Facing an unplanned pregnancy is hard. Fear, confusion, and anger are just some of the feelings that you may be experiencing. Before you decide, you deserve to know the facts. The law gives you the right to be fully informed about this important decision. Here is some helpful information to read through as you, your partner, friend, or family member considers having an abortion. Take the time to think this decision through and learn about relevant information to make an informed decision. Remember, you are your own best advocate.
If you are struggling with any kind of issues, in addition to this pregnancy, please see my listing of International Crisis Hotlines and Resources to find help for your situation, near you
If you are considering having an abortion due to maternal health issues or a poor prenatal diagnosis, please visit Adverse Prenatal Diagnosis and Maternal Health Conditions Information and Support for resources, information, and support.
Do you know that you can get real, confidential, free, non-judgmental help to continue your pregnancy and continue your goals and care for your family? Go to this link to learn more.
Pregnancy termination, also known as therapeutic or elective abortion, is the medical process of ending a pregnancy by surgical or medical means which remove the developing human embryo or fetus and other pregnancy tissue.
General Medical Information on Procedures:
(These websites are written in an easy to understand format for the lay person)
E-Medicine: Abortion
A non-political, professional medical site with an overview of information on medical and surgical abortion
MEDLINEplus Medical Encyclopedia: Abortion
A Service of the U.S. National Library of Medicine and National Insitutes of Health. A non-political professional medical website.
American Pregnancy Association: Surgical Abortion Procedures
An overview of information on surgical abortion, description of procedures, side effects, and risks.
American Pregnancy Association: Medical Abortion Procedures
An overview of information on medical abortion, description of procedures, side effects, and risks.
Medical Abortion - Methotrexate and Misoprostol (4 to 9 weeks LMP):
This method is used from five to nine weeks Last Menstrual Period. Methotrexate stops the growth of rapidly multiplying cells by disrupting the availability of folic acid, which is needed to build new cells. In a pregnant woman, methotrexate goes straight to the cells of the "trophoblast" - the cells that are rapidly forming the placenta. Once the trophoblast has been cut off from its supply of folic acid, the connection that it did have to the uterine lining loosens, and production of HCG (the hormone that tells your body not to shed its lining) stops. The embryo is deprived of its blood supply and food source, and will therefore expire and float within the uterus. Three to seven days later you are instructed to insert misoprostol suppositories into your vagina (alternatively you may take pills orally) which causes the cervix (opening into the uterus) to dilate and contractions (cramping) which empty the uterus. The experience will be very similar to a miscarriage: there will be heavy cramping and bleeding and for up to 72 hours, and some women experience nausea associated with the pain and what is expelled may contain large blood clots and/or the grayish-colored gestational sac with the embryo.
Methotrexate and Misoprostol
Information on the medications used in a medical abortion can be found here, under the medication name. A Service of the U.S. National Library of Medicine and National Insitutes of Health. A non-political professional medical website.
Medical Abortion - Mifepristone (RU486) and Misoprostol (4 to 9 weeks LMP):
This method is used from five to nine weeks Last Menstrual Period. Mifepristone (also known as RU486) is a stomach ulcer medication which is being off-prescribed in combination with Misoprostol to terminate pregnancies. First, a thorough exam should be given to be sure that your pregnancy is not ectopic (tubal) and that there is no IUD in place. Mifepristone is first given and blocks the hormone progesterone, which is necessary to sustain the pregnancy. Misoprostol is then give day to a few days later and causes contractions which empty the uterus. The experience will be very similar to a miscarriage: there will be heavy cramping and bleeding, and what is expelled may contain large blood clots and/or the grayish-colored gestational sac with embryonic tissue.
Mifepristone (RU486) and Misoprostol
Information on the medications used in a medical abortion can be found here, under the medication name. A Service of the U.S. National Library of Medicine and National Insitutes of Health. A non-political professional medical website.
United States Food and Drug Administration: Mifeprex (RU-486)
This is the US Government's Food and Drug Administration website which includes the FDA labeling of Mifeprex™, patient forms, Medication Guide, and other documents about the approval of this drug.
RU486 Facts
This website contains medical information on RU486 documented from quotes and citations from reliable sources such as government documents, medical journals and newspapers articles.
Surgical Abortion - Manual Vacuum Aspiration (5 to 12 weeks after last menstrual period (LMP)):
This surgical abortion is done early in the pregnancy up until 12 weeks after the woman's last menstrual period. A long, thin tube, called a cannula is passed through the cervix and into the uterus. The end of a large syringe attached to the tube is drawn out, creating suction and and the cannula is swept across the surface of the uterus, drawing the embryo/fetus, and other pregnancy tissues through the cannula, into the tubing, and into a collection bottle.
WebMD: Manual and Vacuum Aspiration for Abortion
A non-political, professional medical site with information and an overview on the manual vacuum aspiration and vacuum aspiration procedure.
Surgical Abortion - Vacuum Aspiration/Suction Curettage (5 to 12 weeks LMP):
Machine vacuum aspiration involves the use of a hollow tube (cannula) that is attached by tubing to a bottle and a pump, which provides a vacuum. First, the cervix is injected with a local anesthetic and then dilated with sticks of an absorbent material or rods of increasing diameter. The cannula is then passed into the uterus, the pump is turned on, and the cannula is swept across the surface of the uterus and the amniotic fluid, embryo/fetus, and other pregnancy tissues are removed by suction, passing through the cannula, into the tubing, and into a collection bottle. A curette (a spoon or loop at the end of a long handle) may then be used to ensure all pregnancy tissue has been removed. After the surgical abortion, you can expect bleeding to continue for four to six weeks.
WebMD: Manual and Vacuum Aspiration for Abortion
A non-political, professional medical site with information and an overview on the manual vacuum aspiration and vacuum aspiration procedure.
Nucleus Medical Media - Medical Illustration of a Suction Curettage Abortion at 9 Weeks Gestation (12 weeks LMP)
The Doe Report - Medical Illustration of a Suction Curettage Abortion at 9 Weeks Gestation (12 weeks LMP)
Nucleus Medical Media and the Doe Report are both non-political, professional medical illustration sites
Surgical Abortion - D and C (Dilation and Curettage) (4 to 14 weeks LMP):
In a D and C (Dilation and Curettage) abortion, the cervix is injected with a local anesthetic and then dilated with sticks of an absorbent material or rods -of increasing diameter. Then a curette (a spoon or loop at the end of a long handle) is introduced into the uterus and swept across the surface of the uterus to remove the embryo/fetus, placenta, and other pregnancy tissue. After the surgical abortion, you can expect bleeding to continue for four to six weeks.
E-Medicine Health: Dilation and Curettage
A non-political, professional medical site with information and an overview on the D and C procedure
MEDLINEplus Interactive Tutorial: Dilation and Curettage
A Service of the U.S. National Library of Medicine and National Insitutes of Health. A non-political professional medical website.
Medical University of South Carolina- Medical Illustration of a Dilatation and Curettage (D and C)
Surgical Abortion - D and E (Dilation and Evacuation) (12 to 24 weeks LMP)
This procedure occurs over the course of 1 to 2 days. At the first appointment, the cervix is injected with a local anesthetic and laminara, sticks of an absorbent material, are inserted into the cervix and the procedure may occur later in the day. If the procedure is to occur on the second day, the laminara are removed and replaced with additional laminara to continue to dilate the cervix. The procedure may then preformed several hours later. When the procedure is to be preformed, the patient is given an anesthetic and the laminara are removed. A suction cannula is passed into the uterus, the pump is turned on, and the cannula is swept across the surface of the uterus and the amniotic fluid, fetal tissue, and other pregnancy tissues are removed by suction, passing through the cannula, into the tubing, and into a collection bottle. Forceps may be then used to dissect and remove the remaining fetal body and placental tissue. A sharp curette (a sharp-edged spoon or loop at the end of a long handle) may then be used to ensure all pregnancy tissue has been removed. After the surgical abortion, you can expect bleeding to continue for four to six weeks.
WebMD: Dilation and evacuation (D and E) for Abortion
A non-political, professional medical site with an overview of information on the D and E procedure
Nucleus Medical Media - Medical Illustration of a Dilatation and Evacuation Abortion Performed at 14 Weeks Gestation (16 weeks LMP)
Nucleus Medical Media - Medical Illustration of a Dilation and Evacuation Abortion (D&E) at 23 Weeks Gestation (25 weeks LMP)
Nucleus Medical Media is a non-political, professional medical illustration site
Surgical Abortion - D and X (Intact Dilation and Extraction) (24 to 38 weeks LMP)
This procedure occurs over the course of 2 to 3 days. At the first appointment, the cervix is injected with a local anesthetic and laminara, sticks of an absorbent material, are inserted into the cervix. Also, at this time an intracardiac injection may be given to the fetus to stop the heart. On the second day, the first set of laminara are removed and replaced with additional laminara to continue to dilate the cervix. The procedure may then preformed several hours later or the next day. When the procedure is to be preformed, the patient is given an anesthetic and the laminara are removed. The abortion practitioner, then uses a suction cannula to rupture the amniotic sac and drain the amniotic fluid. Next, the practitioner introduces forceps through the dilated cervix, into the uterus and grasping a fetal limb, delivers the fetus feet first, until the head is near the cervix. The practitioner then either collapses the fetal head with forceps or using surgical scissors, making an incision at the base of the skulls and using a suction cannula to remove intracranial material until the fetal head is collapsed, the fetus is then completely delivered. A suction cannula or curette is then swept across the surface of the uterus to remove the remaining pregnancy tissue.
Surgical Abortion - Labor Induction (24 to 38 weeks LMP)
This procedure occurs over the course of 2 to 3 days. At the first appointment, the cervix is injected with a local anesthesic and laminara, sticks of an absorbant material, are inserted into the cervix. Also, at this time an intracardiac injection may be given to the fetus to stop the heart. On the second day, the first set of laminara are removed and replaced with additional laminara to continue to dilate the cervix. The procedure may then preformed several hours later or the next day. When the procedure is to be preformed, the patient is given a pelvic exam and the laminara are removed and a medication to soften the cervix may be placed in the vagina. The patient is then given a bed and given an anesthestic or pain relief and a medication intraveinously to induce labor. The patient may then labor anywhere from a few to several hours to deliver the stillborn baby. The baby will then be quickly removed upon delivery and weighed and measured and cleaned up at this time if you wish to view or hold it. You will then be taken to an exam room or given privacy in your bed and given a pelvic exam and uterine massage to help deliver the placenta and remaining pregnancy tissue. Sometimes a dilation and curettage is needed to ensure all the pregnancy tissue is completely removed. If you so chose, you will then be given an opportunity to view and hold your baby. Your baby will then be taken away and cared for according to your wishes, whether you prefer it is turned over to a mortuary, medical examiner, or if it is to be disposed of with medical waste (incinerated).
Self-Induced/Herbal Abortion (3 to 9 weeks LMP):
There are two types of herbs that can have an effect on a developing pregnancy: emmenagogues and abortifacients. An emmenagogue is an herb which encourages your period to start. Most emmenagogue sare not strong enough to cause an abortion; however, they can in some women. Abortifacient herbs can be used to both encourage your period to come or cause an abortion. Herbs, can be beneficial to our health, but they can also be potentially dangerous. Fresh herbs can be potent and certain herbs are toxic if taken internally - just because they grew out of the ground doesn't make them safe. Herbal supplements are not tested or regulated by the FDA (U.S. Federal Drug Administration). The quality and potency of an herbal supplement varies from product to product. Also, keep in mind that labels may not always accurately represent the contents of the bottle. A number of factors must be taken into consideration when thinking about herbal abortion: has a viable uterine pregnancy been confirmed and ectopic pregnancy ruled out, how old is she, what is her general health, emotional state, support network, etc. Also, keep in mind that an herbal abortion can be dangerous if you take more than you should, take something not meant for internal consumption, have an undiagnosed ectopic pregnancy, and/or have certain health conditions (high blood pressure, epilepsy, allergies, diabetes, liver, heart or kidney problems, an IUD or recent PID (pelvic inflammatory disease). The results and effects of using herbal supplements to end pregnancy are often based off of personal anecdotes, not solid evidence from studies. Every individual elicits a different response to using herbs and the outcome is unpredictable. Inducing miscarriage is not worth risking your life.
http://choicetolivewith.com/herbalabortionpc.html
http://www.sisterzeus.com/risks.htm
United States Food and Drug Administration Warns About Home Abortion Kits
A consumer health warning about unsafe home abortion kits and female self-sterilization kits sold on the internet.
Guides - What to Expect/What It's Like:
What to Expect: Medical Abortion
Describes how a medical abortion is done, what it will physically feel like to have a medical abortion and how one may feel after it is over. A non-political and non-religious article for informational purposes.
What to Expect: Surgical Abortion
Describes how a surgical abortion is preformed, what it will physically feel like to have a surgical abortion, and how one may feel after it is over. A non-political and non-religious article for informational purposes.
Women Speak About Their Pregnancy and Abortion Experience:
After Abortion Support Site
I recommend this site for insight on how you might feel emotionally after your abortion and for support afterwords. This is a neutral, non-political, non-judgmental peer support site for women who have had an abortion and their support persons.
The Voices of Men and Women Who've Experienced Abortion(s)
There's a growing group of blogs where women and men write about their personal experience with abortion. The following is a listing of online journals and blogs, written by individuals, often from the day they found out about the pregnancy to recovery after the abortion.
Women's Abortion Stories - Speaking for Ourselves
The following stories have been sent to Abortion Concern by women who have experienced difficulties or distress after their abortions. We acknowledge that not all women react this way after an abortion. However, the purpose of this list is not to provide ‘balance,’ but to help other women who are hurting after an abortion to realize that they are not alone.
Abortion Changes You: Explore Stories
Women and men write about their personal experiences with abortion.
Project Voice
Write anonymously about your abortion experience and read a range of other women's stories.
Abortion Decisions: Many Voices. Many Choices
Telling our stories helps us to understand each other.
Considerations for Choosing an Abortion Provider:
Here are some considerations to keep in mind to help you find a reputable and safe clinic. You're a worthy person and deserve quality health care.
Do not trust the appearance of newspaper or Yellow Pages advertisements!
They don't contain enough information to make an informed decision about the provider and may provide misleading information. If you feel comfortable, ask a friend or family member if they know a good clinic in your area. Call a local hospital referral service or your doctor’s office.
Beware of clinic workers who try to rush you into a quick decision.
Beware of clinic workers who rush you into a decision, especially when you call to make an appointment. This is a difficult and life-changing decision which shouldn't be rushed. Take some time to think it over and seriously consider your other options. Ask if you can take a week to be sure. A few days of consideration will not limit your choices. If you feel pressure to book quickly, you might want to search elsewhere.
Beware of abortion clinics that are stuffed with clients.
They are probably performing the abortions "assembly line" style on particular days of the week. The doctor and support staff are more prone to being tired, and he or she will most likely not take the time to get to know you, your concerns, or your situation. They may not have time to adequately clean rooms and equipment between abortions. If the waiting room seems stuffed with patients, you might want to look for a different clinic - one that takes the time, consideration, and the safety precautions that you deserve.
Ask About the Clinic’s Services:
How many visits are required? Do they offer pre and post-procedure counseling? Are you permitted to bring children with you to the clinic? Are there childcare facilities on the premises? What types of anesthesia or other pain management options are offered? Can your support person attend counseling with you and/or stay with you during the procedure? Are there counselors available to accompany you in the procedure if you request it? Also, if a male physician will be performing the exam or procedure, you have the legal right to have a support person or a female nurse/surgical assistant present in the room. How long will you be at the clinic? Is there a 24 hour hotline you can call about post-procedure concerns?
Beware of clinics that offer counseling but promote abortion as the only workable choice.
The "counselors" have probably been trained to sell you an abortion and are not looking after your best interests. Such persons may try to make pregnancy sound frightening. A fair-minded counselor will be realistic about pregnancy, but help you explore all of your choices. It would be best to talk with someone who will present all your options in an objective manner.
Beware of clinics which do not give you a frank discussion of your health risks.
When you ask a question about your risk of developing a complication, you should be answered with a statistical number, not "It's rare", "Don't worry about that", or "That won't happen." Common problems include pain and infection. Less common but more serious risks include incomplete abortion/retained products of conception, hemorrhaging, and anesthetic complications. If you ask about fetal development in relevance to your pregnancy, it's important that they discuss the developmental stage with you (the size and capabilities for instance)and portray fetal development accurately. Beware of clinics which use euphemisms or use vague and misleading comparisons. Frank and honest discussions are always better than leaving things unsaid.
Your health and safety, as well as your well-being matter.
You can safeguard your health by making sure the procedure is being preformed by a a board-certified physician who has completed a residency in obstetrics and gynecology, not a nurse or other clinic personnel. Ask if there are any lawsuits pending against the clinic. Ask if any of the clinic doctors have been implicated of any wrongdoing. Also ask about the support staff, does the staff consist of RNs, LPNs, or lay volunteers? Will there be an attending R.N. in the recovery room and will the performing physician be present at all times in the hospital or clinic while patients are recovering? Will they treat you for both immediate and post-procedure complications? If you need to be hospitalized, does the administrator or attending doctor have hospital admitting privileges and if so, at which hospitals? What are the transportation arrangements? Beware of any "waivers" or "disclaimers" that release the doctor and/or staff from liability for abortion related complications. You do not have to sign this waiver, and if you feel pressured to do so, take it as a sign that you should find a different clinic.
Make sure the clinician takes a detailed health history.
There are many important factors that can affect the safety of the procedure for you, including past pregnancies, any chronic health conditions you may have, illegal drug use or excessive alcohol use, RH factor, etc. If the abortion will be done non-surgically, then any history of circulatory disorders, liver, or heart trouble is crucial. Missing something on the history could mean serious complications for you. Blood work and a pelvic examination should be performed as well as an ultrasound at the initial appointment.
Parental Involvement (Teens):
If you are a teen, be careful at a clinic that does not want to involve your parents. They might tell you that your parents don't need to know or offer to help you get a judicial bypass. Remember that your parents care about what happens to you and would want to know about this to help you through. If you fear violence or abuse from your parents, the clinic should be offering to help you find a safe place to go instead of sending you back home. A secret abortion will do nothing to change your abusive situation, so make sure that they are thinking of you.
Support and Recovery Resources After Abortion:
Abortion Recovery Resources
This is a comprehensive directory of resources for men and women seeking emotional recovery and peace after an abortion. Here you will find organizations, websites, and books of diverse beliefs and practices. No one will judge you or try to make you believe anything, they have been where you are and are there just to help.
E-Medicine: Abortion Complications, an article by Slava V Gaufberg, MD, FACEP
Aftercare and clinical indications of complications to look out for following an induced abortion. A non-political professional medical website.
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