Pregnancy: Unplanned Pregnancy, Abortion, and Adoption

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pregnant stomachWhat are my options if I have an unplanned pregnancy?

If you are pregnant you have 3 options:

  1. Continue with the pregnancy and become a parent
  2. Continue with the pregnancy and arrange a plan for adoption
  3. Terminate (end) the pregnancy (abortion)
All of these options have pros and cons, and there is no “right” or “wrong” answer. You’ll need to think about a lot of things before you decide what option is best for you.

It might be helpful to begin by asking yourself the following questions:

  • Are you ready to become a parent? Do you think that you are emotionally ready? Are you in good health?
  • How will becoming a parent affect your ability to finish highschool or college?
  • Can you reach your school and career goals while raising a child?
  • Can you support a child? Do you have a job, health benefits, and a stable place to live?
  • What are your beliefs (and your family’s beliefs) about having a child?
  • What are your (and your family’s) beliefs about having an abortion?
  • Will you have the help and support of your parent(s) or guardian(s), siblings, and friends?
  • Do you have housing? Can you live at home, or do you need shelter?
  • Will your partner be involved? How much? Will he be able to help support you and your baby?
  • Would you be able to handle all the responsibilities as a single parent?

How do I make a decision that I can live with?

It’s important to talk with a trusted adult and make a decision as early as possible. You may know right away what you want to do, or you may need time to figure it out. Often the decision comes from within. Although difficult, and often stressful, the final decision is up to you.

Deciding whether to continue the pregnancy, choose adoption, or have an abortion can be a life changing choice that comes with all sorts of feelings. Most girls find that talking to a counselor helps to accept their decision and cope with their feelings. The earlier you get help, the easier it will be for you to deal with your emotions. You should understand ALL of your options and know the risks and benefits involved before making a decision. Surround yourself with people who love and care about you, and try to limit your stress. It probably feels overwhelming right now, but with time, you’ll feel comfortable with your decision and be able to move forward and plan for your future.

If you’ve decided to continue your pregnancy it’s very important to make healthy choices.

  • Make an appointment with your health care provider (HCP) and begin prenatal care early.
  • Make sure you don’t drink alcohol or take drugs. If you smoke, quit right away.
  • Talk with your HCP about what medications are safe to take during your pregnancy. Be honest and tell your HCP if you have used or abused drugs in the past or present. Be sure to tell your HCP about ANY medication you take – including herbs or over-the-counter medicine. Certain drugs can cause birth defects.
  • Take the prenatal vitamins that your HCP has prescribed.
  • Talk to your guidance counselor at school about your pregnancy, and find out about ways you can attend classes and finish your education. Many schools have special programs for teen parents.
  • Eat nutritious food. Teens need extra calories. Your body is still growing so while you are pregnant, you’ll need more calories from nutritious food to keep you and your baby strong and healthy. Your baby depends on you for food and water. Ask your HCP if you can meet with a nutritionist (a person who is trained to give advice on how to eat healthy).
  • Stay active and keep moving. Don’t be a couch potato. Unless your HCP has told you otherwise, you can participate in activities such as walking, running, swimming, dancing, etc. Exercise will keep your body strong and flexible, but avoid risky physical activities such as contact sports, downhill skiing, and amusement park rides.
  • Drink plenty of fluids (3-4 cups of milk or calcium fortified soy beverage, plus water, herbal tea, or other nonalcoholic drinks).
  • Brush your teeth after meals and take care of your gums every day.
  • Rest whenever you can. Pregnancy takes a lot of energy! There will be times when you feel tired. Resting will help.
  • Keep a diary or blog of your pregnancy; reflect on your thoughts and feelings.
  • Stay away from chemicals that could be harmful to you or your baby, such as certain strong cleaning products, paint, hair dyes, and chemicals that straighten or perm hair. It’s a good idea to think about a low-maintenance hair style during your pregnancy that doesn’t involve the use of hair chemicals.
  • Learn the early signs of labor so you know what to do.
  • Take a parenting class. Ask your HCP about teen parenting classes. You may want to check your school or local YWCA or YMCA for classes. Being proactive and learning about how to care for your baby before it is born will help you feel more in control and confident about your ability to be a good parent.
  • Find out about resources such as WIC (Women, Infants and Children Programs, Healthy Start) options for completing your high school or college degree, childcare, and other resources.
  • Stay positive. You’ll need to surround yourself with people who love and care about you. You’re going to need help during your pregnancy and when your baby is born. Aim to limit your stress so you can be healthy mentally as well as physically.

Abortion

For lots of reasons, teens may have an unplanned pregnancy. Depending on a young woman’s beliefs and resources, she may choose to carry the pregnancy to term and keep her baby, place her baby up for adoption, or have an abortion (before 20 weeks). Terminating a pregnancy is often an emotional and complex decision for a woman at any age. If a young woman has an unplanned pregnancy in the US (or many other countries) she has a legal right to decide to have a safe termination of the pregnancy, an abortion. Since 1973 abortion has been an option in the US for women of all ages. However, if she is under 18, depending on the laws in her state, she may need to obtain one or both of her parents’ or legal guardian’s permission. In some states she may be excused, if she was the victim of sexual assault. For more information about different state laws regarding abortion, see the Planned Parenthood website.

There are different reasons why someone might think about having an abortion:

  • The pregnancy wasn’t planned
  • The pregnancy is harmful to the mother’s health
  • The pregnancy is the result of rape
  • The fetus may have a birth defect

What are the options for a woman who has an unwanted or unplanned pregnancy?

There are many things to think about before having an abortion. If a young woman decides that an abortion is the right decision for her, the next thing she’ll need to think about are her options; whether she wants to have a:

  • Medical abortion (take the “abortion pill”)
  • Surgical abortion (a procedure)

What is a medical abortion?

A medical abortion involves taking a prescription medicine called “Mifepristone” which is also called the “abortion pill”. The pill is used to end an early pregnancy. It works by blocking progesterone, the hormone that builds up the lining of a women’s uterus (womb) during pregnancy. Without progesterone, the lining of the uterus is unable to hold a pregnancy. As the lining of the uterus breaks down, bleeding occurs. The abortion pill can only be used up to 49 days after the first day of the last period (or 9 weeks). It’s about 97% effective.

Other facts about taking the abortion pill:

  • The first pill is usually taken in a doctor’s office or a clinic – (this is when the termination begins)
  • The second pill should be taken at home – you’ll need to make plans to have someone stay with you. The medicine in this pill is called misoprostol, and it will cause heavy bleeding and cramps which usually lasts a few hours.
  • Bleeding can be light-heavy with or without clots and it can feel like a regular period or a miscarriage
  • It is also common to feel dizzy, nauseous (sick to your stomach), and/or have loose stools

Is the medical abortion safe?

A medical abortion is considered safe; however, when taking any medication there’s always the possibility of having a reaction. In just a small percent of the time, the abortion pill is not effective. If it doesn’t work, the pregnancy will need to be terminated by a surgical abortion. Rarely, someone may have: an allergic reaction to the pills, heavy bleeding, or infection. It’s also possible but rare to have an incomplete abortion (this is when some of the pregnancy is left behind in the womb) or an undetected pregnancy outside of the womb (ectopic pregnancy). Very very rarely, a complication can be fatal.

There are some reasons why the abortion pill may not be the right choice for you.

You should not take the abortion pill if:

  • You are more than 9 weeks pregnant
  • You don’t plan on taking the 2nd dose
  • You can’t keep your follow-up appointment with your doctor
  • You do NOT have a phone and ride to and from the clinic
  • You don’t have someone who can be with you when you take the pills
  • You have a blood-clotting disorder or if you take any anti-blood clotting medicine
  • You have an IUD (intrauterine birth control device) in place. You will need to have this removed before having a medical abortion.

A medical abortion is a termination method that is a safe option for some women but not for others. Talk with your health care provider to see what method is best for you.

What is a surgical abortion?

A surgical abortion is a procedure that terminates a pregnancy, which is typically performed up to 16 weeks after the pregnant woman’s last period. A doctor or advanced practice nurse usually performs the procedure in an out-patient office or clinic, or hospital.

What is the surgical abortion like?

First, relaxation and pain medicine is given. Next, the cervix is numbed. Once numb, a thin tube is inserted into the vagina, through the cervix and into the uterus. The tube is attached to a special vacuum. When the suction is turned on, the pregnancy is removed. Sometimes tissue is also removed with another medical instrument called a “curette”. Afterwards, the doctor will usually prescribe an antibiotic, and tell the patient to rest. The patient will then be given instructions to call her doctor or nurse if she has heavy vaginal bleeding, pain or tenderness in the abdomen, vaginal discharge that has an odor or looks like pus, or a temperature of 101° or more.

Is it safe to have a surgical abortion?

An abortion performed by a medical doctor or clinical nurse specialist today is a typically safe and a routine procedure. Before abortion became legalized in the US, there was no regulation or standard-of-care. Illegal abortions were expensive, painful and there was a high risk of infection because of unclean conditions and lack of follow-up care. Now abortions are performed in safe, clean offices with a staff of medical professionals who also provide counseling and after-care.

Although complications with a routine abortion are rare, it’s important to be aware of the possible risks involved:

  • Too much bleeding
  • Infection of uterus (womb) and/or fallopian tubes
  • Damage to womb and/or cervix

Sometimes young women are concerned about going to a clinic or office due to reports of picketers or threats of violence by people who don’t believe in abortion. Most clinics have a strong security presence and patients coming to the clinic can ask for an escort if necessary.

Where can I get an abortion?

Once your pregnancy is confirmed by a home pregnancy test and an exam by a health care provider, and you have decided that an abortion is the right choice for you, ask for the name of a local clinic, hospital or doctor’s office where abortions are an option. If for some reason you are uncomfortable doing this, or your provider is unable to help, go online to the Planned Parenthood website to access local services. Check on your state’s rules about consent and parental involvement or ask your local Planned Parenthood. Three visits with a clinic or doctor may be required: the first to confirm the pregnancy and discuss options in detail; the second to perform the actual procedure, and the third for medical follow-up.

How much does an abortion cost?

The price of an abortion can vary among clinics and hospitals. It’s possible that the procedure may be covered by your health insurance.

How can I make this decision?

Many young women find it useful to talk with a trusted adult about the decision to terminate a pregnancy. For teens, this is usually a parent or other relative; sometimes a counselor, nurse or your primary care provider is the first person you talk to when you find out about the pregnancy. Many clinics offer free counseling if you have a positive pregnancy test. This can be a good time to talk about your feelings and your options.

It’s important to consider your:

  • Moral and/or religious beliefs
  • Financial situation, now and in the future
  • Educational and career plans
  • Your sources of emotional support and people who can help you make your decision, particularly your family, partner, relatives, and friends

Does my partner in the pregnancy have any say in this decision?

Some young women choose to tell the person with whom they became pregnant that they are considering an abortion and some do not. Some take the guy’s feelings into consideration and some choose to make the decision on their own. Sometimes the partner helps with the cost of the abortion and goes along for the appointment and other times they are not involved. There is no right or wrong way to do this. Ultimately, it is your body and your decision.

Do my parents have any say in my decision to have an abortion?

Parents can be very helpful in your decision about what’s best for you. Some young women feel comfortable talking with one or both parents/guardian(s), others are not comfortable. Don’t assume that your parent(s) or guardian(s) won’t be understanding and supportive about this important decision!

If you are under 18 years old, some states require your parent(s) or guardian(s) to be notified (your parent/legal guardian being told that you are seeking an abortion) or to give permission for the abortion unless a court is involved. No one can force you to have an abortion. Abortion laws vary greatly from state to state. For up-to-date information about your legal rights you can go to the Planned Parenthood website and search for your state’s laws.

Will I be able to get pregnant and have children in the future if I have an abortion?

Since abortion became legal and regulated, there is very little risk involved with this procedure, so your future fertility should not be affected. Other factors such as a history of sexually transmitted infections can damage your fallopian tubes, making it difficult to become pregnant in the future.

How can I deal with people who tell me they do not believe in abortions and are angry with me for thinking about having one?

A woman’s right to choose abortion can be very complicated. It is also an emotional topic for just about everyone. Both those who support abortion rights and those who don’t believe in abortion often feel strongly about their beliefs, and some conversations may feel very uncomfortable. You can say that they have the right to their opinion; however, you also have the right to your opinion. If the conversation feels at all uncomfortable, or awkward, you should excuse yourself and walk away. This is your decision to make and does not belong to anyone else.

The decision to end a pregnancy can be complicated; therefore it is best to talk with someone with whom you trust. You should understand ALL of your options and know the risks and benefits involved before making a decision.

Adoption

Adoption is one option for women who are pregnant and not ready and/or unable to care for a child once it is born. There are several reasons why a young woman may decide to give custody of her child to someone else, such as a relative or someone she does not know.

Some of these reasons might be that she:

  • Is still in high school or college
  • Has few financial resources
  • Isn’t emotionally ready to be a parent right now
  • Isn’t comfortable terminating the pregnancy (having an abortion)

How does adoption work?

There are different ways in which an adoption plan can be made, and this varies greatly from state-to-state. Your health care provider can help with providing information about adoption agencies (private and public) or the name of a lawyer who specializes in adoption. Sometimes private adoptions (for example: having a relative take care of the child) are facilitated by clergy or people in the community, or it can be done formally with a lawyer. Potential parents are carefully screened to make sure that a baby is placed in a loving and safe home. In some instances, the birth mother (the woman giving birth) meets with the soon-to-be (adoptive) parents beforehand; in some situations, the birth mother has on-going contact with the child and family (open adoption). In other instances, the birth mother knows some information about the family who is adopting her child but chooses not to meet them.

How do I know adoption is the right choice for me and the baby?

It is important to know and feel that you are making the best decision you can. Take your time and explore your resources and options. You should feel comfortable with the process and with the information about the adoptive parents, both before the baby is born and afterwards.

Here are some questions to think about:

  • What kind of parents do I want to raise my baby?
  • Is religion, ethnicity, or race important?
  • Do I want to meet the adoptive parents?
  • Are the adoptive parents able to provide an emotionally and financially stable environment?
  • How much contact do I want with the baby and adoptive parents afterwards?
  • Does the agency I have chosen help with my health care, transportation and other expenses while I am pregnant?
  • Will I have any time with my baby after it is born? For how long?

I’ve decided to make an adoption plan. How do I explain to people who are curious or disagree with my decision?

You do not owe anyone an explanation for your decision. Being a parent is a life-long commitment and if you are not able to make it at this time, placing your child for adoption is a responsible and loving decision.

What if I change my mind and decide that I want to raise the baby?

Just as committing to an adoption plan was a serious decision, so is changing your mind. If after very careful thought, a consultation with trusted adults in your life you feel you have made a mistake, you may be able to stop the adoption process. The laws from state-to-state are all different, but all states require a waiting period between the time a child is transferred to another family and when the adoption becomes legal. Check with the agency or lawyer that originally helped with the adoption process.

What is an open adoption?

An open adoption is one in which the birth mother (and father if involved) have regular contact with the child and his/her adoptive parents. Your adoption agency can tell you more about the pros and cons of having an open adoption. This is a personal decision and there is no right or wrong way to do this.

What if I want to hear about the child as he/she grows up?

In many instances birth mothers and adoptive parents (who are not in an open adoption situation) have contact over the years on a schedule suggested by the adoption agency. For instance, pictures of the child may be sent to you every year around the child’s birthday or on a holiday. You can also ask for the birth parent to write a note each year about the child’s milestones, successes, likes, and dislikes. As part of the adoption process you will decide upon the type and amount of contact you would like to maintain with the child and the adoptive family.

What if I want to write a letter to the child after he/she is adopted?

Birth mothers (and fathers if they are involved) are encouraged to write a letter to the child who is adopted.

These letters can include:

  • Your reasons for choosing adoption
  • Some details about yourself (likes/dislikes, hobbies, talents)
  • Some details about your family
  • Your wishes and hopes for the child as he/she grows up

Typically this letter is sealed, given to the adoptive parents or agency but not given to the child until he or she is a teenager or young adult. Other than this, communication with the child as they are growing up is part of the adoption process. You will talk about this and work this out with the adoption agency before the baby is born.

Choosing to move forward with an adoption plan can be an emotional process even when a young woman is positive she is unable to be a parent right now. It is often very helpful to talk with a trusted adult about your concerns and fears. Be sure to take care of yourself and surround yourself with people who love and support you so that you can make the best decision for you and your baby.