Unplanned Pregnancy: Causes, Implications, Management

What is an unplanned pregnancy?

An unplanned pregnancy occurs when conception happens without explicit intention or preparation. It can catch individuals and couples off guard, leading to a range of emotions and necessitating careful consideration of available options.

What are the causes of unplanned pregnancies?

1. Failure of contraception: 

   • Even with the best intentions and careful planning, contraceptives can sometimes fail due to inconsistent use, incorrect application, or method-related issues.

2. Lack of contraception: 

   • Unplanned pregnancies often occur when contraception is not used or used inadequately..

3. Failure of sterilisation procedures: 

   • In rare cases, individuals who have undergone sterilisation procedures, such as tubal ligation, may still experience unintended pregnancies if the procedure fails.

4. Lack of sexual education:

   • Insufficient knowledge about sexual health, reproductive anatomy, and contraception can contribute to unplanned pregnancies. Comprehensive sexual education is crucial for informed decision-making.

What are the implications in management of unplanned pregnancies in Singapore?

1. Emotional impact: 

   • An unplanned pregnancy can bring a whirlwind of emotions—surprise, fear, and uncertainty are all normal feelings. Your emotional well-being might be influenced by societal expectations, relationship dynamics, and personal beliefs.

2. Relationship dynamics: 

   • Discovering an unplanned pregnancy can significantly affect your relationships. Open communication and mutual support from your partner and loved ones are essential during this time.

3. Financial considerations: 

   • The financial implications of an unplanned pregnancy can be significant. You may need to reassess your financial situation and plans to accommodate the new addition to your family.

4. Balancing career/education and parenthood: 

   • Balancing the demands of parenthood with your career and education goals becomes crucial. 

   • For many women, balancing the demands of a career with the responsibilities of unexpected parenthood can be daunting. The pressures of maintaining employment and securing adequate maternity leave can create additional stress.

   • Thoughtful planning and adjustments will help you navigate these new responsibilities while pursuing your aspirations.

5. Cultural and societal stigma: 

   • In Singapore, strong cultural and societal norms can create stigma around unplanned pregnancies, particularly for unmarried women. This stigma can lead to feelings of shame, isolation, and reluctance to seek help or discuss their situation openly.

How to deal with an unplanned pregnancy?

1. Take a deep breath: 

   • First and foremost, give yourself time to process the news. It's natural to feel overwhelmed, but taking a moment to breathe and reflect can help you think more clearly about your next steps.

2. Seek support:

   • Talk to someone you trust, whether it's a partner, friend, family member, or counsellor. Sharing your feelings and concerns can offer emotional relief and provide valuable perspective. 

   • Professional counseling services can guide you and your partner through processing emotions, making informed decisions, and developing effective coping strategies.

   • Support groups and community resources also offer opportunities to share experiences and receive advice from others who have faced similar situations.

3. Gather information: 

   • Educate yourself about your options. This includes understanding your choices for continuing the pregnancy, adoption, or termination. Reliable sources like healthcare providers, counsellors, and trusted organisations can offer valuable information. Remember, this is your journey, and it's important to choose the path that aligns with your needs and circumstances.

     • Continuing with pregnancy and becoming a parent: Deciding to become a parent may require reevaluating your life plans, financial stability, and emotional readiness. It's important to seek prenatal care early in your pregnancy to ensure the health of both you and your developing baby.

     • Adoption: If you feel unprepared for parenthood, adoption offers an alternative. Thoroughly research adoption processes and agencies to make informed decisions and find the best path for you and your baby.

     • Termination: Choosing to terminate a pregnancy is a deeply personal decision. Access to safe and legal abortion services, where available, is essential for those considering this option. Pre-abortion counseling and post-abortion support can help you cope with the emotional aspects of your decision.

4. Consult a doctor:

   • Schedule an appointment with an obstetrician/gynaecologist to discuss your situation. They can provide medical advice, answer questions, and help you understand the implications of each option – continue with pregnancy or termination.

   • Prenatal care: If you choose to continue your pregnancy, early and consistent prenatal care is crucial. Regular check-ups help monitor your health and your baby’s development. Your doctor can offer valuable guidance on nutrition, lifestyle adjustments, and emotional well-being.

   • Reproductive health services: Access to comprehensive reproductive health services empowers you with the information and resources needed to make informed choices about your pregnancy. Family planning services, contraceptive counselling, and sexual health education are vital in preventing future unplanned pregnancies.

5. Consider your values and beliefs: 

   • Reflect on your personal values, beliefs, and circumstances. Think about what is most important to you and how each option aligns with your life goals and values.

6. Assess your support system: 

   • Consider the support you have available from your partner, family, and friends. A strong support system can make a significant difference in managing an unplanned pregnancy.

7. Evaluate your financial situation: 

   • Take a realistic look at your financial situation. Consider the costs associated with raising a child, as well as any available resources or assistance programs that could help.

8. Think about your long-term goals: 

   • Consider how an unplanned pregnancy might affect your long-term goals, such as education, career, and personal aspirations. Think about the adjustments you may need to make and how you can achieve your goals with a new set of circumstances.

9. Make a decision: 

   • Once you have gathered all the information and considered your options, make the decision that feels right for you. Remember, this is a personal choice, and it’s important to do what’s best for your well-being.

10. Take care of yourself: 

    • Regardless of your decision, prioritise self-care. Eat well, get enough rest, and seek emotional support when needed. Taking care of your physical and mental health is crucial during this time.

11. Follow up with professional care: 

    • Stay in touch with healthcare professionals to ensure you receive the necessary medical care and support throughout your journey, whether you continue the pregnancy, choose adoption, or decide on termination.

Remember, you are not alone, and there are resources and people available to support you through this process.

What are the reasons to keep an unplanned pregnancy?

1. Emotional and personal fulfillment: 

   • You may discover a deep sense of joy and fulfillment in becoming a parent. The bond you form with your child can be incredibly rewarding and bring immense happiness to your life.

2. Partner’s wishes: 

   • If your partner is eager to become a parent and is committed to raising the child together, their support and desire can significantly influence your decision.

3. Strong support system:

   • If you have a supportive partner, family, or friends, they can provide the emotional, financial, and practical help you need. A strong support network can make the journey of parenthood more manageable and fulfilling.

4. Alignment with personal beliefs:

   • Your personal, cultural, or religious beliefs might prioritise the sanctity of life and the value of family. These values can strongly influence your decision to continue the pregnancy.

5. Financial stability:

   • If you have the financial resources or access to assistance programs, you might feel prepared to provide for your child’s needs. Financial stability can give you confidence in your ability to raise a child.

6. Future family planning: 

   • Even if the timing wasn’t planned, you might have always wanted to start or expand your family. This pregnancy could be an opportunity to welcome a new member into your family sooner than expected.

7. Health considerations: 

   • Your health circumstances might make continuing the pregnancy the best option for you. Consulting with your healthcare provider can help you understand the implications for your well-being.

8. Comfort with alternatives: 

   • You might feel uncertain or uncomfortable with alternatives like adoption or termination. Keeping the pregnancy can seem like the most straightforward and comfortable choice for you.

9. Availability of resources: 

   • Access to quality healthcare, educational programs, and community support can provide you with the necessary resources to navigate pregnancy and parenthood successfully.

10. Personal growth: 

    • Facing the challenges of an unplanned pregnancy can lead to personal growth and development. Many find that parenthood strengthens their resilience, adaptability, and capacity for love.

Remember, the decision to keep an unplanned pregnancy is deeply personal. Take the time to reflect on your unique circumstances, values, and the support available to you. Reach out to trusted individuals for advice and support, and make the choice that feels right for you.

FAQ

What is an unplanned pregnancy hotline that I can call in Singapore?

If you're facing an unplanned pregnancy and need someone to talk to, you can call the following hotlines:

1. Pregnancy Crisis & Support at 6339 9770

2. AWARE Women’s Helpline at 1800 777 5555

3. Babes Pregnancy Crisis Support – for individuals aged 21 and below – at 6206 6641 or 8111 3535 (WhatsApp)

4. aLife at 9183 4483 (WhatsApp only)

Is abortion legal in Singapore?

Yes, abortion is legal in Singapore under specific conditions outlined by the Ministry of Health's Termination of Pregnancy Act.

A medical practitioner can perform an abortion on a pregnancy that is less than 24 weeks if the woman is:

• A citizen of Singapore or the wife of a Singapore citizen.

• A holder or the wife of a holder of a work permit pass or employment pass. Having a temporary work permit is insufficient. Either the pregnant woman or her husband must hold a work permit pass issued under the Immigration Act.

• A resident of Singapore for at least four months.

Exceptions are made if the procedure is immediately necessary to save the life of the pregnant woman. A pregnancy termination after 24 weeks can only be performed if it is immediately necessary to save the life of the pregnant woman or to prevent grave permanent injury to her physical or mental health.

The decision to terminate a pregnancy must be made by the pregnant woman herself and requires her explicit consent.

What can I do to stop 1 week of pregnancy?

If you are considering terminating a pregnancy at one week, it's essential to seek professional medical advice as soon as possible. Here’s what you can do:

1. Confirm the pregnancy: 

   • First, confirm that you are indeed pregnant. Home pregnancy tests are a good starting point, but a visit to a doctor can provide more accurate results.

2. Consult a doctor: 

   • Schedule an appointment with a gynaecologist to discuss your options. He/she can provide you with information on the safest and most effective methods for early termination.

3. Understand your options: Your healthcare provider will explain the available options, which may include:

   • Medication abortion: This involves taking prescribed medications (usually mifepristone followed by misoprostol) to terminate the pregnancy. This method is effective in early pregnancy and can be done at home under medical supervision.

   • Surgical abortion: Although less common at such an early stage, a surgical procedure (such as aspiration) may be an option. Your gynaecologist will advise if this is suitable for you.

4. Follow professional guidance:

   • It’s crucial to follow the instructions and guidance provided by your gynaecologist. He/she will ensure that you receive the appropriate care and support throughout the process.

5. Seek emotional support: 

   • Consider seeking counselling or support from trusted friends, family, or professional services to help you cope with the emotional aspects of your decision.

Important considerations:

• Act quickly: Early intervention is important for the effectiveness and safety of termination methods.

• Legal and safe: Ensure that you access services that are legal and safe. In Singapore, abortion is legal and accessible up to 24 weeks of pregnancy, but specific regulations apply.

• Confidentiality: Medical consultations and services are confidential, so you can seek help without fear of your privacy being compromised.

What are the types of induced abortion?

If you're considering an induced abortion, there are two common methods available:

1. Instrumental evacuation of the uterus after cervical dilation

2. Medication induction (drugs to stimulate uterine contractions)

The stage of your pregnancy plays a significant role in determining the appropriate method. Here’s how it breaks down:

• Before 11 Weeks: Medical abortion can be performed on an outpatient basis using medication induction. This involves taking prescribed medications at home or in a clinical setting.

• 11 to 15 Weeks: Most pregnancies in this range are typically handled with instrumental evacuation. This method ensures a controlled and safe procedure.

• Beyond 15 Weeks: Medication induction is often used, but it requires careful monitoring due to the risk of significant bleeding. Patients undergoing this procedure should be observed by healthcare professionals to ensure safety.

What are the major complications of induced abortion?

Complications from legal abortions are rare, with serious complications occurring in less than 1% of cases and mortality rates being less than 1 in 100,000. However, the risk of complications increases as the pregnancy progresses. Here are some potential complications to be aware of:

Serious early complications:

1. Uterine perforation: 

   • An instrument may accidentally perforate the uterus, and less commonly, the intestine or another organ could be injured.

2. Major bleeding: 

   • This can occur due to trauma or uterine atony (when the uterus doesn't contract properly).

3. Cervical laceration: 

   • The cervix may be injured during the procedure.

Anesthesia complications: Both general and local anesthesia are typically safe, and serious complications are rare.

Common delayed complications:

1. Bleeding and infection: 

   • These are the most common complications following an abortion.

2. Infertility: 

   • This can result from adhesions in the endometrial cavity (Asherman syndrome) or tubal fibrosis due to infection.

3. Cervical incompetence: 

   • Forceful dilation of the cervix in more advanced pregnancies can lead to cervical incompetence. However, with evidence-based techniques such as gentle suction and adequate cervical preparation, the risk of future pregnancy complications is not expected to increase.

4. Psychological complications: 

   • Some women may experience psychological effects such as depression or, in rare cases, psychosis.

It’s important to discuss any concerns with your gynaecologist. They can provide detailed information on the procedure, help you understand the risks, and ensure you receive the best possible care. Remember, legal abortion is generally very safe, and your healthcare team is there to support you throughout the process.

References 

1. Frances E. Casey , MD, MPH, Virginia Commonwealth University Medical Center. Induced Abortion. MSD Manual. Reviewed/Revised Jul 2023 | Modified Aug 2023.

2. Guideline On Termination Of Pregnancy (Top) For Hospitals In The Ministry Of Health