What Is An Abortion?
An abortion is a very common medical procedure that uses various methods to end an established pregnancy before birth, generally within the first twelve weeks of gestation. A medical abortion may be performed in a doctor's office or at home. While it is a fairly taboo topic, it's also a very common procedure: one in three women will have an abortion.
If you are pregnant, you should be aware of your options, including abortion. Deciding to have an abortion is a major decision with both emotional and psychological consequences.
If you are under age eighteen, your state may require one or both of your parents to give permission: Here is a state-by-state listing of abortion parental consent and notification laws.
What Is the Difference Between a Medical and Surgical Abortion?
A medical abortion is an abortion that involves taking medication (mifepristone or methotrexate along with misoprostol) to terminate a pregnancy. A surgical abortion ends a pregnancy by emptying the uterus with special instruments.
Why Do Women Choose To Have Abortions?
A woman's reasons for choosing to terminate a pregnancy are highly personal and may include:
- Mixed feelings about pregnancy
- Financial difficulties
- Being unable to parent due to physical or mental illness
Many anti-abortion groups claim that having an abortion increases a woman's risk for developing breast cancer and endangers future childbearing. These groups claim that women who have had abortions without complications are more likely to experience infertility, become unable to carry a pregnancy to term, develop ectopic pregnancies, deliver stillborn babies or become sterile.
These claims have been refuted by a significant amount of medical research.
Types of Abortions:
There are currently two types of abortion methods:
Medical Abortion - a woman takes either mifepristone or methotrexate along with misoprostol to end a pregnancy. These pills can be taken up to nine weeks after the first day of the woman's last menstrual period and are effective 97 out of 100 times used.
It can take anywhere from a single day to four days after a woman takes the pills for the abortion to be complete. The length of time depends upon which medications are used (mifepristone generally takes less time than methotrexate).
During the medical abortion, women will experience vaginal bleeding after the first drug is taken. The bleeding may be very light or like a heavy period. After the misoprostal is taken, cramping and bleeding begin - more cramping and bleeding than associated with a normal menstrual period. These cramps and clots should last several hours before the greyish gestational sac is passed.
Most women take these drugs and expel the embryo at home, which means that she should be prepared for this. The clinic staff should provide guidance as to how to best prepare and what to expect.
If abdominal cramping or flu-like symptoms last greater than 24 hours, a woman should call her abortion provider.
A menstrual cycle following a medical abortion may be longer or different than a normal menstrual cycle, but by the second cycle, the cycle should return to normal.
Common Symptoms Associated With The Abortion Pill:
- Nausea and vomiting
- Abdominal pain
- Mild fever or chills
Serious Complications of the Abortion Pill:
Call your doctor IMMEDIATELY if you experience any of the following:
- Clots for two or more hours which are larger than a lemon
- Heavy vaginal bleeding: soaking through two or more maxipads for two hours in a row
- Fever over 100.4 degrees for over four hours
- Abdominal pain that cannot be managed with medication, heating pad or rest
- Vomiting for more than four hours so severe you cannot keep anything down
- Smelly, unpleasant vaginal discharge
- Any signs you're still pregnant
Surgical or In-Clinic Abortion is another option for terminating a pregnancy. The cervix is gradually opened with tapered rods, until it is wide enough for a cannula to fit through. A cannula attached to some sort of suction machine is inserted into the cervix and the contents of the uterus are emptied by suction. This type of abortion is highly effective and completed within minutes. It allows for sedation, can be used in early pregnancy and generally requires only one visit to the provider.
- Aspiration: This is the most common type of abortion performed, typically before 16 weeks gestation.
- D&E (Dilation and Evacuation): This type of abortion is performed normally after 16 weeks gestation.
Common Problems After an In-Clinic Abortion:
- Heavy bleeding for a few days with minor bleeding and spotting for several weeks
- Undetected ectopic pregnancy
- Injury to the uterus or cervix
- Incomplete removal of pregnancy
- Blood clots in the uterus
Serious Complications of In-Clinic Abortions:
Call your doctor IMMEDIATELY if you experience any of the following:
- Very heavy bleeding: passing of clots larger than a lemon or soaking through two or more pads in an hour
- Pain not helped by medication, heating pads or rest
- Unpleasant, smelly vaginal discharge
- Signs you are still pregnant
Preventing Abortion Complications:
There are some things women can do to lower their risks for post-abortion complications. The first way to reduce complications is to have the abortion early. Generally speaking, the earlier the abortion occurs, the safer.
Asking questions about the procedure, what to expect and what to do to prepare, is really important.
Any woman choosing to have an abortion should:
- Find a good clinic or qualified practitioner
- Tell the practitioner about any medical problems, usage of current medications or street drugs, medication allergies and all other health information
- Follow post-operative instructions
- Return for a follow-up examination
Because earlier abortions are less complicated, they are typically safer than later-term abortions. It is important that any woman seeking an abortion do so as soon as possible. However, there are compelling reasons that a woman would have a later-term abortion.
- Undiagnosed Pregnancy - due to various reasons, many women do not realize they are pregnant until the pregnancy is advanced.
- Maternal Medical Complications - pregnant women, like anyone else, are susceptible to cancer, heart disease, depression, and other serious health problems. Treatments, vital to the survival of the mother, may be ceased if a woman is pregnant.
- Tragic Events - while a pregnancy may have been well-planned or eagerly anticipated, tragedy - such as a debilitating disease, car wreck, job loss, or natural disaster - may lead a woman to believe that it is the wrong time to have a baby.
- Severe Fetal Abnormalities - through routine prenatal testing, it may be discovered that a fetus has severe abnormalities - anencephaly, severe metabolic disorder, or other severe abnormalities - that may lead a woman to decide it is better to terminate a pregnancy than to allow a child to suffer and die in infancy.
- Lack of Money - many women, due to economic circumstances, cannot afford to pay for a first trimester abortion and must save up to obtain a later term abortion.
Emotional Issues After an Abortion
While most people feel relief after having an abortion, it's completely normal to feel other emotions, too. Women choose to have abortions for many reasons, but generally it is because pregnancy is, at that time, wrong for them. Even if abortion were the best option for the woman, it's normal for emotions, post-abortion, to be all over the place. Many women feel regret, shame, guilt, sadness and anger.
Some women feel comforted by talking to a friend, family member or counselor about their abortion. Feelings of loss resulting from a lack of support by someone close shouldn't be confused with regret about having an abortion. Most women, while having many conflicting emotions, report that their feelings are manageable.
If you are feeling any of these emotions and find them interfering with your ability to carry on your daily duties, please seek help from a doctor or therapist. You can also contact Exhale, an after-abortion talkline.
How Much Does An Abortion Cost?
The cost of abortions at health centers ranges from about $350 to $950 (costs vary depending upon how far along you are and what clinic you go to) for a first-trimester abortion. The cost is generally higher for a second-trimester abortion. Hospital abortions tend to cost more.
Most insurance companies offer some benefit for elective abortions. Contact your insurance provider for details. Insurance is covered by Medicaid generally only in instances of life-endangerment, rape, and incest. Check with your state. The military only covers elective abortions in the case of life-endangerment.
Contact the National Abortion Federation to see if you qualify for a loan or financial assistance for an elective abortion: 1-800-772-9100
How Do I Find An Abortion Provider?
You can call National Abortion Federation at call 1-877-257-0012
Planned Parenthood also has an abortion clinic locator with over 800 locations around the country.
Exhale is an after-abortion talk-line that serves women who have abortions and their partners, friends, and family. They respect all various cultural, social, and religious beliefs.
National Abortion Federation: For unbiased information about abortion and other resources, including financial assistance, call toll-free: 1-800-772-9100
National Abortion Federation Abortion Provider Finder: 1-877-257-0012
Additional Abortion Resources:
Exhale is an after-abortion talkline. It's confidential and serves those who have had abortions or their friends, families, and partners.
National Abortion Federation: The National Abortion Federation (NAF) is the professional association of abortion providers in North America. They believe that women should be trusted to make private medical decisions in consultation with their health care providers. NAF currently offers quality training and services to abortion providers and unbiased information and referral services to women.