There are two main types of abortion: pharmacological and surgical.

The surgical method is an outpatient procedure performed under general anesthesia, where pregnancy tissue is suctioned out, and it lasts about 10-15 minutes.

In practice, there is sometimes a distinction between the surgical methods of mini-abortion (up to 7-8 weeks) and abortion (from 8 to 12 weeks). The mini-abortion is a less invasive (and in some medical facilities, cheaper) procedure, considering it is performed at an early stage of pregnancy.

Pharmacological abortion is usually performed only up to the 7th week of pregnancy and involves the administration of two medications (mifepristone and misoprostol), which must be taken in the hospital under the supervision of medical staff, with a 36- to-48- hours interval between them.

After taking medication and spending the mandatory time in the hospital, you can return home. The abortion process will begin after the second dose of medication, within about 1-4 hours.

Abortion up to the 12th week of pregnancy must be paid for by you; abortions for medical reasons (due to embryo pathological reasons, threats to the life and health of the pregnant person, and in the case of an ectopic pregnancy) are covered by health insurance.

The cost of an abortion varies depending on the chosen method and facility. On average, the price for a pharmacological abortion and mini abortion is around 4000 CZK. The cost of surgical abortion in a hospital is about 5000 CZK, while in a private clinic, it’s around 9000-11000 CZK. In addition to the procedure or medication, you will also need to pay for a referral for pregnancy termination (500-1000 CZK) from a gynecologist.

If the pharmacological method fails, and a surgical abortion is required to complete the termination, no additional payment is required for the procedure. The abortion is free of charge if fertilization occurs despite having an intrauterine device in place

Abortion is safe, whether performed using the vacuum aspiration method or prescription medicine. It is one of the safest medical procedures, with a lower complication rate than other common medical procedures, such as wisdom tooth extractions. In fact, abortion pills are safer than medications like penicillin or Viagra. [1]

[1] https://www.ncbi.nlm.nih.gov/search/research-news/18556/

a) Deaf/Hard of Hearing People

If you need sign language interpretation and the hospital’s website does not provide information about such an option, you can check the Ticha Linka map to see if the hospital works with interpreters.
Ticha Linka is a free service that provides sign language interpretation and transcription of spoken language to text online. The client selects the appropriate service when using it. If they communicate in sign language, they choose the online interpretation service and connect with an interpreter via video call. If they communicate in Czech, they select the transcription service and connect with a transcriber through a text window. The interpreter/transcriber then facilitates communication over the phone or in person, editing or translating text.

b) Blind People / People with sight impairment

A person with a sensory disability who uses a specially trained dog has the right, due to their current health condition, to have the dog with them for care and support in any medical facility in the Czech Republic.

c) Persons with Mobility Disabilities

All hospitals should be accessible to people with mobility disabilities. Unfortunately, hospitals rarely provide information about their accessibility on their websites, so in case of doubt, contact the facility directly.
A person with a physical disability who uses a specially trained dog has the right, due to their current health condition, to have the dog with them for care and support in any medical facility in the Czech Republic.

Hormone therapy and abortion do not affect each other, so even if you are undergoing hormone therapy, you can safely terminate your pregnancy.

Since sterilization is still one of the conditions for official gender change in the Czech Republic (this is expected to change in 2025 after a decision by the Constitutional Court in May 2024), our legislation unfortunately does not foresee that men may need to terminate a pregnancy. Therefore, if you need an abortion but are officially recognized as a man (if you officially transitioned outside the Czech Republic), you may face refusal of abortion at the hospital or clinic.

Since the Constitutional Court has abolished the sterilization requirement, we believe the law will change in this regard as well. In the meantime, you can use the option of ordering abortion pills for at-home pharmacological abortion from Women Help Women or travel abroad (e.g., to Germany or Austria). More information about abortions abroad can be found here. 

If you are under 16 years old, you will need parental or guardian consent. Between the ages of 16 and 18, consent is not required, but the clinic or hospital must inform your parent or guardian after the procedure.

If you are a minor and are from outside the Czech Republic, a parent or legal guardian must be with you.

In Austria and Germany, abortion is available to minors without the presence or notification of a parent/legal guardian. You can learn more about abortion abroad here.

A) People from the EU

Individuals who have permanent residence in any EU country have the right to terminate their pregnancy in the Czech Republic. Unfortunately, due to an unclear legal provision from 1986, hospitals often deny this procedure to people from outside the Czech Republic and require proof of permanent residence in the Czech Republic. However, the termination of pregnancy is legal for all EU citizens, as evidenced by a statement from the Ministry of Health in 2022.

In the Czech Republic, the activist collective Ciocia Czesia helps people from Poland access abortion services—you can contact them for information, as well as ask for logistical or financial support.

B) People from outside the EU

If you are from outside the EU and do not have permanent residence in any EU country, you may face refusal for an abortion procedure. In such a situation, you can:

• Order abortion pills (a set of mifepristone and misoprostol) from the feminist organization Women Help Women for a donation of 75 EUR. You can read about how a pharmacological abortion works here. You can learn about the procedure of at-home abortion on the Women Help Women website.

• Travel to a country where abortion is legal regardless of nationality (e.g., Germany or Austria, where abortion without providing a reason is legal up to the 14th week of pregnancy). More information about abortion in other countries can be found here. 

Ectopic pregnancy is a condition in which a fertilized egg implants in a location other than the uterus (most often in the fallopian tube). It is a life-threatening and health-compromising complication that requires prompt medical intervention.

In early pregnancy, it may happen that the pregnancy will not be visible on ultrasound, even if it has implanted in the uterus. In such a case, if it is an unwanted pregnancy, the doctor may recommend dilation and curettage (similar to surgical abortion). Then, the level of the pregnancy hormone HCG in the blood is checked. If HCG remains in a similar range, and an embryo is present in the fallopian tube, in many cases, the pregnancy must be removed surgically (through removal of the fallopian tube or its incision and removal of the embryo).

In some cases, there is a chance that the pregnancy will miscarry naturally without the need for surgery, so even in the case of an ectopic pregnancy, the doctor may choose to wait and observe.

It is important to always be under the supervision of a doctor, so do not delay your visit or attempt to treat an ectopic pregnancy on your own.

Do not trust false information about the possibility of reimplanting or transferring an ectopic pregnancy to the uterus. Unfortunately, this procedure is not possible even today and attempts to perform it can lead to further health complications, such as secondary infertility.

In the Czech Republic, abortion cannot be performed earlier than 6 months after the last abortion (unless there are serious medical reasons). The only exceptions are situations where the person has given birth at least twice, has reached the age of 35, or there are valid reasons to suspect that pregnancy occurred due to a crime committed against them.

There are very few contraindications for medical abortion. These are:

• Genetic porphyria
• Chronic adrenal insufficiency or liver failure
• A prior severe allergic reaction to mifepristone or misoprostol
• Ectopic pregnancy

If you have an intrauterine device (IUD) in place, it is recommended to remove it before the abortion because bleeding during the abortion will be heavier than for those without an IUD.

In the case of an ectopic pregnancy, the medications used for medical abortion will not work. In such a situation, do not hesitate to seek medical help as soon as possible.

M 

• If you already know that you are pregnant or suspect that you might be, first go to a gynecologist to confirm the pregnancy and perform an ultrasound to check the age of the fetus.
• If you want to terminate the pregnancy, immediately inform the doctor and ask for a referral for abortion.
• The doctor will provide you with documentation of the visit, which should indicate that it is an unwanted pregnancy, and will issue a referral for abortion (usually costing around 500-1000 CZK).
• If the doctor refuses to issue a referral, request a written refusal. The decision to terminate the pregnancy is entirely up to you, and the doctor should not interfere or assess it. According to the law, the patient has the right to terminate the pregnancy up to 12 weeks, and a refusal to issue a referral can be considered a violation of patient rights.
• After receiving the referral, schedule a visit to the hospital or gynecological clinic for the abortion (by email, phone, or in person). Medical abortion can only be performed legally at a healthcare facility with inpatient care (usually only hospitals). Larger gynecological clinics have facilities for surgical procedures, but expect higher costs.
• If you are unsure about something, take some time to think through your doubts and write down any questions you may want to ask the doctor. Don’t be afraid to ask questions – as a patient, you have the right to receive all the essential information. Even if you have decided to terminate the pregnancy, it is normal to have concerns or doubts. Also, remember that until the abortion begins, you have the right to change your mind and cancel the procedure.

• Upon arrival at the hospital, the doctor will first confirm that the pregnancy does not exceed the allowed limit. 
• The doctor will then conduct a medical interview and check if there are any conditions that might be considered contraindications (but these are very rare). If you have other health issues, have had a C-section, or are taking any medications, make sure to mention this.
• You will fill out the necessary documentation and then pay for the procedure and additional services.
  It is also necessary to have a blood test to confirm your Rh factor and a syphilis test. If you already know your Rh factor, bring the documentation to confirm the result.
• Essential blood tests cost around 700 CZK, and the medical abortion method costs approximately 3500-5500 CZK (depending on the hospital). If you have Rh- blood type, you will also need to pay for an immunoglobulin injection (about 2000 CZK) to prevent the production of antibodies during the next pregnancy and the development of hemolytic disease in the newborn.
• You will then receive the first dose of the abortion medication, Mifepristone (600 mg, known as Mifegyne, 3 tablets of 200 mg, taken orally). The tablets must be taken in the presence of a doctor.
• After taking the medication, you will stay in the hospital for about an hour due to the possibility of side effects. The exact waiting time is not specified by law, so you may be discharged earlier.
• Before leaving the hospital/clinic, you will be immediately scheduled for the second dose.

• Most people do not experience any symptoms after taking Mifepristone and continue functioning normally. There may be light spotting and/or nausea.
• Miscarriage after the first dose is rare, but it can happen in the case of a threatened pregnancy.

• After 36-48 hours, return for the second dose. This is a medication containing misoprostol in a 400 μg dose (known as Mispregnol, 1 tablet). It is usually placed under the tongue, where it is kept until the tablet dissolves.

• Before the second visit, it is recommended to avoid alcohol and eat light, easily digestible foods due to possible nausea.

• Bring with you: any medications you are taking, pads (in case bleeding starts before you get home), something to drink, and a close person to take care of you.

• You will stay on the ward for about an hour in case of side effects – these may include nausea or rapid action of the medication causing strong pain (in which case you will stay until you feel better – but this happens very rarely).

• If you experience nausea, the doctor may give you Ondansetron. You can also ask for pain relief.

•  You should have a companion with you who will take you home, especially if you live far from the hospital.
• At home, prepare: a supply of pads (avoid tampons and menstrual cups), a hot water bottle or heating pad, a blanket to cover yourself, comfortable clothing, something to drink, something light to eat, and your favorite movie or TV show. You should also have access to a toilet.
• What to do while waiting? Physical activity can speed up the miscarriage process. However, if you feel unwell, lie down and turn on the TV or some relaxing music. Your mental and physical comfort is the most important thing at this time. Try to relax as much as possible – you have nothing to worry about.
• If possible, it’s good to have someone with you for support and to distract you. Or at least have a phone nearby in case you feel worse.
• You can take painkillers like ibuprofen. Avoid using Ataralgin, Buscopan, and especially antispasmodics (e.g., No-spa), as they may interfere with the action of misoprostol, which causes uterine contractions – these are key for a smooth miscarriage.

What to expect:

• Misoprostol can start working within 1-4 hours (but sometimes later).
• Bleeding is usually the first sign that the abortion has begun. Then, contractions and pain will follow. The symptoms may vary – some people experience stronger menstrual-like cramps, while others may have pain similar to labor (this is less common). Everyone experiences them differently, but there is no need to fear the worst – complications are very rare.
• The bleeding is usually heavier than a normal period, and you may notice pieces of shedding uterine lining (which look like clots and are completely normal) or pregnancy tissue. The embryo is the size of a blueberry at 7 weeks, so do not be afraid to look at the tissue. The higher the gestational age, the stronger the uterine contractions and bleeding.
• The heaviest bleeding usually starts 2-5 hours after taking misoprostol and gradually decreases within 24 hours. The strongest contractions and bleeding typically last 3-5 hours.
• Side effects include: elevated temperature, chills, diarrhea, or vomiting, which usually resolve within a few hours. Light bleeding (spotting) may last for 1-3 weeks.
• All time frames mentioned are approximate and may vary slightly for each person. Everybody is different and reacts differently.

Complications are very rare with medical abortion, and although the abortion process may seem scary at first glance, the body reacts as it would with a natural miscarriage.
However, as with any procedure, it is important to consider possible complications. If you believe you have experienced any medical complications, do not hesitate to seek medical help immediately.

Heavy bleeding (less than 1% of cases)
If you experience heavy bleeding (more than 2 maxi pads per hour for more than 2 hours), accompanied by dizziness or lightheadedness (which may indicate blood loss), you should immediately contact a doctor. This is a serious medical complication that requires help.

Infection
Persistent symptoms such as high temperature (lasting more than one day), chills, foul-smelling discharge, nausea, vomiting, or physical weakness are possible signs of an infection. In such cases, uterine cleansing and the administration of antibiotics are necessary, so you should contact a doctor as soon as possible. If you experience fever, chills, physical weakness, or fainting, go to the emergency room immediately.

No bleeding or very light bleeding
No bleeding may indicate an ectopic pregnancy (especially if there are contractions but no blood). This is a serious and life-threatening complication, so seek medical help as soon as possible. Lack of bleeding may also mean the medication did not work. In this case, contact your doctor. The medical abortion can be repeated, but doctors usually recommend surgical abortion (for which you will not have to pay again). In such a case, do not hesitate to go to the emergency room.

Incomplete abortion
Heavy and prolonged bleeding, as well as pain, persistent pregnancy symptoms, may indicate that pregnancy tissue remains in the uterus and will need to be surgically removed.

Allergic Reactions
Severe skin rashes, such as itchy red spots, blisters, or lesions, may be signs of an allergic reaction to the medication.

Cardiovascular Events
Chest pain, difficulty breathing, confusion, or irregular heartbeat.
Serious or fatal cases of toxic or septic shock. Fever with muscle pain, rapid heartbeat, dizziness, diarrhea, vomiting, or weakness.

More information is available in the Mispregnol medication leaflet.

Check if everything went as it should and schedule a follow-up appointment after 2-3 weeks (again at the healthcare facility where you went for the first and second doses of the medication).
During the follow-up visit, an ultrasound will be performed, and possibly a pregnancy hormone (hCG) test to confirm that the pregnancy has been terminated and that all pregnancy tissue has been expelled. In some cases, surgical uterine cleansing is necessary. If the doctor suspects an infection, the patient will undergo a procedure and receive antibiotics.

In rare cases (1-3%), the medication may not work, and the pregnancy will continue. If you choose to continue the pregnancy at this time, the doctors will inform you about the increased risk of abnormal fetal development, and you will sign an informed consent form and receive information about other necessary tests.

In the Czech Republic, a pregnancy cannot be terminated earlier than 6 months after the last abortion (unless there are serious medical reasons). The only exceptions are situations in which the person has given birth at least twice, is over 35 years old, or there are reasonable grounds to suspect that the pregnancy resulted from a crime committed against them.

Contraindications to vacuum abortion may include multiple cesarean sections, blood, and heart diseases. Any concerns regarding your health should be discussed when scheduling the procedure.

• If you already know that you are pregnant or suspect that you may be pregnant, the first step is to visit a gynecologist to confirm the pregnancy and undergo an ultrasound to check the fetal age.
• If you wish to terminate the pregnancy, inform the doctor immediately and request a referral for an abortion.
• The doctor will provide you with documentation from your visit, which should include confirmation that this is an unwanted pregnancy, and will issue a referral for the abortion (for which you will typically pay around 500-1000 CZK).
• If the doctor refuses to issue the referral, ask for the refusal in writing. The decision to terminate the pregnancy is solely yours, and the doctor should neither interfere with nor judge it. According to the law, the patient has the right to terminate the pregnancy up to the 12th week, and a refusal to issue a referral by the doctor can be considered a violation of patient rights.
• You will receive a referral for preoperative testing, which is required before general anesthesia. This test is carried out by your general practitioner or an internist. In some facilities, it can be done immediately at the hospital—ask about this when scheduling the visit.
• After receiving the referral, schedule an appointment at the hospital or gynecological clinic for the abortion.
• If you are unsure about anything, take some time to think through your doubts and write down any questions you may want to ask the doctor. Don’t hesitate to ask questions— as a patient, you have the right to receive all necessary information. Even if you are certain about having an abortion, it is normal to have concerns or doubts. Remember that until the procedure begins, you have the right to change your mind and cancel the procedure.

Before the procedure, you must fast, so it is recommended that you refrain from eating, drinking, or smoking for at least 6 hours before arriving at the clinic.

Take the following items with you to the hospital/clinic:

• ID card
• Referral from the gynecologist
• Preoperative test results (preoperative profile)
• Nightgown/long t-shirt
• Socks
• Large sanitary pads
• Pain relievers (e.g., paracetamol, ibuprofen, but not antispasmodics like No-Spas)
• Medications you take regularly
• Also, plan your return trip—after general anesthesia, you are not allowed to drive for 24 hours.

• The procedure lasts about 15 minutes, but you will spend around 3-4 hours at the clinic—this includes completing documentation, preparing for the procedure, and recovering after the p.
• The visit begins with a medical examination, including an ultrasound to confirm the pregnancy’s age.
• After changing, the doctors will administer general anesthesia in the operating room. In the Czech Republic, it is not possible to perform the procedure with only partial anesthesia.
• Using a speculum, the doctor will first expose the cervix and then suction the contents of the uterus with a special tube.
• After waking up from the anesthesia, you will rest in the recovery room to recover from the anesthesia.
• If you are Rh-, you will receive an injection to prevent a potential Rh incompatibility in future pregnancies.
• After waking from anesthesia, you cannot drive for the next 24 hours.

Complications after a vacuum aspiration abortion are extremely rare, and they are usually easy to treat with no long-term health consequences.

However, as with any procedure, it’s important to consider possible complications.

Infection

Persistent symptoms such as a high temperature (lasting more than one day), fever, chills, foul-smelling discharge, nausea, vomiting, or physical weakness may indicate an infection. In such cases, uterine cleaning and antibiotics are necessary, so you should contact the doctor immediately. If you experience fever, chills, physical weakness, or fainting, you should go to the emergency room immediately.

Severe Bleeding

If you experience heavy bleeding (more than 2 maxi pads per hour for over 2 hours), accompanied by dizziness or lightheadedness (which could indicate blood loss), you should immediately contact a doctor. This is a serious medical complication that requires medical assistance. In such a case, do not hesitate to go to the emergency room.

Incomplete Uterine Cleaning

After the procedure, it may happen that tissue remains in the uterus. This could present itself with symptoms like increased bleeding, pain, or a high temperature. In such cases, additional cleaning of the uterus is required.

Uterine Perforation

This occurs very rarely—less than 1 in 1000 cases. If this happens, surgery may be necessary. Symptoms of uterine perforation typically include lower abdominal pain and bleeding.

After an abortion, there are several hygiene recommendations that can help prevent infections:

• Use pads instead of tampons.
• Take showers instead of baths.
• Avoid swimming in a pool for a few weeks.
• Use condoms during sexual intercourse.

An abortion does not negatively affect fertility, which returns immediately after the procedure. Ovulation usually occurs 2-4 weeks after the procedure, and the next menstrual bleeding happens around 4-6 weeks later. The first period may be longer and heavier.

After an abortion, individuals with Rh- blood type receive an injection to prevent the formation of antibodies, to avoid a possible Rh incompatibility in future pregnancies. For this reason, it is necessary to determine blood type before the procedure.

After an abortion, you may experience a range of emotions. Whether it’s relief, joy, sadness, or even anger, everyone experiences abortion differently, and all of these feelings are normal. You don’t need to worry about your mental health [3] – scientific studies show that abortion itself does not have a negative impact on mental health, and most feelings, whether positive or negative, subside within 2 years. In fact, the most common emotion after an abortion is relief. As many as 97.5% of people with abortion experience believe it was the right decision. [4] Of course, negative feelings can also arise and it is normal but it does not mean it was a mistake. Negative emotions are more often related to other factors, such as lack of support from others, uncertainty about the decision to have an abortion, stigma surrounding abortion, lack of self-belief, or pre-existing psychological issues.

If you need psychological support, don’t be afraid to seek professional help.

[3] https://www.apa.org/monitor/2022/09/news-facts-abortion-mental-health

[4] https://www.medpagetoday.com/obgyn/pregnancy/84345

After a pharmacological abortion, bleeding is a normal symptom, typically lasting up to two weeks, with spotting possibly continuing until the first menstrual period. This is not alarming and is a sign that the uterus is clearing out. Physical exertion and sexual intercourse may intensify the bleeding. Other possible symptoms include diarrhea, nausea, or breast pain, with possible discharge of fluid from the breasts. Cold compresses or crushed cabbage leaves can be applied in such cases. Breast pain should subside within two weeks after the procedure.

After a vacuum aspiration abortion, bleeding is a normal symptom, usually less heavy than during menstruation, and there may be nausea or diarrhea from the anesthesia. These symptoms should subside after a few days.

Other symptoms include abdominal pain and sore breasts, with possible discharge from the breasts. Cold compresses or crushed cabbage leaves can be applied in such cases. Breast pain should resolve within two weeks after the procedure.

If any of the following symptoms occur, you should visit your doctor for a follow-up appointment:

• Severe lower abdominal pain that doesn’t subside despite taking painkillers.
• Fever.
• Unpleasant vaginal odor.
• Excessive bleeding (if you are using more than 2 maxi pads per hour).