Choosing to have an abortion is never an easy decision. As with any medical procedure, there are a variety of unknowns, even if you have a pretty good idea of what the procedure will entail before going into it. The enormity of the decision and all of the unknowns can add up to create a stressful and overwhelming experience, especially if the information is hard to find.
As part of helping you make a fully-informed decision, we want to help you know what you can expect.
A medication abortion is a non-surgical procedure that involves taking a series of two pills by mouth. You may have heard of the “abortion pill,” or RU-486 — these are both different names to describe a medication abortion. A medication abortion is prescribed by a doctor after determining how far along you are and is the most common form of abortion prior to 10 weeks gestation.
The first pill in the series you’ll take is mifepristone. This is usually taken at the doctor’s office, and it blocks your body’s progesterone which causes fetal demise (the fetus stops growing).
The second pill (misoprostol) is usually taken at home, anywhere from 24-48 hours later. This pill causes your uterus to contract and your cervix to open so your body can pass the expired fetus.
What to expect during a medication abortion
It’s common for you to experience mild to heavy cramping, as well as bleeding while the fetus is being passed. These symptoms, along with nausea and vomiting, can last up to two weeks after the procedure.
Occasionally the medication is not effective in completing the abortion, and a surgical abortion, called a D&C, will be recommended to remove the fetus or any retained tissue from the uterus. It is also possible that the pregnancy will continue despite taking the medications. This is more likely to happen if a medical abortion is attempted after 7 weeks gestation. If your baby survives a medical abortion attempt, there are risks of side effects on the developing fetus, but many babies have been carried to term without evidence of harm.
You will also likely experience a variety of emotions during and after the procedure. It’s important to remember that any emotions you feel are your own and they are valid. Whatever you’re feeling is okay, whether that’s sadness, grief, regret, or whether you aren’t feeling much of anything at all. Regardless of your emotional state, don’t walk this road in isolation. If you need someone to talk to in confidence, we have staff members available to offer you support and healing after you have made the abortion decision. We do not however, recommend an abortion and have services available to assist you if you want to explore keeping the baby.
The length of recovery after a medication abortion can vary. If the bleeding, cramps, nausea, and other side effects last longer than two weeks, be sure to call your doctor right away. They can examine you to make sure the procedure was completed and may prescribe a medication for your symptoms.
Some women have experienced regret, and changed their minds about having the abortion after taking the first pill. There are resources available through the Abortion Pill Rescue hotline 877.558.0333 for help in reversing the effects of the abortion pill. Although these methods are not always successful, they can increase the chance of successfully carrying the pregnancy to term.
If you’re more than 10 weeks into your pregnancy, medication abortion won’t be an option for you, so a surgical abortion procedure may be offered. There are a couple of different ones and the one you go through is dependent on how far along you are in your pregnancy.
Aspiration abortion is usually performed at 10-16 weeks. You’ll be given a pain medication to numb the cervix area, and the procedure begins by the doctor inserting rods increasing in size to dilate the cervix. Once your cervix is dilated, a long tube with a suction device at the end will be inserted into the uterus and the fetus and other uterine contents will be suctioned out.
A dilation and evacuation abortion (or D&E abortion) is the procedure performed after 16 weeks. It’s similar to an aspiration abortion in that your cervix is dilated, and a long tube with suction device is inserted into your uterus. Sometimes a shot is also given before the procedure begins to ensure fetal demise. In addition to the tube, sometimes forceps are also necessary to remove larger parts such as the head. Finally, the lining of your uterus is scraped to make sure everything has been removed. This procedure generally takes 15-30 minutes and an antibiotic prescribed to prevent infection.
Common side effects after both types of surgical abortion include bleeding, cramping, and nausea for up to two weeks after the surgery. Other possible side effects include: a perforated uterus, damage to the lining of the uterus, damage to the cervix, infection, and blood clots. Signs and symptoms of these complications may be: severe abdominal pain or tenderness, heavy vaginal bleeding, fever, lightheadedness or fainting, swelling in the legs, chest pain, or trouble breathing. If you experience ANY of those symptoms you should contact your doctor immediately or seek emergency medical care.
Like with the medication abortion, it’s very common to feel a lot of different emotions after the procedure. It’s important you take the time to heal and seek counseling, especially if the emotions feel overwhelming or you aren’t feeling anything at all.
You’re not alone
If you need to talk with someone before your appointment, we offer free, confidential options counseling on ALL of your options. Remember that there are options other than abortion, and we offer support if you need it. We’re here for you!