Once you know you are pregnant, you must decide your next step. Not every pregnancy is expected. When it comes as a shock, the stress can be overwhelming.
Abortion is in the news a lot, but what you don’t hear is information about it. What does it mean to get an abortion, and is it safe? Lack of information adds to the stress of making what will be one of the most critical decisions of your life. We want to ensure you have all the information you need to make an informed choice. Consider some key facts about abortion that you might not know.
What Are the Types of Abortions?
Abortion is a word that you do hear a lot, but what is it exactly? An abortion is the elective or deliberate termination of a pregnancy. Though there may be many reasons a person gives for choosing abortion, it is important to understand exactly what each procedure entails.
There are different types of abortions. They generally fall into two categories:
Surgical abortions are broken down into the following categories:
- Dilation and evacuation (D&E)
Understanding each can help as you decide your next step.
What is a Medical Abortion?
Medical abortion is done using two drugs: Mifepristone and Misoprostol. Mifepristone is taken first and then Misoprostol about 24 to 48 hours later. The first pill blocks the hormone production required to sustain a pregnancy. The second pill(s) causes contractions to expel the pregnancy and other pregnancy tissue from the uterus. As a result, the embryo cannot stay implanted in the uterus.
The medical abortion is FDA approved up to ten weeks from last menstrual period. Between 3% and 10% will need follow-up care to finish the abortion; however, up to 39% of women will require surgery if taken in the second trimester of pregnancy. Since a medical abortion does not require surgery, it is a common choice for an unexpected pregnancy discovered in the first ten weeks of gestation; however, “One of the best studies…found that the chemical abortion patients had four times the complication rate than the surgical abortion patients.” – Dr. Donna Harrison, M.D. https://pubmed.ncbi.nlm.nih.gov/19888037/
What Is an Aspiration Abortion?
A suction, or aspiration, D&C abortion is a procedure in which a suction catheter is inserted into the mother’s uterus to extract the pregnancy. Tools are then used to scrape the lining of the uterus to remove any remaining parts. This procedure is performed during the first trimester, typically during five and thirteen weeks LMP (that is five to thirteen weeks after the first day of the woman’s last menstrual period). A suction, or aspiration, D&C abortion is performed in-clinic. Prior to the abortion, the woman should receive an exam that includes an ultrasound in order to confirm that she is pregnant and diagnose any complicating factors, such as a tubal, or ectopic, pregnancy. An abortionist uses metal rods or medication to dilate the woman’s cervix and open the uterus to the pregnancy. A suction catheter is used to vacuum the pregnancy from the womb. The suction machine has a force approximately 10 to 20 times the force of a household vacuum cleaner. The procedure is completed as the abortionist uses a sharp metal device called a curette to empty the tissue remains of the uterus.1 A follow-up exam and ultrasound can be performed to help minimize the risk of incomplete abortion.2
- World Health Organization, “Safe Abortion: Technical and Policy Guidance for Health Systems.” 2nd Edition, 2012. <http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf>.
- Debby, A, et. al. “Transvaginal ultrasound after first-trimester uterine evacuation reduces the incidence of retained products of conception.” Ultrasound in Obstetrics & Gynecology, Vol. 27, Issue 1, January 2006, pp. 61-64. <http://onlinelibrary.wiley.com/doi/10.1002/uog.2654/full>.
What Is a D&E?
Dilation and evacuation abortions are available from 13-24 weeks of pregnancy. The abortionist dilates the cervix and uses instruments to extract the tissue using a suction catheter and a sopher clamp (a grasping instrument). A curette is used to assure that all pieces have been removed in order to avoid infection.
What Is an Induction Abortion?
An induction abortion happens later in the pregnancy from 25 weeks to full term. This procedure will take several days. A substance is injected through the woman’s abdomen or vagina into the heart of the fetus to cause cardiac arrest. Following the injection, laminaria sticks are inserted to open up the woman’s cervix. It may also be necessary for the abortionist to administer labor-inducing drugs. The woman will usually wait a period of two to four days for her cervix to dilate enough for her to deliver.
How Safe is Abortion?
There is a possibility of complications with any medical procedure. Side effects can include heavy or persistent bleeding, infection, sepsis (infection entering blood), incomplete abortion, allergic reaction to drugs, damage to the cervix, and scarring of the uterine lining. Abortion has been linked to subsequent preterm births and increased risk for mental health issues. https://www.ajog.org/article/S0002-9378(15)02596-X/fulltext
How Will I Feel After Having an Abortion?
Abortions affect women differently. The abortion provider should supply you with aftercare instructions that you should follow closely. A follow-up visit is recommended and some lab tests to ensure you are no longer pregnant. The test looks for an essential hormone made during pregnancy.
You can expect cramping and bleeding that may be heavy at times. Sometimes, your provider might want to track the blood loss, so they will ask you to use a pad. That way, when they ask, you can say you are using a certain number of pads an hour or a day. The bleeding will probably last between 9 and 16 days if you have a medical abortion. If you feel ill or run a fever, contact your healthcare provider.
How Will I Feel Emotionally After Having an Abortion?
A lot happens when you have an abortion, both mentally and physically. The changing hormones may make you moody, but you might also experience other emotions. For example, you might wonder if you did the “right” thing. Initially, some people feel relieved and have no regrets. You might experience many emotions at one time, and that’s okay. There are studies that indicate the risk of depression, anxiety, and suicide is greater for a woman who aborts an unwanted pregnancy than it is for a woman who carries an unwanted pregnancy to term.
Fergusson, David M with Joseph M. Boden and L. John Harwood. “Does abortion reduce the mental health risks of unwanted or unintended pregnancy? A re-appraisal of the evidence.” Australian & New Zealand Journal of Psychiatry, Sept. 2013, Vol. 47, No. 9, pp. 819-827. <http://www.ncbi.nlm.nih.gov/pubmed/23553240>.
If you feel down or question your choice, talk to someone, either a friend, family member, or your healthcare provider. We are always there at Willowbrook Women’s Center if you want to talk about your abortion. There will be no judgment, only support.
Various pregnancy services are available at Willowbrook Women’s Center in St. Joseph and Cameron, Missouri. We can help confirm that you are pregnant and then help you understand your options if you choose to have an abortion. Call or text us today to make an appointment.