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Abortion refers to induced termination of pregnancy before pregnancy week 20. Abortion will not affect fertility in the future if it has no post-procedure conditions, i.e. complications. If you are pregnant and want to have an abortion, please contact our healthcare professionals. If you wish, you can first discuss your situation with them. 

Conditions for an abortion

The Act on Induced Abortion permits abortion at the request of a woman if her grounds for seeking an abortion meet the conditions mentioned in the Act. 

  • Abortion can be performed with the consent of one doctor before the end of pregnancy week 12 if the woman is under 17 years of age, over 40 years of age, or has given birth to at least four children. 
  • The consent of two doctors is required for abortions performed before the end of pregnancy week 12 in situations where giving birth to and taking care of the child would cause considerable strain for the woman, if the pregnancy is linked with a crime, or if the mother’s or father’s condition seriously restricts their ability to take care of the child.  
  • After pregnancy week 12, abortion requires permission by the National Supervisory Authority for Welfare and Health Valvira. 
  • Regardless of the duration of pregnancy, abortion can be performed with the consent of two doctors if the continuation of pregnancy or giving birth to the child would pose a danger to the woman’s life or health. The permission of Valvira will be required in situations where abortion is requested because of a severe condition or malformation of the foetus. 

Most abortions (about 90%) in Finland are performed on social grounds. In these cases, the decision is often influenced by family relations, financial situation and future plans. 

Medical abortion

Nearly 95% of abortions in Finland are performed by means of medication. This option is safe and effective if the woman is less than 9 weeks pregnant. With medication, pregnancy is terminated in up to 98% of cases. In pregnancy weeks 9 to 12, medical abortion is the standard option, even though it’s slightly slower and the medication often needs to be repeated. 

If the woman is more than 12 weeks pregnant, abortion is always initiated with medication. Medication administered via the vagina causes the womb to contract and the foetus to abort via the vagina. The placenta and the membranes are then inspected. This is followed by vacuum aspiration of the womb if necessary. 

In medical abortion, two different medicinal agents are taken every 1 to 3 days. The first agent, mifepristone, works by blocking the effects on the womb of progesterone, the hormone essential for the continuation of pregnancy. The second agent, prostaglandin, makes the womb contract and empty. 

Complications due to heavy bleeding occur in less than 1% of medical abortions. In these cases blood transfusions or aspiration of the womb may be required. In medical abortions, bleeding persists much longer after the procedure compared to surgical abortions. An infection or a suspected infection requiring antibiotics occurs in about 3% to 5%. If the womb doesn’t empty with medication, aspiration has to be performed. This happens in about 2% to 4% of the patients.

Surgical abortion

Surgical abortion (aspiration) is required in some cases. The procedure includes widening of the cervix and vacuum aspiration of the womb. Before aspiration, softening of the cervix using medication may be required. Vacuum aspiration is usually performed under anaesthesia. After the procedure, the patient’s condition will be monitored for a few hours at the hospital.

Follow-up examination

A follow-up examination will be required within 2 to 4 weeks after both medical and surgical abortions. In complication-free abortions, the follow-up examination will be performed in outpatient care. It is essential to confirm the termination of pregnancy with a pregnancy test or a clinical examination. 

Birth control planning often begins before the abortion. The use of contraceptive tablets can be started as early as the day following the abortion. An intrauterine device (IUD) can be installed at the time of the surgical abortion. After a medical abortion, an IUD can, if necessary, be installed a week later during the follow-up examination or during the woman’s next periods after the abortion. Proper emptying of the womb must be confirmed.

Long-term birth control methods such as IUDs and contraceptive implants are recommended particularly for women who have undergone repeated abortions. 

Complication-free abortions have not been shown to reduce female fertility. Ectopic pregnancy, miscarriages during the second trimester of pregnancy, premature births and placenta praevia do not occur more often in women who have had an abortion. 

Information sources: The Finnish Medical Society Duodecim: Terveysportti, Lääkärin tietokanta database

FSHS General Practitioner / 19 September 2019 

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