If you are reading this article, you may be pregnant and considering an abortion. Most women do not come to the decision to abort lightly. You may be concerned about your school or employment, housing, what your family will say, finances, etc. According to a recent Public Opinions survey, one of the biggest factors in women deciding on abortion is the relationship with the father of the baby. Women contemplating an abortion are often in most need of their friends, family, partner. This may feel like a very lonely time for you. Whatever your reasons for considering abortion, at Support Circle, we are able to provide you with a caring, listening, non-judgmental patient advocate that can help you through this time.
Before going any further, first things first. Have you confirmed your pregnancy by visiting a medical office or clinic? Medical pregnancy tests can be more accurate than home pregnancy tests purchased at your local Walgreens pharmacy, CVS pharmacy or Target pharmacy. After confirming your pregnancy, you may choose to have an ultrasound performed. Why? Ultrasounds are able to provide accurate dating of your pregnancy. This is important because your options are determined by how far along in the pregnancy you are. And, an ultrasound can go one step further to see if this is an ectopic pregnancy. Ectopic pregnancies are usually treatable with medication if discovered early but can be potentially life-threatening.
Abortion Pill
If the pregnancy is less than ten weeks from the date of your last menstrual cycle, the FDA allows for a medical abortion, also known as the Abortion Pill. Medical abortions are performed using two different drugs while under the supervision of a doctor, nurse practitioner, or midwife. The Abortion Pill is a drug called Mifepristone (also called Mifeprex or RU-486) and is available by prescription only. Mifepristone, when used in combination with Misoprostol, disrupts an existing pregnancy. Typically, during the initial medical visit, you will be asked to complete blood tests, an ultrasound and counseling prior to beginning the drug regimen.
The two-part drug regimen can only be obtained with a prescription. The first drug makes the uterus a difficult place for the fetus to remain implanted. The second drug helps to remove the fetus from the uterus. In technical terms, Mifepristone is an anti-progesterone that causes the lining of the uterine walls to shed and it softens and dilates (expands) the cervix, thus facilitating an abortion. Misoprostol, the second drug, is a prostaglandin that induces uterine contractions and softens and dilates the cervix. It is taken approximately 48 hours after taking Mifepristone. When these two drugs are taken in combination with each other, a medical abortion is complete approximately 97% of the time.
After taking the Mifepristone and Misoprostol regimen, it is common to experience pelvic cramping and vaginal bleeding and spotting, including the expelling of tissue and blood clots for an average of 9-16 days. It is also common to experience nausea, vomiting, dizziness, headaches, fever, chills, weakness, and diarrhea.
A follow-up visit 7-14 days after taking the abortion pill regimen is very important to ensure there is no tissue left behind and that the abortion occurred successfully. In the event Mifepristone has not worked, as determined by an ultrasound during the follow-up visit, a woman will discuss her options with her provider.
Surgical Abortion
Depending upon how far your pregnancy has progressed, there may be two kinds of surgical abortion options available to you. Aspiration (also known as vacuum aspiration, suction curettage, or D&C) can be performed up to 12-14 weeks after the start of the last menstrual cycle. It only requires one visit to a medical clinic. Typically, during that visit, you will be asked to complete blood tests, an ultrasound and counseling prior to the procedure. A local anesthesia will be applied to the cervix to numb pain. You might feel some minor pressure but should not feel pain. The cervix is dilated (expanded) and the aspiration device removes the fetus and contents of the uterus. A curette, which has a sharp edge, may be used to scrape the walls of the uterus, to be sure that nothing remains behind. While the aspiration procedure only takes approximately 5-15 minutes, you will need to recover for about 30 minutes afterward.
For pregnancies from 13-24 weeks after the start of your last menstrual cycle, a Dilation and Evacuation (D&E) is the most common surgical abortion procedure available. The cervix is dilated more than in a D&C and this procedure requires two or three visits. For the first appointment, blood tests, an ultrasound and counseling session are standard. Also on the first visit, either medication or fiber rods are used to begin to dilate the cervix. On the next visit, if your cervix is sufficiently dilated, the doctor will use a combination of forceps, suction, and curettage to dismember the fetus and remove the contents of the uterus. A local anesthetic to numb the pain and make you semi-conscious is often used. Sometimes, a general anesthetic may be used to put you to sleep, depending upon the medical facility. The D&E procedure is usually 10-45 minutes with at least one hour of recovery time afterwards.
References:
1. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111323.htm
2. http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088643.pdf
3. http://www.rhtp.org/Abortion/mifepristone/default.asp
4. http://www.medscape.com/viewarticle/429755_3
Image posed by model.
Deciding to abort a pregnancy is seldom a decision made lightly. No one should pressure you into making a decision about your pregnancy. This includes the father, family, friends, counselors, etc. And sometimes, the greatest pressure comes from ourselves. If you would like to talk to someone about your decision, thoughts, emotions, or ask medical questions at any time, the caring patient advocates at Support Circle are available to listen and to provide non-judgmental emotional support before and after the pregnancy decision. Our nurses can confirm your pregnancy test results, provide you with pregnancy verification and assist with dating the pregnancy during an ultrasound.
Call or visit one of our three medical clinics in San Francisco, Oakland and Redwood City. All appointments are confidential and free of charge.
In order to safeguard against conflicts of interest (such as profiting directly from any medical procedures you pursue related to your pregnancy), Support Circle provides information about abortion procedures to our patients, but does not perform or refer for abortion. We also do not operate as an adoption agency, or perform/refer for labor and delivery.
Images posed by models.
