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). According to Planned Parenthood, millions of women face unplanned pregnancies every year, and about 4 out of 10 will decide to have an abortion. 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 or a judge’s approval. 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”)
- In-clinic or Surgical Abortion (a procedure done in a clinic such as Planned Parenthood or in a hospital with light anesthesia)
What is a medical abortion?
A medical abortion involves taking a prescription medicine which is also called the “abortion pill”. The pills are used to end an early pregnancy. They work 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 is very effective. It works about 94-98% of the time if a woman is 8 weeks pregnant or less. If taken between 8-10 weeks of pregnancy, it is about 91-93% effective. If the abortion pill doesn’t work, a woman can choose to have a surgical abortion.
Other facts about taking the abortion pill:
- The first pill (Mifepristone) is usually taken in a doctor’s office or a clinic – (this is when the termination begins)
- The second pill (Misoprostol) is taken at home (6-48 hrs. later) – you’ll need to make plans to have someone stay with you. The medicine in this pill will cause vaginal bleeding (similar to a period) and cramping which empties the uterus (womb). This process will usually last 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 diarrhea or 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 is 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 tissue 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 not sure that you want to terminate the pregnancy
- 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 pill(s)
- You have a blood-clotting disorder or 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 (who do not want to be pregnant) but not for others. Talk with your health care provider to see what abortion method is best for you.
What is an In-clinic or surgical abortion?
An In-clinic or surgical abortion is a procedure that terminates a pregnancy, which is typically done up to 14-16 weeks after the pregnant woman’s last period. It is 99% effective. A health care provider (doctor or advanced practice nurse) usually performs the procedure in an out-patient office, clinic, or hospital.
What happens with a In-clinic or surgical abortion?
In most cases, the procedure itself usually takes about 10 minutes (not counting the prep time and recovery 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 medicine 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, and tell the patient to rest.
- The patient will then be given instructions to call her health care provider if she has any questions or concerns such as: 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 or just not feeling well.
Is it safe to have a surgical abortion?
An abortion performed by a medical doctor or clinical nurse specialist today is typically a safe and 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 your health care provider 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 varies among clinics and hospitals. It’s possible that the procedure may be covered by your health insurance. Call to find out the cost of both a medical and in-patient or surgical abortion and follow-up visits. All visits are usually bundled into one price.
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. The counseling that you receive should be non-judgmental and with a trained professional such as a nurse, social worker or therapist. The goal should be to provide support (in a safe environment) so you can talk about your feelings and ultimately make your own decision without any pressure from anyone else.
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, and be there to support you, 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.