Blk 721 Ang Mo Kio Ave 8, #01-2813 Singapore 560721
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Questions

Commonly Asked Questions
What can you and your clinic offer me, as compared to a large public hospital?

I offer a personalized and experienced service which is safe, intimate, confidential and speedy.

Abortion is a very traumatic and private procedure and what you do not want is to go through a very public hospital with lots of doctors and nurses, maybe even medical students seeing you go though this painful event in your life.

Why should I trust you?

I am been performing this procedure since the early 1980s, and therefore have more than 25 years’ experience in the field. I can confidently handle abortions up to 24 weeks in my clinic without the need for hospitalization. My clinic in Ang Mo Kio has been offering this uninterrupted service since the late 1980s. You can therefore be assured of reliable and experienced service.

When should I come to see the doctor?

Hiding from reality or waiting till you have saved up enough money is not a good plan of action.

It is important to confirm your pregnancy immediately and for the doctor to explain all your options.

If you decide to keep the pregnancy for example, you need to know how to look after yourself and your baby for a successful outcome. Whether you choose to give the baby up for adoption or if you wish to bring up the child yourself, you will benefit for the advice of a doctor with many years of experience in this field. How to deal with your parents is also an important issue.

On the other hand, if you choose to abort your pregnancy, then you need to know your choices and what are the costs involved before it is too late to act and when to have this done with the least complications.

All too often I have seen a young mother come in too late for help to be rendered to her, either because she had already endangered her baby, or it is too late to abort.

It is painful? It is risky? Will I damage my fertility?

Prevention is better than cure, so it is better to use condoms or other methods of contraception, than to use abortion as a method of family planning.

However, if you are pregnant by accident, then abortions can now be performed very safely so that the risk of complications should be the main reason why you wish to carry on with the pregnancy. Instead, you should decide on whether to proceed with the abortion based purely on personal reasons.

Risks are therefore very low and it is unlikely to harm your fertility. In fact, the main problem I see all the time is how to keep the patient from getting pregnant again. I often see the patient with a second request for abortion after the first.

How long does the procedure take?

The procedures are safe and speedy, and for abortions up to 10 weeks, you only need about one hour in a clinic after the first consultation for the abortion to be completed. Between 10 to 15 weeks, you only need one short extra visit to insert medication to soften the doorway to your womb. From 15 to 24 weeks, the baby would need to be delivered intact, and most would only need about 3 to 6 hours in the clinic for this to be completed successfully.

How much does the abortion cost?

For the cost of the abortion, it is important to know exactly how big your pregnancy is. You will need to come for a consultation and an ultrasound examination performed by me. The charges total about $250.

Prices for abortion start from $900 in my clinic, but increase with the increase in the size of the pregnancy. There is also an anaesthetic fee of about $150.00.

Can the price be lowered?

Your health and safety is my main concern. I do not believe in cutting corners, or using cheaper drugs or instruments which can compromise on the quality of the service I provide. I am sorry about the price but I cannot lower it by much for the simple reason that I feel that I cannot compromise on quality and safety. I could use poorer quality drugs or non-disposable instruments - but do you wish to end up with permanent damage to your body, fertility and health after the procedure just to save money?

How much time do I need for the abortion? It is long and painful?

The procedure itself is very fast and needs only 5 minutes for pregnancies up to two and a half months. It is a vacuum suction procedure. However, you will need to be fully prepared before the procedure. This means you need to fast for 4 hours (no food or drink - even water) before seeing the doctor. Also, be prepared to spend about 2 to 3 hours in the clinic. The procedure is performed during sleep - so it is painless. There is no need to stay in hospital because I have the ability to complete the procedure entirely in my clinic - so nobody will suspect that you have gone for an abortion unless you wish people to know.

How many days should I prepare for recovery?

The bigger your pregnancy, the longer the number of days you should take leave.

Providing you with more days of MC or even Hospitalization Leave is no issue. However, many do not wish to take so much leave as it only attracts more questions from your colleagues or your bosses. It really depends on each patient.

So, whilst some wants 2 weeks of Hospitalization Leave to undergo a period of ‘confinement’, other only want one of two days of MC so that nobody will ‘find out’.

Please discuss with me on how many days of rest you need as each person is different with their needs.

How much pain or bleeding will I suffer after the procedure?

This is hard to predict.

Many have hardly any pain or bleeding the day after – and go to work without any problems. This usually occurs to those who have been pregnant before.

Some patients get more bleeding and cramps after the abortion, and need more painkillers and rest. Trying to predict who gets more pain is like trying to predict who gets heavier or more painful periods in future. This is more often the case with first-timers.

Generally when compared to the pain or flow of normal periods, it can be the same, or at most, a doubling of these symptoms at the most. More rest and pain-killers will usually be sufficient.

However, if it persists, please come back and see me.

All patients are given a review date with me and it is import to keep this appointment to ensure that all is well and there are no complications in the future.

Will anyone find out that I’ve had an abortion?
Do I need my parent’s consent? Will my parents find out?

Will anyone find out that I’ve had an abortion?

Full confidentiality is ensured. Parents, boy-friends and husbands are not my patients - you are. Therefore, they will not be informed unless you give me the permission to do so.



Do I need my parent’s consent? Will my parents find out?

No parental consent is needed, even if you are less than 16 years of age (but above 14 year's of age). However, you need to be above 16 years of age before an abortion can be performed with just your consent alone. There is no need to involve any other relatives.

If you have not reached your 16th birthday, you need to be interviewed by the Health Promotion Board Counseling Centre (HPC CC). They will keep it confidential and your parents will not be informed, unless they suspect foul play - like for example if your boyfriend is an adult taking sexual advantage of you, or you have been raped.

So between the age of 14 to 16 years, you only need the special counseling at the Institute of Health (I.O.H.). After this counseling, you will be given a special permit to have the procedure performed. A police report however needs to be made as this is meant to protect you in future.

If you are less than 14 years of age, its a different story. Unless you are married to your lover, it is an offence (often known as statutory rape) for any male to have sexual intercourse with a woman under 14 year's of age. So, if you are below 14 years (and 13 years if married) there will be no medical confidentiality to protect you from being reported to the police and to your parents.

In conclusion: The abortion procedure is entirely confidential and it can be conducted in my clinic in total privacy without her parent's knowledge. Even if they call, I am not allowed to tell them without the patient's approval, as long as she is above 16 years of age.

The procedure will not require your parents' consent if you are above 14 years. If she is less than 16 years of age however, she needs to go for a special counseling.

Can a foreigner have an abortion in Singapore?

The simple answer is bot YES, but also can be NO.

We can only perform abortions for those who have stayed in Singapore more than 4 months and we therefore need to see one of these documents:

  1. Passport with the date of the entry into Singapore;
  2. Employment Pass;
  3. Work Permit;
  4. Student Pass;
  5. Dependant's Pass;
  6. Proof of being the wife of a Singaporean;
  7. Proof of being wife of Employment Pass/ Work Permit Holder.

We cannot perform abortions for foreigners who come into Singapore on a two week Social or Tourist Pass (except for emergency conditions when she starts to undergo a miscarriage). When a person suffers from a spontaneous miscarriage, emergency surgery can be performed as an emergency procedure since she has suffered from a complication which cannot await her return to her country. The situation is also different if she is suffering from a non-viable pregnancy and other complications of pregnancy.

Can I have the procedure straight away on the first visit?

We do not perform abortions on the same day unless you are already in the process of suffering a miscarriage or if you have already been counselled for TOP 2 days prior. This is the law in Singapore.

The reason we are not allowed to abort on the first visit is due to regulations laid done by the Ministry of Health, which wants you to think about the abortion for 2 days after the first consultation. You will be given a tape to watch which highlights the side effects of the procedure, how the abortion is done and some contraceptive advice. You will need to think about whether to carry on with the abortion over 2 days.

Besides, you need to be fully prepared for the procedure (see above).

Do I need to be hospitalized?

No, you do not need to be hospitalized.

Can I use Medisave for abortion?

Yes, Medisave can be used for this procedure, but you will have sufficient funds in your CPF Medisave funds. Deduction is usually partial only. The maximum which can be deducted is $1,200.00.

However, in order for Medisave to be deducted, you need to show:

  1. Your marriage certificate (if you wish to use your spouse’s Medisave);
  2. Your latest Medisave statement; &
  3. Your NRIC.
What will I feel after the procedure?

After the procedure, you can go home as if nothing happened. At most you will feel like having had menstrual cramps. The procedure is therefore fast and convenient and no one will find out unless you tell them. The effects are similar to having a period with some period cramps – or sometimes a doubling of these symptoms. Sometimes you will get a mild fever within 24 hours of the procedure, but it will pass. Others experience more severe period pains and a heavier menses about one week later. Occasionally the bleeding can flow for two weeks.

That is why it is important to come back to see me for the review of the procedure one week after the abortion.

How do I prepare for a small abortion less than 10 weeks?
What does the abortion procedure involve?

On the day of the procedure, you will need to be fully prepared before the procedure. This means you need to fast for 4 hours (no food or drink - even water) before seeing the doctor. Also, be prepared to spend about 2 to 3 hours in the clinic.

The procedure is performed during sleep - so it is painless. Most patients even forget what has happened during the procedure and their first question is “is it over?” or even “When are we starting the procedure?”.

What I am actually doing when you are asleep is to insert a very slim and tiny "straw-like" instrument into your womb and by applying a vacuum suction - I will suck the blood and tissues out. As I said, this only takes about 5 to 10 minutes for pregnancies up to two and a half months - the faster the better as there will be less trauma and complications.

After the abortion, you will need about 2 to 3 hours in the clinic to recover from the sedation.

What happens when my pregnancy is between 10 to 12 weeks?

Between the sizes of 10 weeks to 12 weeks, you will need to have medicine inserted into the vagina to make the abortion safer for you. Basically, it means one extra visit to see me. However, this medicine costs $100, and the procedure itself increases to above $1000 in price.

This first stage of the procedure itself is very fast and needs only 5 minutes. However, for the second visit, you again need to fast for 4 hours (no food or drink - even water) before seeing the doctor. Also, be prepared to spend about 2 to 3 hours in the clinic. The procedure is performed during sleep - so it is painless. The actual procedure is very fast, but you will need about one hour or more for the sedative drugs given to wear off.

And if my pregnancy is more than 13 weeks?

If your pregnancy is already more than 13 weeks, then the procedure is more complicated and requires more than one visit to the doctor. My procedure however does not require you to be hospitalized.

There are 4 stages for an abortion of this size:

STAGE 1: The preparation of the cervix or 'doorway' to the womb.
STAGE 2: The actual delivery of the fetus.
STAGE 3: The delivery of the placenta with D&C or "washing of the womb"
STAGE 4: The prevention of bleeding, lactation and the recovery.

The first stage of the procedure itself is very fast and needs only 5 minutes.

After the first stage, you will need to wait about 2 days before going on to the second stage.

For the second stage during the second visit, you will need to be fully prepared before the procedure. You should not eat anything on the day of the final 3 stages. Normally, the last 3 stages can be completed in about 3 to 8 hours in the clinic.

First, labour is started with tablets and the exact timing of the delivery depends on the strength of the contractions. After the delivery of the baby, we will need to evacuate the placenta (third stage). This procedure is performed during sleep - so it is painless. The actual procedure is very fast, but you will need about one hour or more for the sedative drugs given to wear off.

The final stage is done partially when you're still asleep with injections, and partially with medicine taken when you go home.

Why must I have an operation for the abortion? Instead, can I not choose to swallow a tablet (abortion pill) to induce the abortion like what I read on the internet?

The simple answer:

Yes you can, but it means suffering a spontaneous miscarriage which can be much more stressful, and also much more painful than the simple surgical procedure. It is also not guaranteed to work, and often leads to an incomplete miscarriage, when complications are more damaging and harder to correct than just a simple TOP procedure. There are also hidden and life-threatening dangers like ectopic pregnancies which can complicate such ‘medical’ abortions.

The longer, more complete answer:

There are two commonly used drugs for abortion in the world. The "gold standard" is RU486 (mifepristone), whilst Cytotec (misoprostol) is the other. Both are usually used in combination, but in many cases, when pregnant women are unable to get hold of both, they may only have access to one.

Both are commonly referred to by the public as the "abortion pill".

The name "abortion pill" gives the mistaken notion that all you need to do for an abortion is to pop a pill. It’s not that simple. The doctor first determines if the woman is actually pregnant and for how long. RU486 or mifepristone can be used only within 7 weeks from the last menstrual period. To take it when the pregnancy is beyond 7 weeks will usually end up with the mother with complications and in hospital.

In the Philippines, for example, from an estimated 400,000 induced abortions each year, about 80,000 cases resulted in problems serious enough to require hospitalization. Many of these are due to the mis-use of drugs like Cytotec.

The procedure of using the "abortion pill" is long, tedious, painful and filled with potential dangers. An abortion using mifepristone consists of three steps and using the two different drugs mentioned above in combination. The entire procedure needs to be supervised by a physician.

The woman takes three pills of mifepristone during the first visit after seeing the doctor. After 36 to 48 hours, she has to return to the doctor to take two tablets of misoprostol (Cytotec), which has been long been in use locally as an "abortion pill", distributed through the black market. Misoprostol is a prostaglandin that makes the uterus contract to expel the embryo.

Finally, two weeks after initiating the abortion, the woman has to return to the doctor to make sure the abortion is complete and that no fetal tissue remains in her uterus. In about 5 percent of the cases using this misoprostone-misoprostol combination, the abortion is incomplete and the doctor will have to surgically remove the fetal tissue from the uterus. About 1 percent of the women may experience bleeding that is so severe it will require blood transfusions. In France, where RU-486 has been legal since 1988, the number of abortions has not increased, with some women actually complaining that taking the pill can be more distressing than going through a surgical abortion.

We can see this method of abortion is not without problems. The most common side effects are bleeding, cramping, nausea, headaches and diarrhea.

RU486 is not legally available in Singapore, mainly for the above complications and inconveniences. Where it is available, it is also not cheap. Besides, you need to undergo a miscarriage - an unpleasant experience for anyone. Also there are other complications - like prolonged bleeding and incomplete abortions where the woman still needs to undergo operation to clean up the womb.

It is far better to have the standard procedure as performed in Singapore: See a qualified doctor, go to sleep and when you wake up a few minutes later, the painless procedure is fully completed. It is basically a vacuum aspiration method to clean the womb of its contents. It is a simple 5 minutes procedure when performed in experienced hands and with extremely low complication rates. I have been performing this without problems for the past 20 years in my clinic.

The use of Cytotec carries many risks mainly because it is self-administered at home, and without access to trained health professionals. Bleeding and incomplete abortions are the most common problems with self-administered Cytotec and may be serious as to require hospitalization. The use of Cytotec is therefore not recommended for use in Singapore because of the high incidence of these side-effects.

What exactly is “Menstrual Regulation” and how is it done?

"Menstrual regulation" is just another name for the standard procedure performed by me and other doctors in Singapore - a simple painless washing procedure of your womb.

Menstrual regulation is the induction of a menses before a pregnancy test is positive and can be performed either medically or surgically. Just come and consult me first and I will attempt to induce your menses with an injection, or oral tablets. If the pregnancy is very early (before usual methods of detection) and has not taken hold yet, this induction of the menses can 'flush' the pregnancy out. However, it is only successful in one third of the cases where there is a pregnancy present which cannot be detected yet by a urine test.

Once you have missed your menses, and if your pregnancy test is still negative, you can 'clear up' the contents of your womb with a standard 'D&C" or Dilatation and Curettage method, which is similar to the abortion process. Therefore you need to be fully prepared (see above). Besides the normal risks associated with a standard abortion, Menstrual regulation by D&C carries the added risk of not aborting a very early pregnancy which is still in the Fallopian Tubes. This may require a second D&C to be performed once the pregnancy enters the womb.

When you choose this approach, you only need to pay for consultation fees ($80). However, once your pregnancy test is positive, you need to go through the normal process for an abortion and an ultrasound examination (another $80) needs to be performed.

However, you can see that there are certain disadvantages to doing a 'Menstrual Regulation' (=MR).

Firstly, it may just be a delayed menses and if you wait the menses may just come on it's own. Doing a MR may therefore be not necessary. Secondly, if the MR is performed too early when a women is pregnant and the pregnancy is still in the Fallopian tubes and hasn't entered the womb would mean that the operation will be unsuccessful in removing the pregnancy.

What are the complications of abortion?

Like all surgical procedures there is the possibility of complications, the most common of which include infection and physical harm to the womb if incorrectly done. The immediate side effects are damage done to the womb like perforation which occurs when the scrapping is not done properly. Also important is infection which occurs because once the womb is evacuated, there is an internal wound within the womb that can get infected by germs coming up from the vagina.

I offer ‘live’ ultrasound coverage during the abortion procedure to ensure that your womb is fully cleared and that such perforation is prevented. Antibiotics are also offered in all cases to prevent infection.

You will be given a video to explain the procedure and it's complications will be explained there. If you're still in doubt, you can ask me during the consultation. You need to wait 2 days after seeing me before the abortion can be performed.

After the procedure, you can go home as if nothing happened. At most you will feel like having had menstrual cramps.

Can I pay in installments?

I sympathize with your present predicament, but I am sorry but I do not accept partial payments.

However, if you have a UOB credit card, you can pay by interest free installments.

In the early years I used to accept such payments, but almost all the patients after having had the abortion never came back to see or pay me. They were just taking advantage of my trust and charity.

However, don't wait too long as the cost for the procedure rises very rapidly. Better to borrow the money and have the procedure done earlier when it is simpler, cheaper and less likely to give you problems.

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