In some cases where an unplanned pregnancy develops, the couple has a need to terminate the pregnancy. Termination of pregnancy is permitted in Israel. It can be carried out in different ways. In what situations is pregnancy permitted in Israel? What are the ways to implement it and will pregnancy be possible in the future?
Unplanned pregnancy results from sexual intercourse without the use of contraception, or because of contraceptive failure. In some situations, although the pregnancy is not planned, the couple chooses to continue it. Conversely, in other cases, an unwanted pregnancy triggers the need for pregnancy termination.
What is pregnancy termination?
Pregnancy termination is defined as a condition in which pregnancy are stopped and the uterus is emptied in various techniques, whether in a drug or surgical form. 22,000-25,000 pregnancies are performed in Israel every year.
In what situations is the termination of pregnancy permitted in Israel?
In Israel, termination of pregnancy is permitted to almost every woman, while meeting medical or social criteria.
According to the Penal Law of 1977 and the Penal Code (Termination of Pregnancy) of 1978, termination of pregnancy is permitted in situations where:
- The woman is younger than 17 years of age.
- The woman has reached 40 years of age.
- Pregnancy resulting from relations prohibited by law.
- Incest or that occurred as a result of prohibited relationships outside marriage.
In addition, termination of pregnancy is permissible due to medical reasons including:
- Situations in which the newborn may have a physical or mental defect.
- Cases where the continuation of the pregnancy may cause the woman physical harm or endanger her life.
- Cases where continued pregnancy may lead to mental damage to the woman.
- Situations where the woman takes medications that can cause a fetal defect.
It is important to note that the woman’s will is not taken into account in terms of the law.
When is it permitted?
In medical centers that are defined as surgical clinics, termination of pregnancy is permitted until the 12th week of pregnancy. In medical centers that are defined as hospitals, whether private or public hospitals, pregnancy is permitted until 24 weeks or until 38-40 weeks, with the approval of a Supreme Committee of the Ministry of Health for termination of pregnancy.
Pregnancy termination until 37-38 weeks is possible in cases where a very serious defect is found that may cause the fetus or the fetus to be significantly disabled, and the couple decides that he is not interested in pregnancy.
What is the Committee for Termination of Pregnancy?
The Committee for Termination of Pregnancy is a committee under the authority of the Ministry of Health, composed of two doctors and a social worker. One of the doctors on the committee is a gynecologist, and the second doctor may be an expert on internal medicine, a specialist in family medicine, or a mental health specialist. The purpose of the committee is to see whether the woman meets the criteria for abortion.
Any woman interested in performing a pregnancy termination must contact the Committee for Termination of Pregnancy. These committees are scattered throughout public and private hospitals throughout the country.
How is the pregnancy stopped?
There are two common techniques for stopping pregnancy:
Medical abortion is defined by the Ministry of Health as being until the ninth week of pregnancy. However, the efficacy of the drugs increases, the younger the pregnancy.
How is it done?
After the committee approves the termination of the pregnancy, the woman takes a drug containing an anti-progesterone that stops the pregnancy. 48 hours after the first time, the woman takes two more pills that cause a strong menstruation. The resulting bleeding causes contractions and empties the pregnancy bag that is supposed to be released from the body.
The duration of the bleeding after the operation and the amount of bleeding are individual and depend on characteristics such as gestational age. In most cases, the bleeding will continue for several days to a week and a half, from the time the drug is taken.
About three weeks after taking the drug to stop pregnancy, the patient should return to the doctor for review and perform an ultrasound test to verify that the pregnancy content has been completely ejected.
What are the chances of successful abortion with medication?
Pregnancy termination by medication during the first six weeks of pregnancy results in miscarriage in 95% of cases. On the other hand, the percentage of failures in abortion is about 10% in advanced pregnancies beyond the seventh week of pregnancy. In these situations, a surgical technique should be applied.
What are the risks?
In addition to allergy to the drugs taken, massive bleeding may occur. In this situation, surgical intervention is required in a hospital in order to prevent a large loss of blood. Another risk is infection.
In some cases, an infection may develop as a result of bleeding which can damage the uterus, invade all parts of the body and even lead to an infectious market situation if no urgent intervention is carried out. In these cases, close supervision, antibiotic treatment, and surgical emptying of the uterus will be required.
Who is eligible for an abortion using medication?
Patients who qualify for a drug abortion are mostly young girls and minors, with young pregnancies. Sometimes, the procedure can be long and very exhausting. Therefore, it less suitable for older women and mothers.
Surgical abortion is performed in an operating room, in a public and private hospital approved for this, under general anesthesia under the supervision of an anesthesiologist and by an expert and experienced gynecologist. The length of the operation is between 5-10 minutes.
During the course of the operation, the pregnancy contents are taken through a tube inserted through the cervical canal. The pregnancy content is vacuumed into a unique container. The procedure is performed under abdominal ultrasound supervision to allow accurate picture of the space.
At the end of the extraction procedure, the uterine walls are moved with a small itch. Afterwards, the woman is transferred for recovery for an hour and is released to her home. After the operation, antibiotics are given to prevent infection.
What are the expected side effects after a surgical abortion?
After the operation, slight bleeding is expected to last for one day. After a few days of the operation, there may be another slight bleeding that may be accompanied by cramps in the lower abdomen. Any unusual phenomenon requires a referral to the surgeon.
It is important to note that the day of surgical abortion is now considered the monthly menstruation, and therefore one should expect to regulate a month later.
What are the risks?
Early complications are rare due to the fact that this is a minimally invasive sexual activity, which involves entering the uterine cavity surgically. One of the possible complications is the formation of a hole in the uterine wall.
Today, due to the fact that the operation is performed under ultrasound supervision, this complication is relatively rare. If this occurs, the patient should be taken to a public hospital to make sure that no bleeding occurs. This may lead to additional surgical intervention to stop the bleeding.
In certain situations, the remains of pregnancy parts or pregnancy membranes that have not been pumped during surgery may remain in the womb. As a result, high-temperature infections can develop. In addition, adhesions may occur in the uterus as a result of the surgical procedure. It is important to note that these complications are very rare and very safe.
What are the advantages of a surgical operation?
The surgical procedure is a quick action that empties the pregnancy content immediately without the need for additional procedures. About 98% of the surgical procedures end successfully with complete termination of pregnancy.
What about getting pregnant in the future?
It is important to note that the operations are carried out in a sterile and clean environment, hygienically, and therefore the possibility of infection or the formation of adhesions in the uterus that will impair fertility is rare. It is important to choose a gynecologist with experience and seniority in abortions to avoid complications and to find effective ways of solving them if they occur.