Complications of Abor tion 253
7. Move your finger across the opening and feel
for bits of the pregnancy that may be sticking
out of the opening. They will feel like soft
meat. Gently try to remove them. If the pieces
are too slippery, take your hand out and wrap
2 fingers with sterile gauze, or a clean cloth
that has been boiled in water, and try again to
8. After you have removed the
pieces, put your gloved hand
into the woman’s vagina with
two fingers under the womb.
With your other hand, rub
or massage her belly to help
stop the bleeding. Her womb
should be between your 2 hands.
9. Give the woman an injection of
ergometrine (0.2 mg) in a large muscle,
such as her buttock or thigh. Then give her one 0.2 mg pill
or injection of ergometrine every 6 hours for 24 hours. Or
you can use misoprostol: give 600 mcg by mouth or insert
600 mcg into the rectum (wear gloves).
10. Give antibiotics to prevent infection immediately (see
page 256). She is at high risk of infection because the womb
is open to germs.
11. If she is awake, give her fluids to drink. If she is unconscious, see
the next page.
12. Take her to a hospital right away, even if you think you have
removed the tissue and the bleeding has stopped. She still
needs to have her womb emptied completely. If the bleeding
does not stop, continue to rub or massage her lower belly
while taking her to the hospital.
how to give an
When there is no health worker to help
If you are bleeding too much after an abortion, and you have tried
the steps on page 251, you can also try to remove tissue stuck in
your cervix by yourself.
First wash your hands and genitals well with soap and
clean water. Then squat and bear down, as in childbirth or
passing stool, and follow the instructions above in steps 6
and 7. After you have removed any pieces, massage your
lower belly (see page 251). You should still get medical
help, even if the bleeding becomes less.
Where Women Have No Doctor 2012