Quite literally, contraception prevents conception. If you have sex without using any contraception, you can become pregnant. In order to prevent this, it is best to use contraception at all times. The safety of a contraceptive is strongly determined by how correctly you use the product or the method.
Very safe methods of contraception: the copper and hormone-based intrauterine devices and the hormonal implant. We speak of very safe methods because after correctly placing the contraceptive no more mistakes are possible.
Safe methods: the contraceptive pill, the minipill, the condom, the vaginal ring, the contraceptive patch and the contraceptive injection. We speak of safe methods because it concerns contraceptives you have to use daily, weekly or monthly or the moment you have sex. In other words, more mistakes are possible as opposed to the contraceptives we refer to as very safe. If you use the pill (or another contraceptive) in combination with a condom you protect yourself as well as your partner against sexually transmitted diseases (STDs). More information on STDs is available on http://www.bpas.org/bpaswoman/stiguide
Less reliable methods of contraception: withdrawal (coitus interruptus) and periodic abstinence (calendar method).
The only safe way to guard against an unwanted pregnancy is to use contraception each time you have sex. Discuss the options with your doctor or a family planning specialist in order to identify that contraceptive method that best suits your current circumstances.
The pill is a very reliable contraceptive provided that you use it correctly. Correct use means that every day at about the same time you take a pill and that you are extra careful when you
These various factors can interrupt your contraceptive protection and lead to pregnancy.
No. It is important not to confuse the so-called ‘abortion pill’ with the emergency contraceptive pill (or morning-after pill).
The emergency contraceptive pill (or morning after pill) can be purchased freely from a pharmacy and diminishes the chances of pregnancy. If you have had unprotected sex or something went wrong with your contraceptive, but you do not wish to become pregnant, then you should take the emergency contraceptive pill within 72 hours. The emergency contraceptive pill works better the sooner you take it. For every period of twelve hours that goes by before you take it, the risk of pregnancy increases by 50%. If it has been more than 72 hours since you had unprotected sex, go to a doctor for a prescription of a different kind of emergency contraceptive pill (which can be used up to five days after unprotected sex) or to insert a copper coil.
The emergency contraceptive pill interrupts or delays ovulation. If ovulation had already occurred when you had unprotected sex, then you may become pregnant. Furthermore, the emergency contraceptive pill will not protect you for the rest of your cycle. It is therefore very important you use a condom until you have your period.
The so-called ‘abortion pill’, the substance name is Mifepristone, terminates pregnancy. Mifepristone belongs to a group of drugs known by the name "antiprogestogens". Progesterone is a hormone produced naturally by the female body to support pregnancy. Mifepristone is an anti-hormone which terminates pregnancy. It blocks the effects of progesterone, causes the cervix to soften and dilate and induces the contraction of the uterus.
Doctors and all other medical staff are bound by the oath of professional secrecy. They may not inform your parents. In principle, if your doctor does inform your parents, you can press charges. It is important to clearly express to your doctor that you have come to them in confidence. If you have any doubts, it may be better to consult another doctor. You must also know there is no minimum age for the use of conception control.
The condom is the only method of contraception that protects against infection with a sexually transmitted disease (STD) such as HIV or Chlamydia. However, in terms of contraceptive protection, the condom is sometimes less reliable, because many people "forget" to put the condom on or use it incorrectly. We advise that you use a condom to protect against STDs in combination with one of the other methods of contraception listed above. In this way you are protected against STDs and double protected against pregnancy. If you are using condoms as contraception (for example because you are not having sex very often), then we advise you to use a condom every time you have sex. Make sure you have an emergency contraceptive pill at home, too, so that you can take it immediately should anything go wrong.
If you intend to take birth control pills, or use a vaginal ring or a patch, you should start on the day of the abortion or on the next day. An IUD (Intra-Uterine Device) or contraceptive implant can either be fitted immediately after the abortion or during your next period. A contraceptive injection can also be given on the day of the abortion.
The main reason is that to date, human fertility is still difficult to fully control. Contraception is usually very safe, but not perfect. It might occur that the chosen method fails and that pregnancy follows in spite of an inserted IUD, in spite of a sterilisation or in spite of correct usage of a contraceptive pill. Obviously the rational use of contraception quite often contradicts the irrationality and impulsiveness of sex. Risks are often taken, which can be seen as an important reason. Not getting pregnant when you didn’t intend to, requires real effort and even some luck.
Once you suspect that you may have become pregnant unintentionally, the initial reaction might be one of fear. In many cases, wondering "What if I am pregnant; what then?" constitutes the start of the decision-making process. Indeed, facing this kind of situation might be difficult because you tend to believe, and to hope, that an unintended pregnancy is something that will never happen to you. Nevertheless, the majority of women reach a decision quite rapidly as to whether to terminate their pregnancy. Depending on their individual situation, the majority reaches a responsible conclusion for them at that moment in their lives. Yet if you are having doubts try to organize your thoughts, preferably together with someone you trust, like for instance your partner, a girlfriend, one of your parents, your GP or a professional care worker. You can even get in touch with an abortion centre for an appointment of this nature. In any case, talk to a person who gives you enough space to go through your own decision-making process.
Obviously that is not the idea; the people at the abortion centre will not try to affect you, they do not take any decisions on your behalf and will at no point tell you what you should do. Together, you will think through all of the ins and outs of the situation calmly so as to enable you to be sure that the decision you take is the right one for you.
The doctors at the abortion centres are gynaecologists or GPs. General practitioners here have had specific additional training to perform vacuum aspiration as well as to support women during treatment with medication.
In the West, abortion is no longer a dangerous affair because it is performed under good conditions. In the past, things were different. A captivating account can be read in the book ‘De Engeltjesmaaksters’ (2009) by Diane De Keyzer (see www.dianedekeyzer.be; this book is only available in Dutch). Women used to go to backstreet abortionists and only too often so-called kitchen table abortions were performed, which could have dire consequences. In the most serious cases they could die. Unfortunately this is still commonplace even today in large parts of the third world.
Nowadays in Belgium, terminations are carried out in legally recognised abortion centres and are paid for by the mutual health insurance scheme. Complications can occur during any medical treatment, including abortion, but experience has shown that such complications are rare and can be dealt with rapidly (in 2011 the complication level was 0.42%). The abortion centre staff will explain the procedure to you. They will tell you who you can get in touch with afterwards if you are concerned about certain symptoms you may be experiencing, such as severe stomach ache, problematic blood loss or fever.
It is difficult to predict how much pain you will feel. Experiences of pain vary tremendously from one woman to another. Moreover, a distinction has to be made between a treatment with a vacuum aspiration and the procedure using medication.
A vacuum aspiration is performed under local anaesthetic (paracervical local anaesthesia). The cervix is sedated, because making the cervical opening wider without an anaesthetic can be painful. These injections are generally not perceived as very painful, and widening the cervix usually produces light menstrual pain. Aspiration to remove uterine contents causes the uterus to contract which can temporarily cause moderate to serious cramps. This will gradually reduce after treatment.
In case of treatment with medication, some women may experience cramps after ingesting the prostaglandins (the second phase). Here, again, experiences vary greatly. Some women can hardly feel the contraction of their womb at all, whilst others experience slight cramps, and others feel a severe stomach ache. Just like with a vacuum aspiration, pain medication can be administered.
This depends on the method of abortion.
After a vacuum aspiration, you will be asked to relax for a while in the resting room. Depending on how you feel and after consulting the physician, you will be able to go home after half an hour to an hour.
Treatment with medication involves two phases: - at the first visit you take a mifepristone tablet and you stay at the centre for approximately 30 minutes. - 24 to 48 hours later you return to the abortion centre for the administration of prostaglandins, after which you stay at the abortion centre for approximately 4 hours under the supervision of a nurse.
Usually you can go back to work the day after the treatment. Do bear in mind that following an abortion you will generally lose more blood and for a longer time than during a normal period. Avoid serious physical efforts the days after. If your profession involves a lot of standing up, running around or lifting, it might be better to stay at home for a couple of days. In case you have job that is sedentary, you can basically go back to work the next day.
That depends on when the check-up takes place. For example, if you have a blood test in the first three weeks after your abortion, you may still test positive for hCG (human Chorionic Gonadotropin, the so-called pregnancy hormone). This does not mean that you are still pregnant: it takes a few weeks for the hCG to disappear from the bloodstream. In addition, after an abortion your womb may remain somewhat swollen and your cervix may remain slightly open for a couple of weeks. In all likelihood, after roughly one month there will be no further physical signs of your abortion.
Our abortion centres uphold the highest standards of responsible medicine. Complications can occur during any medical treatment, including abortion, but experience has shown that such complications are rare and can be dealt with rapidly. In fact, you could get pregnant again very quickly. Indeed that is why abortion centres focus to such a great extent on contraception. You will be advised to start using a method of contraception immediately, or to use one each time you have sex.
No. The Belgian law stipulates that it is up to the pregnant woman to reach her own decision, no matter what age she is. The physicians working in our abortion centres are authorised to carry out an abortion at the request of an underage woman. The legislator has assumed that underage women are able to reach their own responsible decision. (Note: If the intervention is carried out in a hospital under a general anaesthetic, then your parents must nonetheless be informed. This is standard medical procedure with respect to the use of general anaesthetics).
The staff of the abortion centre are bound by medical confidentiality. They are not to inform the parents of a minor of her wish to have an abortion or indeed of the abortion itself. However, if the people at the abortion centre discern that a minor finds herself in a situation they deem perturbing for her health or safety, they may discuss the issue with the underage girl and encourage her to talk to her parents or involve another person she trusts.
Since 2001, the abortion centres and the National Institute for Health and Disability Insurance (RIZIV/ ENAMI) have an agreement, meaning that your medical insurance pays most of the costs directly to the abortion centre. You only pay minimum co-payment of a few euros. With this arrangement, both the National Institute of Health and Disability Insurance and the health insurances also guarantee anonymity. Even if you are a youngster on your parents' insurance, your anonymity is guaranteed on the level of the health insurances. You can of course pay all the costs yourself if you don't want the health insurance to intervene.
Yes. In legal terms this is referred to as “the right to physical integrity”. This right to physical integrity is an individual right thus a right that is guaranteed for each person and is one that is not affected by marriage or cohabitation. The Belgian law concerning pregnancy termination stipulates that a pregnant woman may decide independently whether to continue or terminate her pregnancy.
After an abortion you may be faced with contradictory feelings. However, this is not always the case, nor is it always distressing. It mostly concerns a healthy coping process and after some time these conflicting feelings diminish and become less frequent. In most cases an abortion does not leave any serious emotional scars. If you do have persistent emotional distress afterwards and that negative feelings are seemingly haunting you, we recommend you seek external help. If unsure where to go for professional help, contact an abortion centre; they will discuss with you what kind of help is most appropriate and can refer you to someone.
You are definitely not alone. In Belgium, between one in five women will have an abortion during their lifetime. Nevertheless, alongside the Netherlands, Switzerland and Germany we do have one of the lowest abortion rates in the world (< 10/1000 women aged 15-44). In 2011, when the most recent official statistics were published, the figure for registered abortions was 19,577. The frequency of abortions carried out is also linked to the female fertility curve: the figures are highest in the group aged 20-29. The average age is approximately 27.