After a woman's egg is fertilized by a man's sperm, the fertilized egg moves along the fallopian tubes and becomes embedded in the lining of the uterus. At this point the pregnancy formally begins.
For couples who are prepared for parenthood, the pregnancy is a much welcomed event. But for those who are not prepared for it, an unplanned pregnancy can bring much anxiety and distress.
Causes and Sign of an Unplanned Pregnancy
Factors which may result in an unplanned pregnancy include:
- No contraception used;
- Contraception used wrongly, e.g. forgetting to take oral contraceptive pills, or wearing condoms incorrectly;
- Contraceptive failure, e.g. expulsion of intra-uterine device(IUD), using contraceptive products beyond their expiry date.
If a woman discovers that her menstrual period is overdue, and has symptoms of breast swelling, nausea, vomiting or frequent micturition, she may be experiencing signs of early pregnancy. Pregnancy can be confirmed one to two weeks after her missed menstrual period by a urinary pregnancy test (preferably on the first morning specimen of urine).
The Pregnant Woman's Options
The pregnant woman can choose to continue with the pregnancy or to terminate it by having an abortion. This is different from a natural abortion (miscarriage) which was caused by problems during pregnancy. Before deciding, the woman should carefully consider various factors relating to her physical, social and emotional well-being. These include her state of health at the time of pregnancy, practical social circumstances such as her financial condition, the number of children she may already have, the pregnancy's effect on her vocational or academic pursuits, her relationship with her partner and their views on life and childbearing.
If the woman decides to continue with the pregnancy, she should attend regular ante-natal check-ups to safeguard the health of herself and her baby. Single teenage mothers who decide to have the baby may apply to voluntary agencies such as Caritas, Mother's Choice or the Birthright Society for residence in hostels for unwed teenage mothers where they can stay until they give birth. After the baby is born, they can choose either to keep the baby themselves or to arrange with the Social Welfare Department for adoption.
If the woman decides to terminate her pregnancy, she should learn more about the procedure and safety of the abortion. Termination of pregnancy should be provided in full compliance with the Law. In Hong Kong, illegal abortion on oneself or on others is liable to prosecution with possibility of penalty and imprisonment.
Applying for Legal Termination of Pregnancy
In accordance with Section 47 of the ""Offences Against the Person Ordinance"" (Chapter 212) in Hong Kong, a pregnancy may be terminated if two registered medical practitioners are of the opinion, formed in good faith, that:
- Continuing the pregnancy would involve risk to the life of the pregnant woman or of injury to her physical or mental health, greater than if the pregnancy were terminated; or
- There is a substantial risk that if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped.
For example, in the case of a pregnant woman who is below the age of 16, or has made a report to the police within 3 months that she has been the victim of incest, rape, intercourse by threat, intercourse by false pretence, or drug rape, the doctors, in forming an opinion, may presume that continuing the pregnancy would involve risk of injury to her physical or mental health greater than if her pregnancy were terminated.
Termination of pregnancy can only be performed within 24 weeks of pregnancy, unless it is absolutely necessary for saving the life of the pregnant woman. Any treatment for the termination of pregnancy must be carried out by a registered medical practitioner in a government approved or gazetted hospital, or in FPAHK Day Procedure Centre of the Family Planning Association of Hong Kong (FPAHK). In Hong Kong, any person who has anything done with the intent to cause her own or another woman’s miscarriage is liable to imprisonment and fine.
Choices for Termination of Pregnancy
A first-trimester pregnancy can be terminated either surgically or medically. Success rates and safety of both methods are similar.
Surgical termination of early pregnancy uses suction evacuation, in which a plastic or metal suction tube is inserted through the cervix into the uterus and vacuum suction is applied to remove the gestational products.
Medical termination of early pregnancy uses two drugs in combination. The first drug works by inhibiting the function of the reproductive hormone progesterone and thereby causing the embryo to detach from the uterus. At the same time, it increases the sensitivity of uterine muscles to the other drug which stimulates uterine contraction, so that the embryonic tissues can be expelled. Mid-pregnancies can be terminated by induced abortion, with drugs administered through intravenous injections or by vaginal suppositories to stimulate the uterus to contract and expel the foetus.
Safety Concern
The safety of termination of pregnancy is closely related to the gestation of the pregnant woman, method used, the practitioner's competence and standards of the facilities.
Illegal abortion involves great risks as there is no guarantee of good hygiene and equipment standard.
Aftercare and Complications
For termination of early pregnancy, women are usually discharged on the same day.
For second trimester termination, women may need to stay in hospital for a few days.
Medical advice should be sought immediately in case of ongoing fever, excessive vaginal bleeding or abdominal pain after abortion.
Preventing Unplanned Pregnancy
To prevent unplanned pregnancy, both men and women should have a good knowledge of conception and contraception, thorough discussion and commitment to assume shared responsibility of birth control, as well as consistent use of effective contraceptive methods.
Unmarried youths should carefully consider the possibility of unintended pregnancy and its consequences before engaging in pre-marital sex. Young single mothers often face tremendous pressures because of emotional stress, loss of schooling opportunity, financial difficulties, tension with boyfriend and family. Should young people choose to have sexual activities, it would be wise for them to practice safer sex and adopt effective contraceptive methods.
It is advisable to consult a medical and healthcare practitioner before choosing a contraceptive method, and use the chosen method correctly in accordance with instructions, followed by regular physical check-ups and assessments.
Consultation and Counselling for Unplanned Pregnancy
All FPAHK Birth Control Clinics offer consultation for unplanned pregnancy.
Counselling service for unmarried young women below the age of 26 are provided by the Youth Health Care Centres of the FPAHK.
FPAHK Clinic Services Hotline: 2572-2222
