Medical Abortion: What You Need to Know About
medical abortions

What You Need to Know About Medical Abortions

In 1973, Roe v. Wade changed the laws against abortion in the United States. The Supreme Court ruled in favor of “Jane Roe” an unmarried woman who wanted to safely and legally get an abortion, declaring that the constitutional right to privacy “is broad enough to encompass a woman’s decision whether or not to terminate her pregnancy.”

Since then, abortion has become an increasingly convoluted topic and has effectively turned women’s bodies into a political battleground. There are laws dictating many factors of abortion including the required waiting period before an abortion can be performed, parental involvement, insurance coverage, public funding, and gestational limits.

Most recently, the Trump Administration proposed the “Pain-Capable Unborn Child Protection Act,” a bill that would make getting an abortion after 20-weeks illegal, with punishment of a fine, five years in prison, or both. The bill passed the House of Representatives but, as of early 2018, has not passed in the Senate. Many Democrats are confident that the bill won’t make it through the Senate but, the threat against legal abortions is still real in our current political climate.

Part of taking reproductive control out of the government and keeping it between a woman and her doctor is understanding the nuances of what abortion is, how different abortion procedures work, the costs associated with abortion, and where a woman can go to get an abortion should she choose to do so. Read on for a guide to navigating abortion as a woman in 2018.

What is an Abortion?

Abortion is a procedure in which a pregnancy is ended by removing an embryo or fetus from a woman before it can survive outside of her uterus. Abortions can be performed during the first, second, or third trimester of a pregnancy. All abortions are highly effective—between 93 and 99 percent of the time.

Women have abortions for many different reasons. According to research by The Guttmacher Institute, the reasons for having an abortion can include (but are not limited to):

  • Having a baby would dramatically change her life
    • Interference with education
    • Interference with career
  • They have other children
  • Can’t afford a baby and/or childcare
  • Unmarried
  • Can’t afford the basic needs of life
  • Unemployed
  • Not enough support from partner
  • Partner is unemployed
  • Currently on welfare
  • Doesn’t want to be a single mother
  • Having relationship problems
  • Partner and I can’t or don’t want to get married
  • Not in a relationship right now
  • Relationship or marriage may break up soon
  • Husband or partner is abusive
  • Has completed childbearing
  • Not ready for a(nother) child
  • Doesn’t want people to know she had sex or got pregnant
  • Doesn’t feel mature enough to raise a(nother) child
  • Husband or partner wants her to have an abortion
  • Possible problems affecting the health of the fetus
  • Physical problem with her health
  • Parents want her to have an abortion
  • Was a victim of rape
  • Became pregnant as a result of incest

How Does an Abortion Procedure Work?

There are several types of abortion procedures. A woman will typically choose a procedure based on how far along she is in her pregnancy. The types of abortions a woman can get include:

In-clinic abortions

During any type of in-clinic abortion, a doctor, nurse, or other healthcare provider will use medical instruments to perform the abortion. This can be done in a few different ways, depending on how long she has been pregnant. With any type of in-clinic abortion, there is the option of being sedated. Unless there are other health issues or complications with the abortion, all in-clinic abortions are done as outpatient procedures.

First-trimester abortion: Vacuum aspiration, or suction abortion

Vacuum aspiration abortions are done when a woman is up to 12 weeks pregnant. Occasionally, they can be done up to 14 weeks but it’s uncommon. During a suction abortion, a doctor will insert a speculum into the vagina and swab the cervix and vagina with an anesthetic. They’ll then inject an anesthetic into the cervix. A small tube attached to either a suction machine or hand-held syringe will go into the uterus and the contents will be suctioned out. The whole procedure takes a few minutes.

Second-trimester abortion: Dilation and Evacuation (D&E)

Once a woman is past the 12 to 14-week mark of pregnancy, a Dilation and Evacuation, or D&E, is the procedure used to terminate a pregnancy. This type of procedure requires that the cervix is dilated and the uterus softened, to prevent injury to either. Anesthesia is injected into the cervix and, similar to a vacuum aspiration abortion, a vacuum is used to clear out the uterus. Additionally, medical tools are used to scrape the inside of the uterus. Sometimes medication is given to stop the fetal heartbeat before the procedure. This type of abortion takes about 30 minutes.

Third-trimester abortion: Dilation and Extraction (D&X)

Though rare, some women may need or opt to have a late-term abortion. This procedure is called a Dilation and Extraction, or D&X. Several days before the abortion, the cervix is prepared for the procedure using natural or synthetic rods (called laminaria sticks) that absorb moisture and dilate the cervix. During the surgery, the fetus is removed from the uterus.

Medication abortions

The abortion pill is one of the most commonly discussed types of abortions. While at the doctor’s office, a pill called mifepristone is taken. An antibiotic may also be prescribed to prevent infection. Between six and 48 hours after you take the mifepristone pill (based on the doctor’s instructions), another pill, misoprostol, is taken. Between one and four hours later, cramping and bleeding will begin as the uterus expels the pregnancy. Typically, the abortion is complete four to five hours after bleeding starts but this can vary. A follow-up visit is required to make sure the pill was successful.

Is the abortion pill the same thing as Plan B?

Plan B, also referred to as the morning after pill, works to prevent ovulation and stop fertilization of an egg. It’s often used when an accident happens—a condom breaks, a birth control pill was skipped, etc. Though many people confuse this, Plan B is not the same thing as an abortion pill. It does not cause a current pregnancy to end but simply prevents a pregnancy from forming.

Is Abortion Safe?

Generally speaking, abortion is safe. As with any type of medical procedure, there are risks involved but they’re usually rare. Planned Parenthood defines some of the potential risks of having an abortion, based on whether a woman has an in-clinic abortion or a medication abortion.

What are the risks of having an in-clinic abortion?

The following are, according to Planned Parenthood, some of the rare but serious potential risks of having an in-clinic abortion:

  • The abortion doesn’t work and the pregnancy doesn’t end
  • Some of the pregnancy tissue is left in your uterus
  • Blood clots in your uterus
  • Very heavy bleeding
  • Infection
  • Injury to your cervix, uterus or other organs
  • Allergic reaction to medication

There are extremely rare, but sometimes life-threatening, risks associated with in-clinic abortions:

  • Heavy bleeding from your vagina that soaks through more than 2 maxi pads in an hour, for 2 or more hours in a row
  • Severe pain or discomfort in your belly that medication doesn’t help
  • A fever of 100.4 or higher

What are the risks of a medication abortion?

Again, these side effects are rare but can happen with medication abortions:

  • The abortion pills don’t work and the pregnancy doesn’t end
  • Some of the pregnancy tissue is left in your uterus
  • Blood clots in your uterus
  • Bleeding too much or too long
  • Infection
  • Allergic reaction to one of the medicines

Serious, potentially life-threatening risks of having a medication abortion include:

  • Heavy bleeding from your vagina that soaks through more than 2 maxi pads in an hour, for 2 or more hours in a row
  • Passing large clots (bigger than a lemon) for more than 2 hours
  • Belly pain or cramps that don’t get better with pain medication
  • A fever of 100.4 or higher more than 24 hours after taking misoprostol
  • Weakness, nausea, vomiting, and/or diarrhea that lasts more than 24 hours after taking the misoprostol

The best option for avoiding serious side effects is going to a doctor’s office or abortion clinic with healthcare professionals who are licensed and have experience performing abortions. If you do decide to perform an abortion on yourself, the potential for side effects increase exponentially.

Can Having an Abortion Affect my Future Fertility?

Many women who want to have children one day find themselves faced with an unplanned, undesired pregnancy. The good news is that having an abortion usually does not affect future fertility, except in the case that there is an infection. If a woman develops pelvic inflammatory disease (PID) due to having an abortion, this could affect her fertility down the road.

Where Can I get an Abortion?

Depending on where you live, it can be challenging to find a place to get a safe abortion.

Many states, especially those in the South and Midwest, have made it so difficult to get an abortion that women have to travel to other states or regions to get one.

Thankfully, organizations like Planned Parenthood (despite defunding) have clinics in every state. Another option is to schedule an appointment with your primary care physician or gynecologist. Even if they don’t perform abortions themselves, they can direct you to local clinics that do.

How Much Does an Abortion Cost?

The cost of getting an abortion can range from $0 (if you qualify for funding) to $3,275—quite a range, especially considering that abortions are unplanned expenses. Here’s a breakdown of the cost of different types of abortions, as well as the costs many women incur after an abortion.

In addition to the cost of having an abortion, many women are faced with additional costs:

  • Maxi pads for several days after the abortion: around $100
  • Prescribed pain medications: $50 to $80, depending on insurance coverage
  • The cost of sedation during the abortion: around $100
  • Cost of travel, lodging, and food if travel is necessary to get an abortion: cost dependent on how far you travel and for how long

It’s important to note that some health insurance plans do cover some or all of the costs of an abortion. However, some may not cover any or may only cover abortions in certain situations. The best thing you can do is call your insurance carrier directly to find out what they will and will not cover.

Alternatively, if you can’t afford to pay out-of-pocket for an abortion, some organizations, like Planned Parenthood, offer health care services, including abortions, on a sliding scale.

Should I Get an Abortion?

For some women, getting an abortion is an easy choice. They know they don’t want to have a child and believe abortion is the best option for them. Other women struggle with deciding to get an abortion, for a variety of reasons. There’s no simple answer here. Your life goals, your personal circumstance, and your desire to have (or not have) children are all factors you’ll want to weigh before you decide to get an abortion. You are the only one who can decide if getting an abortion is the best option for you.

Featured image by Sylvie Tittel
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One Response to “What You Need to Know About Medical Abortions”

Ellie Davis

October 17, 2018 4:42 pm

Thank you for pointing out that one of the reasons women get an abortion is because pregnancy is dangerous to her health. This is the case for my sister and she is sadly going to need to get an abortion. I’ll have to help her find the best clinic in her area.

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