Operations and procedures

Termination of pregnancy in Estonia is regulated by the “Termination of Pregnancy and Sterilisation Act,” according to which a pregnancy may be terminated at a woman’s own request and on the basis of a signed application if the pregnancy has lasted less than 12 weeks.

Preliminary assessment and counselling

The procedure begins with a gynecologist appointment, where the duration of the pregnancy is confirmed by ultrasound examination and your health condition and possible contraindications are assessed. During the appointment, necessary tests are prescribed and treatment is provided if needed.

Medical abortion

If you have decided in favour of medical termination of pregnancy, then during the appointment with a midwife, the course of the procedure, the use of medications, and possible side effects are explained to you in detail. Medical abortion is based on the sequential use of two medications: mifepristone and misoprostol.

The first medication, mifepristone, is administered orally in the presence of a midwife. Then, usually after 24–48 hours, misoprostol is administered vaginally or orally. The second stage of the procedure usually takes place at home. In most cases, termination of pregnancy occurs within a few hours after administration of misoprostol and in the majority of cases within 24 hours. In a small number of cases, the pregnancy may terminate already after the first medication. If necessary, a certificate for sick leave can be issued.

If your blood group is Rh-negative and the pregnancy has lasted more than 9 weeks, the medication Rhesonativ is administered after the procedure to reduce the risk of Rh incompatibility in future pregnancies.

Associated symptoms

After administration of the medications, the following symptoms are common:

• bleeding, which is usually heavier and lasts longer than menstruation (on average up to 2 weeks, more rarely longer);
• lower abdominal pain and cramps, especially within a few hours after using misoprostol;
• temporary fever and chills;
• nausea, vomiting or diarrhoea;
• general weakness, headache or drowsiness.

Need for emergency care

Termination of pregnancy is generally safe, however, in the presence of certain symptoms, it is necessary to seek emergency medical care.

Seek medical attention:

• if fever persists for more than 4 hours after administration of misoprostol or occurs in the following days;
• if you experience very severe pain that is not relieved by painkillers;
• if heavy bleeding occurs (soaking through two large sanitary pads within two consecutive hours);
• if bleeding lasts more than 45 days or continues after the next menstruation.

Follow-up and further counselling

At the post-abortion gynecologist appointment, completion of the termination of pregnancy is confirmed. Suitable contraceptive methods are also discussed. After termination of pregnancy, fertility is restored immediately, therefore an effective contraceptive method must be started immediately after the abortion to avoid a new pregnancy.