Abortion

An abortion is the termination and expulsion of a pregnancy before birth. An abortion can occur spontaneously, in which case it is often called a miscarriage, or can be induced.

• There is no defined minimum or maximum age for the abortion procedure in Singapore
• There is no legal requirement for parental consent for minors (under 16).
• Abortion is prohibited after 24 weeks (6 months) of pregnancy unless the mother’s life is in danger. (The duration of the pregnancy shall be calculated from the first day of the last normal menstruation of the pregnant woman to the end of the 24th week.)

(Source: Termination of Pregnancy [TOP] Act)

Legal Restrictions on Foreigners
Foreigners are only eligible for abortion in Singapore if they meet one of the four conditions below:

• They have been residing in Singapore for 4 months or more; or
• They are married to a Singapore citizen or have PR status; or
• They hold or are the wife of a holder of a work permit pass (not a temporary work permit) or employment pass; or
• An abortion is immediately necessary to save the life of a pregnant woman.

To get an abortion, the first thing you should do is go to your doctor (you can go to a general practitioner (GP) or gynecologist).

1. Mandatory counselling

Mandatory pre-abortion counselling is required before the procedure for all patients seeking abortions. Your doctor will direct you to the counselling service after your consultation.

Girls below 16 years of age need to be counselled at the Health Promotion Board Counselling Centre (except for rape victims). Mentally disabled patients require certification by a psychiatrist that continuation of the pregnancy will be harmful to the mother before medical procedures can be done.

If you want an abortion and your doctor refuses on personal grounds, you have the right to seek a second opinion.

Note: Before 17 April 2015, non-Singaporean women, or women with three or more children, or women who have not passed the PSLE and have no secondary education were not obliged to undergo pre-abortion counselling, but new guidelines make counselling mandatory for all patients.

2. Waiting period

There is a mandatory waiting period of 48 hours after the counselling is conducted before the procedure can be done.

3. Records

Patients choosing to terminate a pregnancy are required to sign a declaration of marital status, educational level, and number of living children. The Ministry of Health maintains a register of all treatments to terminate pregnancy that records the patient’s name, date of procedure, and method of termination.

Patients will normally undergo post abortion counselling after the procedure and may be required to return a week later to check for any complications.

Because of the risk of infection, some doctors may advise that you should not have sex for up to two weeks after your procedure.

First Trimester Surgical Abortion — (8 to 12 Weeks) If the pregnancy is more than eight weeks gestation, the preferred method is a vacuum aspiration. In this procedure, forceps are inserted into the vagina. A local anesthetic is inserted into the cervix. The cervix is then carefully dilated. A thin tube is passed through the cervix and into the uterus. A tube is attached and used to suction the tissue out of the uterus. A curette is then used to ensure the complete removal of pregnancy tissues

Second Trimester Surgical Abortion — (12 to 24 weeks) This process is more complicated and hospitalisation is usually required for a day or two. Medicine is inserted into the vagina to induce natural expulsion of the pregnancy. After the foetus and placenta are aborted, the womb is cleared by vacuum aspiration as above.

Because the second procedure is much more complicated, it is much better for an early decision for abortion be made. Abortion is not allowed if a pregnancy has progressed beyond 24 weeks. Most doctors would not initiate abortion beyond 23 weeks, so an earlier decision is best.

The only exception to this rule is a severe or lethal foetal abnormality. Even in this case, special approval would have to be sought from the authorities before the procedure can be done.

An abortion can cost from $800 to $5,000, depending on whether the procedure is conducted in a restructured hospital (KK Women’s and Children’s Hospital, Singapore General Hospital, or National University Hospital), a private hospital, or a private clinic. Singaporean patients can use their MediSave accounts to subsidise the procedure.

Pregnant women should seek medical assistance and not self-medicate or turn to folk remedies (e.g. eating pineapple) in order to terminate a pregnancy. Babes offers a helpline, an online chat application, or an in-person meeting with information about various options available to prepare a pregnant woman under the age of 21 to make an informed decision. Once she has made a decision, Babes provides essential support and links to the appropriate resources.

Abortion is one of the safest surgical procedures for women, if it takes place within the first trimester and is done by a trained professional. The risk of death associated with abortion is low and the risk of major complications is less than 1 percent. In fact, giving birth is more dangerous than an abortion. However, problems are more likely if an abortion is carried out later in a pregnancy. The medical risks associated with abortions are:

• haemorrhage (excessive bleeding) – occurs in about one in every 1,000 abortions
• damage to the cervix (the entrance of the womb) – occurs in no more than 10 in every 1,000 abortions
• damage to the womb – occurs in up to four in every 1,000 abortions during surgical abortion, and less than one in 1,000 medical abortions carried out at 12-24 weeks

(Source: National Health Service, UK)

Myth: “Abortion is a very dangerous procedure.”

Fact: Abortion is one of the safest surgical procedures for women, if it takes place within the first trimester and is done by a trained professional. The risk of death associated with abortion is low and the risk of major complications is less than 1 percent. In fact, giving birth is more dangerous than an abortion.

Myth: “Women who have had abortions are traumatised.”

Fact: There is no scientific evidence to support the idea that having an abortion is any more dangerous to a woman’s long-term mental health than delivering and parenting a child she did not intend to have or placing a baby for adoption. Studies demonstrate that the predominant feeling following abortion is one of relief and diminution of stress. Some people do experience guilt and sadness after an abortion. These feelings are legitimate and there are people who can help. Whoever provided your abortion should be able to direct you towards post-abortion counselling services. (Source: MotherJones)

Myth: “Abortion causes breast cancer.”

Fact: Early studies suggesting an increase in breast cancer among women who had abortions have been found to be flawed and widely discredited. Newer, better-designed studies consistently showed no association between induced and spontaneous abortions and breast cancer risk. (Source: National Cancer Institute)

Myth: “Abortion causes infertility.”

Fact: Having an abortion will not usually affect your chances of becoming pregnant and having normal pregnancies in future. (Source: NHS, UK)

Guidelines on Termination of Pregnancy (PDF) – Ministry of Health

A Ministry of Health spokeswoman said there were 10,960 abortions in Singapore in 2012, compared to 12,208 in 2011. During the same period there were 33,205 babies delivered, indicating that roughly 1 in 4 pregnancies are terminated.