What preparations are needed before a medical abortion?

Before undergoing a surgical abortion (also known as induced abortion or pregnancy termination), several important preparatory steps are essential to ensure safety, optimize outcomes, and support physical and emotional well-being. First, a comprehensive clinical evaluation is required—including a detailed medical history, physical examination, and confirmation of gestational age via ultrasound. This helps rule out contraindications such as ectopic pregnancy, uncontrolled coagulopathy, or active pelvic infection.

Patients should undergo appropriate laboratory testing, typically including blood type and Rh factor, complete blood count (CBC), and screening for sexually transmitted infections (STIs) such as chlamydia and gonorrhea—treatment of any identified infection must occur prior to the procedure to reduce the risk of postoperative endometritis. Rh-negative individuals require prophylactic Rh(D) immune globulin administration to prevent isoimmunization.

Pre-procedure counseling is mandatory and should cover the procedure’s nature, risks (e.g., uterine perforation, cervical laceration, incomplete evacuation, hemorrhage, infection), benefits, alternatives—including continuing the pregnancy or adoption—and available support resources. Informed consent must be obtained voluntarily and documented.

Practical preparations include arranging for a responsible adult to accompany the patient home after the procedure (due to sedation or anesthesia effects), fasting for 6–8 hours before if general anesthesia or deep sedation is planned, and avoiding aspirin or other anticoagulant medications for at least one week unless medically indicated and approved by the provider. Patients should also prepare comfortable clothing, sanitary pads (not tampons), and plan for rest and light activity for 24–48 hours post-procedure.

Finally, discussing contraception options in advance is strongly recommended; many providers offer immediate initiation of long-acting reversible contraceptives (e.g., IUD insertion) or short-term methods (e.g., oral contraceptive pills, patch, ring) right after the procedure to prevent rapid repeat unintended pregnancy.