immediately after the abortion procedure as the womb contracts. It is usually manageable with painkillers and pain usually resolves in a day or so. However, if pain persists beyond a few days, it is important to have a check by your gynaecologist.
Infection can occur if bacteria travel up into the womb during the abortion procedure, or if the womb has not been emptied properly. Infection can present as unpleasant vaginal discharge, fever and lower abdominal pains. If some tissue remains inside the uterus, it may be necessary to have an abortion procedure to remove the contents in the womb.
It is advisable to avoid sexual intercourse for about 1 week after an abortion procedure.
Injury to the womb (1%)
During a surgical termination, insertion of instruments may risk puncturing a hole in the wall of the womb. The risk is increased if the cervix was not prepared adequately, or if the womb position is abnormal. There may be a need for a key-hole procedure to have a look internally to assess for injury. This complication, however, is uncommon.
The entire process of consultation and abortion is kept strictly confidential, and no third parties will know about your abortion. This includes parents, companies and employers. No medical information will be released without your prior approval and consent.
A first trimester termination procedure (uncomplicated) is estimated to cost $1500 onwards (total fees including consultation, medications, procedure, sedation, first follow up visit and ultrasound) depending on the gestational age and complexity.
The procedure will be performed at W GYNAE Women’s Clinic (day surgery facility) by our Specialist Dr Ben Choey. You should be able to go home after approximately 1-2 hours of observation post procedure.
(14-24 weeks) will cost more as it involves a more prolonged and complicated process in hospital (estimate amount of $3500 - $4500).
Singaporeans / PRs / Spouses of Citizens and PRs may use Medisave of between $900 – 1050 to pay for the cost of procedure.
Payment may be made by NETS / CREDIT CARD / CASH
Arrangements for Procedure
You will first consult our specialist Dr Ben Choey at W GYNAE Women's Clinic.
An ultrasound will be performed to determine the gestational age of your pregnancy.
Pre-abortion counselling will be conducted in W GYNAE Women's Clinic.
The procedure can only be performed at least 48 hours after counselling.
Specific instructions regarding the procedure will also be given to you on the same day. Contraception will be discussed in greater detail at your first visit.
Following the procedure, our specialist will talk to you about contraception at an appropriate time. A review 2 weeks later will be scheduled to ensure there are no complications resulting from the procedure.
Tel: (65) 6455 0050 (W GYNAE Women’s Clinic)