How abortions are done

How abortions are done

What is abortion?

An abortion is a procedure to end a pregnancy. There are two main methods:

  • An in-clinic abortion is a medical procedure performed by a doctor
  • A medication abortion involves taking prescription pills

Deciding to end a pregnancy is personal decision. For information on factors to consider as well as the legal restrictions, see our article: Should I have an abortion?

Before having an abortion, you'll meet with a healthcare provider to discuss your options. You'll also have an exam that may include some tests – possibly an ultrasound as well as blood tests to check your blood type and see if you have anemia.

You'll also be given some informational material to learn more about the procedure and consent forms to sign. Some states require that you visit a healthcare center or attend a counseling session before having the procedure at a separate appointment.

Some healthcare providers won't in-clinic perform an abortion until you're 5 or 6 weeks pregnant, but many will do it as soon as a pregnancy test is positive.

Note: If you had unprotected sex within the last five days, there's still time to use emergency contraception to prevent a pregnancy.

How does an in-clinic abortion work?

For an in-clinic abortion, a healthcare provider numbs your cervix with local anesthesia. You may also get a sedative to relax you and reduce pain. If you have an abortion in a hospital, general anesthesia is an option, but it's rarely necessary. You'll also receive antibiotics to prevent infection.

Vacuum aspiration (or suction abortion) is the most common type of in-clinic abortion, and it's usually done in the first trimester of pregnancy. It can be performed safely in a healthcare provider's office or clinic.

In this procedure, a doctor or nurse dilates your cervix using medicine or dilating rods. (This may be done a few hours or up to a day before the procedure.) Then a thin tube is inserted through your vagina and into your uterus to gently suction out the embryo or fetus and pregnancy tissue.

The procedure typically takes around five to 10 minutes, but the entire visit may take a few hours.

Dilation and evacuation (D&E) is an abortion procedure done in the second trimester (after 13 or 14 weeks of pregnancy). It can be done in a healthcare provider's office, a clinic, or a hospital. The steps for D&E are similar to vacuum aspiration. However, your cervix will need to be dilated more because the fetus is larger.

This may involve taking medications or having a dilating stick placed in your cervix to open it, sometimes starting the day before the procedure. The doctor will use medical tools such as a curette, forceps, or other instruments as well as suction to remove the pregnancy tissue. It takes between 10 and 20 minutes.

After an abortion procedure, you'll spend at least 30 minutes in a recovery room. You'll also get instructions for how to take care of yourself at home and a number to call if you have questions or concerns.

On the day you have the procedure, it's recommended that you rest afterward. It's common to have cramping for a day or two, and you may have bleeding for up to two weeks. However, many women have no symptoms at all.

You can usually return to work or school and resume your usual activities the day after an abortion, but avoid heavy lifting or strenuous exercise for a few days. It's fine to use a tampon as soon as any heavy bleeding lets up, and you can have sex again as soon as you feel ready.

Use birth control as soon as you resume having sex after an abortion because it's possible to get pregnant again quickly. At some clinics, you can get birth control, including an intrauterine device (IUD) or implant, on the same day you have the abortion procedure.

Abortion pills: mifepristone and misoprostol

A medication abortion involves taking prescription pills to expel the embryo from the uterus. This method is most effective (93 to 98 percent) the earlier it's used. It's not usually recommended after 10 weeks of pregnancy (counting from the last menstrual period).

You may have heard it called the "abortion pill," but it's actually two medications: mifepristone and misoprostol. Mifepristone blocks the hormone progesterone, which the body needs for pregnancy, and misoprostol opens the cervix and causes contractions. (This may feel like you're having your period.)

You take a mifepristone pill first. Within the next 48 hours, you take misoprostol by placing the pills between your gums and cheek. You may also be prescribed antibiotics to prevent infection.

After taking the second medication, you'll start to have lots of cramping and heavy bleeding. These symptoms diminish once the pregnancy tissue has been expelled. This usually happens within 24 hours, but it may take a few days. It will look like a heavy period, with blood clots. Bleeding can continue for about two weeks.

If you're planning to take these pills, make sure you're in a comfortable place where you can rest, ideally with someone to support you. You can take a pain reliever such as ibuprofen, but don't take aspirin because it can make you bleed more.

Don't put tampons (or anything else) in your vagina and abstain from sex for at least one week afterward.

You may also have chills, a fever, or nausea after taking the second set of pills, but this should also go away within 24 hours. Your healthcare provider will give you written instructions on what to do and expect during and after you take the medication as well as a number to call if you need more information or have problems.

You'll be told how to make sure the pills worked. This might involve returning to the clinic for an exam, having blood or urine tests, or monitoring your symptoms.

You can usually return to work or school and resume your usual activities the day after you take the second medication, but avoid heavy lifting or strenuous exercise for a few days.

Start using birth control immediately after an abortion because you can get pregnant again quickly. Some clinics can provide you with birth control (including an implant or shot) on the same day you take the mifepristone. For an IUD, you'll need to return to the clinic to have it inserted after the abortion is complete.

Never buy abortion pills over the Internet. Mifepristone and misoprostol require a prescription and should only be used under medical supervision. If you order the pills online, there's no way to verify that they're safe to take. Plus, a healthcare provider can make sure you take the drugs correctly and help if you have any complications.

These pills aren't recommended for women who have certain medical conditions (such as anemia, chronic adrenal failure, or an ectopic pregnancy), who take certain medications (such as anticoagulants), or who have an IUD in place. Your healthcare provider can help assess whether a medical abortion is more appropriate for you.

How will having an abortion affect me emotionally?

Every woman responds differently, and there are no right or wrong emotions. Some women feel relief after ending an unwanted pregnancy. Others feel guilty or sad. Many women experience a combination of emotions.

You're more likely to have strong feelings or need emotional support if you end a pregnancy for health reasons (like to protect your own health, or because your baby has health problems), if you have a history of mental health problems, or if people close to you don't support your decision to have an abortion.

If you feel upset after having an abortion, find someone to talk to. Tell a supportive friend or family member, talk to your nurse or doctor, or call a support talkline for women who have had abortions. (See the Resources section below.)

Are there risks to having an abortion?

Having an abortion is safe when the procedure is done (or the medication prescribed) by a licensed healthcare provider. Complications are very rare and usually easy to treat. Potential problems include:

  • Failed or incomplete abortion. This will require a follow-up procedure, either with vacuum aspiration or medication.
  • Infection. This is treated with antibiotics.
  • Heavy bleeding. Some bleeding is normal, but rare cases may require a blood transfusion.
  • Injury to the cervix, uterus, or other organs. The instruments used in some in-clinic abortions could make a small hole in the uterus or tear the cervix. The risk of such complications is less than 1 in 1,000. They may be more likely if you have a medical condition (such as uterine fibroids), if you have had a previous c-section, or if you are further along in your pregnancy.
  • Allergic reaction to medications. This may require emergency medical attention.
  • Blood clots in the uterus. This can lead to severe cramping and may require a vacuum aspiration procedure.

Call your healthcare provider immediately if you have any of these symptoms after an abortion:

  • Severe abdominal or back pain
  • Heavy bleeding (soaking two maxi pads per hour for two consecutive hours)
  • Foul-smelling discharge
  • A fever (100.4 degrees F or higher)
  • Weakness, nausea, vomiting, and/or diarrhea that lasts more than 24 hours after taking misoprostol (the second set of abortion pills)

How do I get an abortion?

Ask your doctor: Only a small percentage of ob-gyns and family medicine doctors do abortions, but it's worth asking if yours does. She may be able to refer you to a clinic, even if she doesn't do the procedure herself.

Find a clinic: Find the nearest Planned Parenthood center by searching on their website or by calling (800) 230-PLAN. You can also find a local abortion provider by visiting the websites of the National Abortion Federation or the Abortion Care Network, or calling (877) 257-0012 for a list of clinics that provide abortion services in your area.

Note: Be wary of "crisis pregnancy" centers. These centers are called many different names and are usually run by anti-abortion groups. They don't provide abortion services and may give you false information and try to pressure you not to have an abortion. If a center isn't upfront on the phone about the services they provide, they're probably not legitimate.

How much does abortion cost?

On average, a first trimester abortion, either in-clinic or medication, costs about $550.

However, the cost may be different, depending on where you have it done and whether you have health insurance that covers all or part of the procedure.

Some health insurance providers and government health insurance plans (such as Medicaid or TRICARE) cover abortion in certain states, but others do not. Call your insurance plan provider to find out if abortion is covered or visit to learn if your state's Medicaid insurance program covers abortion.

If you want an abortion, but can't afford one, contact the National Abortion Federation, Planned Parenthood, or the National Network of Abortion Funds. They can help your find clinics that offer sliding scale fees or payment plans, and they'll direct you to a local agency that can provide funds to help cover the cost of your abortion.

Abortion resources

  • Planned Parenthood: (800) 230-PLAN
  • The National Abortion Federation: (800) 772-9100
  • National Network of Abortion Funds
  • All-Options talkline: (888) 493-0092

our site Community groups:

  • Abortion Help, Questions and Concerns
  • Abortion Debate: a fair approach
  • Baby Loss Through Abortion
  • Pregnancy After Abortion

See our article on considering abortion for more information, including what to take into account when making your decision.

Watch the video: Woman films herself during abortion (January 2022).

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