A very controversial and sensitive issue for many, deciding to have an abortion can be extremely difficult. An abortion is a way to end an unwanted pregnancy. The majority of abortions occur during the first 12-weeks of a pregnancy. Those that occur later in a pregnancy are most often for medical reasons.
Abortions are not meant to be used as a regular form of birth control; if you are having sex and do not want to get pregnant, use a reliable form of contraceptives. If it is important that you avoid a pregnancy, remaining abstinent is the best way to do this.
There are two types of abortions: medication and surgical.
Medication Abortion: RU 486
Available in Europe since 1989, the FDA approved mifepristone (also known as RU 486) for use in the United States. It is not available in Canada. Mifepristone is only available through a doctor's prescription and involves a woman taking a series of pills that will end her pregnancy. It can only be used within the first 63 days (9 weeks) of pregnancy.
The first dose of mifepristone works by blocking the body's production of progesterone, which is needed to help keep the uterine lining suitable for the embryo. Without the progesterone, the uterine lining thins and the pregnancy is ended. The second step in a medical abortion is to take another dose of medication, which will cause uterine contractions thereby forcing your body to expel the contents of your uterus. Finally, you will need a follow-up appointment so that your doctor can be sure there are no remnants of your pregnancy left in your uterus.
The abortion process takes about a week and is effective 96 to 97% of the time. Because mifepristone can cause birth defects, it is likely you will need a surgical abortion if a medication abortion fails. Once you have taken the medication, you will begin to have heavy bleeding and may also experience severe cramps, nausea, diarrhea and possibly stomach pains. You will also likely notice large clots in your blood; these are the products of conception and include the embryo and your uterine lining.
Though generally safe, this type of abortion can cause hemorrhaging. This occurs in about 1% of women who use the drug. If you soak more than two menstrual pads in an hour, bleed heavily for 12 consecutive hours, pass clots that are larger than lemons, experience severe nausea or vomiting or run a fever higher than 100.4ºF for more than four hours, or are experiencing pain despite taking pain medication, contact your doctor immediately.
There are three types of surgical abortion: manual vacuum aspiration, dilation and suction curettage and dilation and evacuation. The type of surgical abortion you have will depend on how far along in your pregnancy you are.
Manual Vacuum Aspiration: This type of abortion can be done up to 10 weeks after a woman's last menstrual period. In this procedure, a syringe is used to suction out the embryo. The actual procedure takes about 10 minutes plus prep and recovery time. Local anesthetic is usually given.
Dilation and Suction Curettage: This type of abortion is performed between six and 14 weeks after a woman's last menstrual period. Also known as a D&C, this type of abortion involves a mechanical suction device to remove the contents of the uterus, including the embryo or fetus. A curette is then used to scrape the walls of the uterus in order to make sure everything has been cleaned out. Local or general anesthetic may be administered and the procedure takes about 10 minutes plus prep and recovery time.
Dilation and Evacuation: Performed from the thirteenth week of pregnancy on, this type of abortion involves slowly opening the cervix to allow room for forceps, a suction device and curette. The procedure is very similar to a D&C but forceps are also used to remove the fetus. When an abortion is done late in pregnancy, it is usually for medical reasons.
Some women find the surgical abortion procedure to be painful or experience some discomfort similar to menstrual cramps during the abortion. There are other types of surgical abortions that may be used later in pregnancy, but these are rarely used nowadays.
Risks of Surgical Abortions
So long as a woman goes to a licensed clinic, abortions are generally thought to be safe. However, as they are a type of surgery, there are a number of risks and complications associated with surgical abortions:
- Incomplete abortion
- Extremely heavy bleeding
- Allergic reaction to medication
- Uterine blood clots
- Torn or severed cervix
- Uterine puncture damaging other organs
Additionally, scar tissue may form if a woman's uterus is damaged during an abortion procedure. This may cause a woman to have troubles conceiving later in life and may increase her risk of having an ectopic pregnancy, which can be life threatening. However, the majority of women are able to get pregnant again after an abortion.
Access to Abortion
In the United States, abortion laws vary from state to state. Depending on your age and which state you live in, there may be laws in place that prevent you from having an abortion or require you to get parental permission if you are under a certain age. There may also be mandatory education or waiting periods before an abortion can be done. Additionally, some clinics may require that you pay them up front while others offer a payment plan. In some instances, Medicaid covers the cost of an abortion.
Women living in Canada who have an abortion in a hospital will have the cost covered by provincial health care. Provincial health care plans will also cover the cost of an abortion done at a free-standing clinic for women who live in British Columbia, Alberta, Ontario or Newfoundland. Women living in Prince Edward Island will need to travel out of province to have an abortion. Additionally, some hospitals require parental consent depending on a woman's age.
Abortion and Breast Cancer
For more than 50 years, there has been a debate as to whether or not having an abortion increases a woman's risk of breast cancer. Most studies have found that there is link while others have found no relation. Critics of the theory point out that many of the studies proving the link have been flawed in some way while more recent and accurate studies have shown that there is no link. Those that support the theory suggest that the critics have a financial reason for encouraging abortion and suppressing the information about a link.
Currently, the National Cancer Institute, the American Cancer Society and the American College of Obstetrics and Gynecologists have all refuted that there is any link between breast cancer and abortion. Women who are concerned about the possibility of a link are encouraged to do their own research on this controversial issue.
Emotional Aspects of Abortion
There are many emotional issues a woman must consider before deciding whether or not an abortion is the right course of action for her. Abortion is not the right choice for every woman. While some women are happy with their choice, others end up regretting their decision.
It is not uncommon to experience depression, nightmares, and relationship problems, especially for women who had mixed feelings about their choice. If you are faced with an unplanned pregnanncy, take the time to consider all your options: keeping the child, adoption and abortion. Consider all the issues, what each choice would mean for you right now. Be aware of your own personal and religious beliefs; if abortion goes against them, then you may want to consider adoption or becoming a parent.
Whatever you decide, make sure it is your choice. Being pressured into an abortion may cause you to regret your decision later on. Contact your local pregnancy resource center to talk to a caring counselor if you are considering abortion.
Get advice about having an abortion in our pregnancy forum.