I’m not ready to have a baby and am considering abortion. What are my options? What can I expect?
Morning-After Pill or Emergency Contraception (Plan B One-Step® and Ella®) | Up to 72 Hours
How does the morning-after pill work?
The morning-after pill can be taken during the first few hours or days following unprotected intercourse or contraceptive failure. Since the effects can occur after conception, emergency contraception pills may cause medical abortions.
Plan B One-Step and Ella are two commonly known emergency contraceptives. Plan B One-Step contains a large amount of levonorgestrel that is taken within 72 hours of intercourse. Ella contains ulipristal acetate, a drug in the same class as mifepristone, better known as the abortion pill or RU-486. Ella can be taken up to 5 days after intercourse. Depending on where you are in your menstrual cycle, both drugs may also work by delaying your normal ovulation process. Plan B One-Step and Ella Should not be taken if you think you are pregnant or used as a routine form of birth control.
Abortion Pill (RU-486, Mifeprex®/Mifepristone) | Up to 9 weeks
How does the abortion pill work?
A physical exam is first given in order to determine eligibility for the abortion pill (also called medical or chemical abortion). There are several pregnancy and medical conditions which do not allow the use of the abortion pill.
During the first office visit, you are given mifepristone pills to take orally. Mifepristone blocks the effects of your natural hormone progesterone and causes the uterine lining to break down. This stops the flow of nutrition and blood to the embryo and prevents the pregnancy from continuing.
Two to three days later, you will take the second set of pills, misoprostol, at home. This will cause contractions that expel the embryo. This expulsion process may take a few hours or as long as a few days so it is recommended you stay home until the process has completed. A physical exam is given two weeks later to ensure the abortion was completed and to check for complications.
What are the risks and side effects related to the abortion pill?
Immediate and long-term risks and side effects of the abortion pill may include:
- fever and chills
- heavy bleeding
- trauma from seeing embryonic parts expelled
- possible birth defects if pregnancy is not successfully terminated
All methods of medical abortion have an associated failure rate, and surgical abortion may be required to complete the abortion. Reasons for surgical intervention include prolonged or excessive bleeding, incomplete abortion (remnants of fetal tissue in the uterus) or an ongoing pregnancy.
The abortion pill is unsuccessful approximately 5% to 10% of the time with the potential of requiring an additional surgical abortion procedure to complete the termination.
What about surgical abortion options?
Surgical Abortion (Suction and Aspiration) | Up to 13 weeks – Your abortion provider will give you medication for pain and possibly sedation during the procedure. A speculum is inserted to open the vagina. A local anesthetic is administered to your cervix to numb it. Then a tenaculum (a surgical instrument with long handles and a clamp at the end) is used to hold the cervix in place. The cervix is then dilated with absorbent rods that vary in size. The rods may also be put in a few days prior to the procedure. When the cervix is wide enough, a cannula (a long plastic tube connected to a suction device) is inserted into the uterus to suction out the fetus and placenta. The procedure usually lasts 10-15 minutes, but recovery can require staying at the clinic for a few hours.
Surgical Abortion (Dilation and Evacuation or D & E) | After 13 weeks – In most cases, 24 hours prior to the actual procedure, your abortion provider will insert laminaria or a synthetic dilator inside your cervix. When the procedure begins the next day, your abortion provider will use a tenaculum to keep the cervix and uterus in place. Additional laminaria or synthetic dilators will be inserted into your cervix to open it wide enough for the fetal remains to be removed. A shot may be given before the procedure begins to ensure fetal death has occurred. Then a cannula is inserted to remove tissue away from the lining. Then using a curette (a surgical instrument shaped like a spoon), the lining is scraped to remove any residuals. If needed, forceps may be used to remove larger parts. The last step is usually a final suctioning to make sure the contents are completely removed. The procedure normally takes 15-30 minutes. The fetal remains are usually counted and examined to ensure everything was removed and that the abortion was complete.
Surgical Abortion (Dilation and Evacuation or D & E) | After 24 weeks – The procedure typically takes 2-3 days and is associated with increased risk to the life and health of the mother. Because a live birth is possible, injections are given to cause fetal death. This is done in order to comply with the Partial Birth Abortion Act of 2003 which requires the fetus to be dead before complete removal from the mother’s body. The medications (digoxin and potassium chloride) are either injected into the umbilical cord, amniotic fluid, or directly into the fetus’ heart. Fetal parts are reassembled after removal from the uterus to make sure nothing is left behind to cause infection or bleeding. An alternate technique, called “Intact D & E” is also used. The goal is to remove the fetus in one piece, reducing the risk of leaving body parts behind or of causing damage to the woman’s body. This procedure requires the cervix to be opened wide enough to bring out the fetus head intact.
What are the risks and side effects related to surgical abortions?
Immediate risks and side effects of surgical abortions may include:
- abdominal pain
- anesthesia complications
- damage to the cervix
- heavy or prolonged bleeding
- endotoxic shock
- blood clots
- tearing of the uterine lining
Long-term risks and side effects of surgical abortions may include:
- scar tissue
- increased risk of breast cancer
- increased risk of cervical cancer
- damage to reproductive organs
- increased risk of infertility
- increased risk of miscarriage
In the early weeks of pregnancy, the fetus pain sensory receptors are quickly developing, and the baby’s capability of experiencing pain increases as the pregnancy progresses.
Beyond the Physical
How will I feel after an abortion?
The reality and trauma of an abruptly ended pregnancy can bring on emotional and psychological side effects, ranging from regret to more serious complications like depression. You may experience these effects immediately following the abortion or unexpectedly several months to years later. The intensity or duration of these effects will also vary from one person to another.
Emotional and psychological side effects may include:
- sense of loneliness or isolation
- loss of self-confidence
- flashbacks of pregnancy or abortion
- insomnia or nightmares
- eating disorders
- relationship issues
- suicidal thoughts
It may seem like having an abortion is the easy solution to an unexpected pregnancy, and you can just move on. It is not that simple. Abortion is a medical procedure with many possible risks and side effects. It can be a life-changing event with significant physical and emotional consequences. Many women who have had past abortions will continue to struggle their entire lives with their abortion decision and wish they had been better informed about abortion procedures and the many risks and side effects.
A woman’s decision to abort is often based on the demands and threats of others, even when it violates the woman’s own moral beliefs and desire to keep the baby. This is a known risk factor for psychological complications after abortion.
I can’t go through with an abortion, but what other options do I have?
You have two choices when facing an unexpected or difficult pregnancy — ending the pregnancy through abortion or continuing the pregnancy. The decision to continue with your pregnancy can be overwhelming and frightening, but you are not alone. Aid for Women will provide the support and guidance you need as you continue your pregnancy and either start your journey to parenthood or consider an adoption plan.
The choice to parent is a challenging and rewarding decision. Many women say that an unexpected pregnancy turned their world upside down but that having their baby turned it right side up. Parenting is a very courageous and loving choice.
You will not be alone in your decision to continue your pregnancy. Aid for Women can help answer questions like:
- How can I afford to have a baby right now?
- Where can I find information about insurance, hospitals and doctors?
- How will I tell my family?
- Where will I live with my baby?
- How can I continue my education?
- How will a pregnancy affect my job?
- What resources are available if I choose to raise my child?
We also offer pregnancy and parenting classes, support groups and material assistance (maternity clothes, baby clothes, diapers, cribs, strollers, etc.) Additionally, we have access to a large network of local resources — including referrals for healthcare, housing, food, clothing and employment.
If your current life circumstances are making a decision to parent difficult, let Aid for Women offer you our assistance and support. We will help you during your pregnancy and in planning a future for yourself and your baby. We care about you and your baby and will help you find the support and resources you need to parent your child.
Could adoption be a good plan for you and my baby? If current circumstances in your life make parenting seem difficult, you may want to consider an adoption plan. Many women consider abortion because they feel that it is not the right time to have a baby. Adoption is a way to give your baby a future. Adoption can provide both a loving and life-giving choice for the mom, baby and adoptive family.
Benefits of choosing adoption include:
- You can pursue education and career plans;
- You can live independently;
- You will not parent before you are ready;
- You will have plenty of time to plan your future and your baby’s future;
- You can choose to have continued contact with your child (in open adoption) and know how he or she is growing and developing.
As with the parenting and abortion options, it is important to understand the adoption option and to make a fully-informed decision. At Aid for Women, you can learn how the adoption process works and clear up any myths you may have heard about adoption. Adoption has changed drastically over the years, and you now have many more options in making an adoption plan.
Although Aid for Women is not an adoption agency, you will not be alone in this decision. Our Client Advocates will provide you with accurate information and direct you to a licensed adoption agency to learn more about this loving and courageous choice.
As the birth mother, you are in control when you make an adoption plan. You have the option of choosing the adoptive couple and deciding how involved you would like to be in your child’s life. You can choose an open, semi-open or confidential adoption plan.