Abortion Surgery FAQ

Contributed by Dr Ben Choey, Obstetrics & Gynaecology

W GYNAE Women’s Clinic

Block 721 Ang Mo Kio Avenue 8 #01-2807 Singapore 560721

Tel: (65) 6455 0050
Fax: 6455 2308
Email: w.gynae@gmail.com

Under the Termination of Pregnancy Act in Singapore,an abortion procedure can only be carried out by an authorized gynaecologist in an approved healthcare institution.

Am I eligible to undergo abortion procedures?

Abortion surgery can only be performed on any pregnant woman who is:

  1. She is a citizen/permanent resident of Singapore, or the wife of a citizen/permanent resident of Singapore.
  2. She is a holder of a work pass issued by the Employment of Foreign Manpower Act, or the wife of a work pass holder.
  3. She has been residing in Singapore for at least 4 months
  4. The abortion is immediately necessary to save her life.

According to the Singapore Abortion Act law:

  • There is no defined minimum or maximum age limit for abortion.
  • Parental consent is not a legal requirement for minors above 14 years old.
  • Abortion is prohibited after 24 weeks (6 months) of pregnancy unless the woman’s life is in danger.

The duration of pregnancy is determined from the first day of the woman’s last menstrual cycle.

Under the Termination of Pregnancy Act, abortions are illegal for foreigners who hold a social or tourist pass. Foreigners are only eligible for a Singapore abortion if one of the following conditions are met:

  • They have been residing in Singapore for 4 consecutive months or more.
  • They are married to a Singaporean citizen or have Permanent Resident (PR) status.
  • They hold a work pass or are married to a holder of a work pass.
  • The abortion is immediately necessary to save the life of the pregnant woman.

These restrictions do not apply in the event of a miscarriage where immediate uterus evacuation is required.

Any woman seeking an abortion, regardless of age, parity, marital status and nationality, has to undergo a mandatory pre-abortion counseling with a certified abortion counselor at any accredited abortion clinic at least 48 hours before the procedure. The brief counseling also involves watching a video on how an abortion is performed and its impact.

Unmarried minors under 16 years old are required to have the pre-abortion counselling at the Health Promotion Board Counselling Centre, after which they are issued a Certificate of Attendance (COA). Without the COA, the abortion procedure cannot be legally carried out.

At least 48 hours must lapse after the pre-abortion counselling before the pregnant woman can give her written consent to treatment. This cooling period allows time for the woman to make the final decision on whether to terminate or continue with the pregnancy.

No parental consent is required for a Singapore abortion, even if the patient is less than 16 years old (but above 14 years old). However, she must be above 16 years old before the abortion can be performed with her consent alone.

As mentioned above, unmarried minors will need to attend a pre-abortion counselling at the Health Promotion Board and obtain a Certificate of Attendance before any abortion procedure can take place. This entire process is strictly confidential and no one will be informed, including the parents of the minor.

For girls under 14 years old, there is no medical confidentiality to protect them from being reported to the police and their parents, as it is considered statutory rape for any man to have sexual intercourse with a girl below 14 years of age.

Depending on the duration of the pregnancy, there are two main ways by which a Singapore abortion is performed:

a) Vacuum aspiration (up to 14 weeks)

After a 6-hour fasting period, the patient is placed under general anesthesia. A speculum is inserted into her vagina and dilators are used to relax the cervix. A small tube is then placed through the cervix and into the uterus. Using a handheld suction device, the doctor gently empties out the contents of the womb. The abortion procedure is relatively painless and takes about 10 minutes. The patient will be monitored closely for an hour post-operation and should be able to return home within 3 hours.

Mid-trimester termination of pregnancy (MTMP) (14 to 23 weeks)

MTPT is a more complicated procedure that often involves hospitalization for 1 to 2 days. Dilators and medicines are inserted into the vagina at regular intervals to induce expulsion of the pregnancy. Once the fetus and placenta are expelled, a combination of vacuum aspiration and curettage is performed to ensure complete evacuation of the womb.

A follow-up visit with the Singapore abortion surgeon is usually scheduled 2 weeks after the procedure.

As a medical procedure, any abortion procedure carries risks, with the chances of complications increasing the more advanced the pregnancy. Potential complications include:

Excessive Bleeding

Light bleeding for a few days after an abortion is normal, and menstruation usually returns in 4 to 5 weeks. However, heavy and persistent bleeding (enough to soak through a couple of sanitary pads within an hour) is a cause for concern and may indicate incomplete womb evacuation. It is therefore important to see the gynaecologist for a follow-up visit 1-2 weeks after an abortion surgery for an examination.

Incomplete evacuation of womb

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, under the skillful hands of a Singapore abortion surgeon, the chance of this occurring is very slim.

Pain

Most women experience cramping immediately after an abortion as the uterus contracts to expel its contents. Such pain is manageable with over-the-counter pain relievers and subsides within a few days. If pain persists and cramping worsens, it may be a sign of incomplete womb evacuation and a trip to the Singapore abortion surgeon is required.

Pelvic infection

During the abortion procedure, the reproductive organs are exposed to an environment and medical instruments that may cause bacteria to enter and infect the womb. Infections also arise from an incomplete womb evacuation, necessitating a repeat abortion surgery. Symptoms of infection include a foul-smelling vaginal discharge, fever and lower abdominal pains. Sexual intercourse should also be avoided at least a week after the abortion procedure.

Injury to the womb

Insertion of surgical instruments during an abortion procedure may puncture a hole in the wall of the uterus, especially if the cervix was not prepared sufficiently or if the uterus is in an abnormal position. There may be a need for a keyhole procedure to have a look internally to assess for injury. This complication, however, is uncommon.

Continuation of the pregnancy

Occurring in less than 1 in 100 abortions, symptoms of pregnancy such as nausea, bloating and breast tenderness may continue to manifest after an abortion. If symptoms persist, they may indicate a continuing pregnancy and require a repeat abortion procedure.

The entire process of consultation and abortion is kept strictly confidential to protect the privacy of the patient. As such, no third parties, including the patient’s parents, employers and company, will know about her abortion. No medical information will be released without her prior approval and consent.

As medical professionals are legally obliged to keep abortion procedures confidential, any unsolicited disclosure of information will result in a penalty of SG$2,000 and/or up to 12 months imprisonment.

The cost depends on the duration of pregnancy and complexity of the abortion procedure.

An uncomplicated, first-trimester termination is estimated to cost SG$1,500 onwards. This fee is inclusive of consultations, medications, sedation, the actual abortion, and the first follow-up visit and ultrasound.

The procedure will be performed at W GYNAE Women’s Clinic (day surgery facility) by Dr Ben Choey. Patients should be able to go home after approximately 1 to 2 hours of observation post-procedure.

Mid-trimester termination

(14-24 weeks) will cost more as it involves a more prolonged and complicated process in hospital (estimate amount of $3500 - $4500).

Medisave

Singaporeans / PRs / Spouses of Citizens and PRs may use Medisave of between $900 – 1050 to pay for the cost of procedure.

Payment mode

Payment may be made by NETS / CREDIT CARD / CASH

Arrangements for Abortion Procedure

You will first consult our doctor 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 doctor 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.

  1. Consult gynaecologist Dr Ben Choey at W GYNAE Women's Clinic
  2. An ultrasound will be performed to determine the gestational age of your pregnancy
  3. Pre-abortion counselling will be conducted in W GYNAE Women's Clinic
  4. The procedure can only be performed at least 48 hours after counselling

Tel: (65) 6455 0050 (W GYNAE Women’s Clinic)

Email: w.gynae@gmail.com