Abortion
Many youth have questions about pregnancy and abortion. If you have just found out that you are pregnant, you may feel overwhelmed, sad, happy, or unsure about options and next steps. You may be worried about who to talk to. In some places around the world, abortion is legal and safe, and in other locations, abortion is illegal and/or not easily available. This guide will give you accurate information on your options, depending upon how many weeks pregnant you are, whether you have any special health conditions, and where you live. It can be helpful to talk with a trusted adult (parent, guardian, guidance counselor, etc.) about your situation and receive support in making your best decision.
If you are confirmed to have a normal intrauterine pregnancy, you may have three options:
- Continue the pregnancy and become a parent
- Continue the pregnancy and develop an adoption plan
- End the pregnancy and have an abortion
What kind of abortion is right for me?
There are two types of abortion:
- Medical abortion ( “abortion pill”)
- In-clinic or “surgical abortion.”
- The type of abortion you choose may depend on how far along the pregnancy is, how much support you have at home, your medical history, and your preference. The “right one” for you is the safest one! It’s important to talk with your provider about which type of abortion is the right one for you.
What is a medical abortion?
Medication abortion is using prescribed medicines to have an abortion up to 70 days (10 weeks) in pregnancy, which is similar to a miscarriage, at home. It is both safe and effective, and it works 91-98% of the time. It is usually a multi-step process which requires close follow-up.
The first medicine, mifepristone, works by blocking progesterone, a hormone in your body needed to support pregnancy. This is the medicine that starts the abortion. Usually people don’t have side effects to this medicine, but it is normal if you experience some nausea. If you vomit within 30 minutes of taking the mifepristone, call your provider right away, you may need to take the pill again.
The second medicine, misoprostol, is used at home between 12 and 48 hours later. Misoprostol causes the uterus to cramp and the cervix to open. This step causes cramping and bleeding, which ranges from being like a “regular period” to heavy with large clots. The heaviest bleeding can last several hours, and you may have irregular bleeding for a few weeks after that. During the abortion, you may experience nausea, vomiting, diarrhea, and a mild fever (up to 100.4 F).
The medication abortion can take several hours, so make sure you have a safe place to pass the pregnancy, access to a bathroom, and the support of someone who can help you (such as a parent or guardian).
You will need to follow up with your provider to make sure that the abortion worked. This can be done either with blood work or an ultrasound.
Is the medical abortion safe?
While the medication abortion is considered very safe, there are risks with any procedure. Some of them could be infection, hemorrhage (heavy bleeding that is unsafe), or allergic reaction.
It is also possible that the abortion will not be effective; sometimes the abortion is not complete (when there is pregnancy tissue still in the uterus), or will not work at all. While this is uncommon, it is not impossible, so it’s really important to go to your follow-up appointment with your abortion provider as recommended. If the medication abortion does not work or is incomplete, sometimes the in-clinic abortion procedure is needed to complete the abortion.
You should not take the abortion pill if:
- You are not sure that you want to terminate the pregnancy
- You are more than 10 weeks pregnant
- You don’t plan on taking the 2nd dose, or if you’re not sure you can take the second dose of medicine
- You can’t keep your follow-up appointment with your abortion provider
- You do not have a phone
- You do not have a safe place to pass the pregnancy
- You don’t have someone who can be with you when you take the misoprostol pills at home
- You have certain blood disorders (such as a bleeding disorder, or have a clotting problem and are on blood thinners)
- You have an IUD (intrauterine birth control device) in place. You will need to have this removed before having a medical abortion.
What is an In-clinic or surgical abortion?
An in-clinic/surgical abortion is a procedure that terminates a pregnancy. Although most abortions are performed in the first trimester (up to 12 weeks), each state has different laws about how far along a pregnancy can be to have an abortion. The in-clinic abortion is about 99% effective. A health care provider usually performs the procedure in an out-patient office, clinic, or hospital.
What happens with an In-clinic or surgical abortion?
In most cases, the procedure itself usually takes less than 10 minutes (not counting the prep time and recovery time which is a total of a couple of hours). Basically, gentle suction is used to remove the pregnancy from the uterus. Here’s how it is done:
- First, relaxation and pain medicines are 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 then attached to a special vacuum. When the suction is turned on, the pregnancy tissue is removed. Sometimes tissue is also removed with another medical instrument called a “curette”.
- Afterwards, the health care provider will usually prescribe an antibiotic.
- You will rest in the recovery room for about 20-60 minutes.
Is it safe to have a surgical abortion?
Yes. An abortion is typically a safe and routine procedure. Before abortion became legal in the US, there were no regulations to ensure a safe 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 in the U.S. 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, risks include infection, hemorrhage, damage to organs (cervix, uterus), or an incomplete abortion. If you are experiencing any of these symptoms after your abortion, call your provider right away:
- Heavy bleeding (soaking a pad in < 1 hour, for more than 1 hour)
- Fever (temperature of 100.4 or above)
- Severe pelvic/belly pain that does not go away with medicines
- Vaginal discharge that smells foul and looks abnormal
- Pregnancy symptoms that are not going away
Some people worry about seeing protesters at the clinic. Many clinics have excellent security and escorts to walk you into the building and keep you safe.
Where can I get an abortion?
- Ask your healthcare provider for a list of names
- Go to your state’s NARAL website for a list of clinics
- Call your local Planned Parenthood
There are some facilities that may seem like they provide abortions, but actually do not; their mission is to keep you from getting an abortion. So make sure you do your research and check whether the clinic you have chosen is giving you the counseling and access to abortion and contraception services that you want.
How much does an abortion cost?
Many health insurances cover abortion. If you’re not sure, ask when you book your appointment and double check with your insurance company by calling the number on the back of the card.
If your insurance does not cover abortion, check the National Network of Abortion Funds to see how they can help.
The price of the abortion may vary depending on many factors (where you live, how far along the pregnancy is, sedation, transportation, etc). Ask when you call to book your appointment.
How can I make this decision?
Sometimes the decision to have an abortion can be difficult, and sometimes it isn’t. It really depends on the person. Many people find it helpful to talk to a trusted adult (a parent, guardian, counselor, a nurse or a primary care provider) about your options. No matter what you decide, you have the right to accurate information and judgment-free support.
Some factors that people think about when they become pregnant are their living situation, support from their partner, family or friends, education or career plans, religious beliefs, and their financial situation…the list could go on and on!
Does my partner in the pregnancy have any say in this decision?
Some people choose to tell the person with whom they became pregnant that they are considering an abortion and some do not; it really depends on the person and the situation. Although some people think it is helpful to tell their partner, it should always be YOUR decision about how to move forward with the pregnancy. The same is true of friends or relatives.
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 teens feel comfortable and safe talking with a parent or guardian, others do not.
If you are under 18 years old, some states require your parents/guardian to be involved with giving permission, or you can seek judicial bypass (permission from the court) instead of notifying a parent/guardian. No one can force you to have an abortion.
Check the to see what your state requires.
Will I be able to get pregnant and have children in the future if I have an abortion?
Yes. The best ways to protect your future fertility is to avoid getting sexually transmitted infections (STIs) such as chlamydia and gonorrhea by not having sex and/or using condoms every time you have sex. It is also very important to talk with the clinic before the abortion about what kind of contraception you’d like to start after your abortion. For a list of options, click here.
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?
Abortion can be an emotional topic for some people. 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 and your decision.