Whenever the word abortion was mentioned, if a reaction was expected from me, disappointment would find its way to the expectant faces. I never degraded the choice of abortion or saw the act of killing a foetus as unethical. However, most people would think otherwise regarding the matter of having abortions in Singapore.
The Ethics of Abortion
During GP lessons in college, my classmates questioned me mercilessly on my stand on the ethics of abortion; I sat through countless abortion videos, each time savouring a Mars bar; graphic images of abortion were slipped into my notebook by friends who thought I needed to see the real thing but nothing could change my mind and perspective on abortion.
It was not something I supported but it was not something I protested against, as well.
This was the case until a few months back when a friend who works in the medical industry was having a casual chat with me and somehow, the topic of the alarming rate of rising numbers for adoption crept into our conversation.
That set me thinking. Are people sleeping around without a care in the world because the solution of abortion is always a ready measure to turn to should things go wrong?
54 countries allow abortion, which is about 61 per cent of the world population. Only 97 countries, about 39 per cent of the population, have abortion laws that make it illegal according to the pro-abortion Centre for Reproductive Law and Policy in New York.
In 2006, one out of four, or 12,000 babies were aborted. What is more disturbing is that these terminations of pregnancies were not mostly limited to teenagers or unmarried women.
A study by the Department of Obstetrics and Gynaecology of the National University of Singapore in 2002 reported that up to 75 per cent of women who went for abortions in Singapore were married.
What Is Abortion?
Abortion is a method of terminating a pregnancy. It’s also referred to as pregnancy termination. The pregnancy is terminated either through medication or surgical procedure.
The decision to terminate a pregnancy is highly personal. Most health care providers recommend counselling if you are considering having an abortion.
Image source: iStock
Abortion has two main options:
- Medical abortion (for pregnancies less than 8 weeks)
To induce abortion, you take an “abortion pill.” It does not necessitate surgery or anaesthesia.
- Surgical abortion (for pregnancies between 8 – 12 weeks)
To induce abortion, a vacuum aspiration procedure is used. This is done while sedated or under general anaesthesia. After 14 weeks of pregnancy, medical abortion combined with evacuation (removal of remnant tissue) under general anaesthesia is the preferred method.
The practise of abortion dates back to ancient times. Abortion was carried out in a number of ways such as the administration of abortion-inducing herbs, the use of sharpened implements, the application of abdominal pressure, and such. Laws preventing abortion have risen throughout different periods of time.
In the 18th to 19th centuries various doctors, clerics, and social reformers successfully pushed for an all-out ban on abortion. In the 20th century, multiple women’s rights groups, doctors and social reformers successfully repealed abortion bans.
Is Abortion Legal in Singapore?
Abortion, also known as Termination of Pregnancy (TOP), is typically performed when a pregnancy is unplanned or if the woman’s health would be seriously jeopardised if the pregnancy were to continue.
Abortion in Singapore is governed by specific government regulations, which doctors must strictly follow. Induced abortion is a clinical procedure used to end a pregnancy that is already underway.
It can only be performed by a doctor who specialises in Obstetrics and Gynaecology, either in a clinic or hospital approved by the Ministry of Health (MOH) to perform abortions.
Abortion Law in Singapore
Termination of Pregnancy Act (TPA) contains Singapore’s abortion laws (TPA). In Singapore, you can legally obtain an abortion if you meet the following criteria:
- Your pregnancy is less than 24 weeks long.
- You are either a Singaporean citizen or the wife of one.
If you are not a Singaporean, you can only have an abortion if you meet the following criteria:
- You have permanent residency or are married to a Singaporean citizen.
- You’ve been in Singapore for more than four months.
- After 24 weeks, you can only have an abortion if your life is in danger or your foetus has a severe abnormality; this must be done in a public hospital.
Pre-abortion counselling and a 48-hour waiting period are required in Singapore before any abortions can be performed.
At What Age Can You Have an Abortion in SG?
Image Source: iStock
Anyone 16 and above are allowed to have abortions in Singapore. Perhaps this part of the law should be revised? To a kid waiting for her O’levels result, the knowledge that the law allows her to terminate her pregnancy without her parents’ consent almost appears to be an incentive for her to go ahead and make merry with her boyfriend.
However, what is most troubling is that 75 per cent of the women who had abortions in Singapore were married. With the silent crisis Singapore is facing on the lack of births, this is something that has to be looked into.
If this was the case in 2002 with married couples, then the numbers are bound to rise as we are smothered by the economic crisis currently.
Abortion Legal Guidelines in Singapore:
- In Singapore, abortion is legal for up to 24 weeks, unless the woman’s health is jeopardised.
- Parental consent is not required by law for women and girls over the age of 14.
- Women must go through mandatory counselling and wait at least a day before confirming their decision to undergo the procedure.
- Prior to undergoing the procedure, girls under the age of 16 but over the age of 14 must seek counselling from the Health Promotion Board.
- There will be no medical confidentiality for girls under the age of 14 because having sex with a girl under 14 is considered statutory rape.
Mandatory counselling and cooling-off period
Prior to the procedure, every pregnant woman, especially those under the age of 16, will be required to attend mandatory counselling.
If a pregnant woman wishes to terminate her pregnancy after receiving counselling, she must wait at least 48 hours before consenting to the abortion. She can only have an abortion after this 48-hour period has passed.
Abortions in Singapore: The Procedures Used Today
Abortions in Singapore come under 2 main types of abortion procedures, depending on the gestation of the pregnancy. Vacuum aspiration is used for early pregnancies at 3 months (12 weeks). This usually involves being put to sleep for about 10 minutes, during which time a small tube is placed into the womb via the vagina. An attached vacuum will then remove all the pregnancy contents of the womb.
For pregnancies 3 to 6 months (13 to 24 weeks), the procedure is known as Mid Trimester Pregnancy Termination (MTPT) which is more complicated. Hospitalisation is usually required for a day or two, during which medicine is inserted into the vagina to induce the natural expulsion of the pregnancy.
After the foetus and placenta are aborted, the process of evacuation of the womb follows. This is basically the same procedure as used in vacuum aspiration; it ensures that the womb contents have been thoroughly evacuated.
The second method takes a little longer and is messier, so it is far preferable that an early decision for abortion be made, before 3 months if possible. Abortion is not allowed if a pregnancy has progressed beyond 24 weeks. The legal limit of termination of pregnancy in Singapore is 6 months, or 24 weeks, beyond which abortion of any pregnancy is illegal.
Most doctors would not initiate abortion beyond 23 weeks as the abortion has to be completed by 24 weeks. The only exception to this rule would be a severe or lethal foetal abnormality but even then, special approval would have to be sought from the authorities before the procedure can be done.
Medical Abortion in Singapore
Image source: iStock
Medical abortion is a method of terminating a pregnancy that involves the use of medication. The embryo or foetus and placenta are removed from the uterus using medicine or surgery.
A medical abortion does not require surgery or anaesthesia, and it can be performed in a medical office or at home, with follow-up visits to your doctor. It is most effective and safe during the first trimester of pregnancy.
Medical abortion is a major decision with emotional and psychological ramifications. If you’re thinking about having this procedure done, make sure you’re aware of the risks, side effects, complications, and alternatives.
Abortion Pills in Singapore
The “Abortion Pill” refers to Cytotec (Misoprostol) and RU486 (Mifepristone). These medications terminate the pregnancy and cause uterine contractions to expel the products of conception.
Medical abortions are most commonly used for pregnancies of less than eight weeks, after which using this method may result in additional complications.
The main disadvantage of medical abortions is that the duration of the bleeding and the severity of the cramping is unpredictable.
Due to licensing requirements, only Cytotec is available in Singapore.
Cytotec must be administered and monitored by a gynaecologist in Singapore. You should see a gynaecologist to confirm:
- Your pregnancy is not an ectopic pregnancy, but rather an intrauterine pregnancy.
- To determine the date of the pregnancy
Because of the high risk of complications, you should never buy abortion pills online. There is no way to tell if what you’re purchasing is authentic.
Cost Of Abortion In Singapore
How much is an abortion in Singapore?
Abortions in Singapore cost between $750 and $3000, depending on gestation, with prices varying between public hospitals and private clinics:
Type of care and its cost
Public Hospital (1-2 weeks waiting time): $750 – $1500
Private Clinic (1-2 days waiting time): $1000 – $3000
These costs include:
- Doctor consultation and follow-ups
- Ultrasound scans
The age of your pregnancy is the most important factor in determining the cost of your abortion.
Aborting a late pregnancy is much more complicated and thus more expensive. Other factors that may influence costs include:
- Abortion method
- Anaesthetist charges (if required for sedation or general anaesthesia)
- Previous medical conditions
A polyclinic can also refer you to a public hospital for an abortion as a subsidised patient.
You can use up to $1050 from your Medisave for both private and public transportation.
Simply present your NRIC at the clinic, and the clinic staff will process the claim for you.
Abortion Clinics in Singapore
A public hospital or a private abortion clinic are the most common places to get an abortion.
Singapore’s public hospitals that perform abortions are:
- KK Women’s and Children’s Hospital (KKH)
- Singapore General Hospital (SGH)
- National University Hospital (NUH)
Here are other private abortion clinics:
- Women’s Clinic of Singapore
- The OBGYN Centre – Obstetric Gynae & Abortion Clinic
- Dr Jen Shek Wei – Abortion Clinic
- Lien Clinic For Women
- W Gynae – Singapore Abortion Clinic
- Parkway Women & Fertility Clinic
- Seng Clinic – Pregnancy Termination
- Hii Women’s Clinic
- Singapore Women’s Clinic (Tampines)
- Dr Beh Suan Tiong (SOG – Beh Clinic For Women)
- The O&G Care Clinic
- SIDEK CLINIC FOR WOMEN PTE. LTD
- Singapore’s Women’s Clinic Clementi
- SP Teo Clinic For Women Pte Ltd
- Theresa Women’s Clinic
- Women’s Clinic
- K M Heng Women’s Clinic Pte Ltd
- Seng’s OG Practice
- Specialist Women’s Medical Centre
- SBCC Women’s Clinic (Clementi)
- SMG Women’s Health
- KK HO CLINIC FOR WOMEN – Dr Ho Kok Kee
- Beh Clinic for Women
- Astra Women’s Specialist Clinic by SMG
- The Women’s Specialist
- John T.L. Lim Clinic & Surgery
- Healthline Womens Clinic
- Kusuma Lee Clinic & Surgery for Women
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What To Eat After Abortion For Fast Recovery?
1. Protein-rich foods
Proteins are required for quicker recovery and the formation of new blood cells. Protein should be obtained from meat, fish, eggs, beans, and dairy products. These foods are also high in iron and vitamin B.
Eating a high-protein diet after an abortion lowers the risk of anaemia, and new research suggests that eating fish can help with post-abortion sadness.
2. Grains and Cereals
Grains and cereals are high in fibre and contain a variety of essential nutrients. Many kinds of cereal and flours are fortified with iron, minerals, and vitamins, which can aid in the prevention of deficiency. Additionally, they are low in calories and make an excellent post-abortion snack. Brown rice, bread, oats, and other grains are examples.
3. Fruits and vegetables
Remember to include fruits and vegetables in your daily diet. These are excellent sources of critical nutrients required for rapid recovery and should be consumed in large quantities. Four to five servings of fruits and vegetables per day are recommended for optimal health and should be included in what to eat after abortion.
4. Foods enriched with iron
An abortion is usually followed by heavy bleeding, which can result in anaemia. Iron-rich diets are required following an abortion to prevent anaemia. Anemia causes tiredness, weakness, and weariness, which can be avoided by eating iron-rich foods such as red meat, shellfish, and dairy products. Spinach, beans, seeds, and soy products also contain iron.
Iron is most easily absorbed in meat. Make sure the meat is thoroughly cooked. Take it with vitamin C-rich foods for better absorption.
5. Foods enriched with calcium
Pregnancy can cause the body’s calcium stores to deplete, and calcium deficiency is common after a pregnancy loss. Milk and dairy products are important calcium sources and should be included in your post-abortion diet. Seafood, soy, and green leafy vegetables are also high in calcium.
Specific food combinations that will help make a fast recovery
- Dates and milk
- Turmeric and milk
- Sesame and pumpkin seeds
Foods to avoid after abortion
These are the dietary changes and food avoidances that can cause constipation and inflammation. The foods are as follows:
- Starches with a Low Fiber Content
- Sweet products
- Meats and fatty dairy products
- Unhealthy foods
- Products made from soy
If I had to take a stand on abortion, it would one that does not condone it unless it’s a situation that has no other solution. When precautions, such as the pill or abstinence, are around, what seems to be the reason? Ultimately, whichever way you look at it, abortion is the prevention of life.
And who knows, that “kid” who wasn’t given the chance to be, could have been the next Lee Kuan Yew, Barrack Obama or even Mahatma Gandhi.
Updates by Matt Doctor
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