Abortion Services

Medication Abortion video:
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After abortion services: http://www.4exhale.org/resources.php
Pregnancy Options: http://www.pregnancyoptions.info/
Post abortion emotions: http://www.imnotsorry.net/whythis.htm
Religious Coalition for Reproductive Rights: http://www.rcrc.org/

Surgical Abortion

Manual vacuum aspiration (MVA) empties the uterus with gentle suction of a manual syringe. It is used for very early surgical abortion. It can be done as soon as you know you are pregnant and up to 12 weeks after your last period, based on provider preferences.

Dilation and suction curettage, also known as D&C, or vacuum aspiration, gently empties the uterus with machine-operated suction. This method is used for first and second trimester surgical abortions. It is performed from six to 19.6 weeks after your last period.

Dilation and extration, also know as D&E, can be performed from 15 weeks up to 19.6 weeks from the first day of your last period. It uses instruments such as forceps and/or curette to remove the pregnancy.

_{What Do I Need To Do To Have a Surgical Abortion?}
During the first visit, you will need to:

• Have an education session
• Download and sign informed consent forms
• Give a medical history
• Have laboratory tests
• Have an ultrasound

_{How Long Does it Take?}
The  procedures take about 15-20 minutes to complete, depending on the type of procedure. Allow four hours for the entire appointment, which also includes counseling/education, lab work, ultrasound, a physical exam and a recovery period.

_{How Does it Feel?}
Most women feel pain similar to very strong menstrual cramps. For others, abortion is more uncomfortable. Local pain medications are routinely offered. We also offer oral medications for pain and anxiety. For an additional fee, we offer I.V. sedation.

How is an MVA Performed?

• Your vagina is washed with soap.
• The doctor will inject a numbing medicine into your cervix.
• The opening of the cervix will be gnetly stretched with dilators
• A tube is inserted through the cervix into the uterus. A hand-held pump empties the uterus.

How is a D&E performed?

• Your vagina is washed with soap.
• The doctor injects a numbing medicine into or near your cervix.
• The opening of the cervix is stretched with dilators
• A tube is inserted into the uterus. This tube is attached to a suction machine.
• The suction machine is turned on. The uterus is emptied by gentle suction.
• A curette may be used to clean the walls of the uterus.

What are the health risks of a surgical abortion?

In the first 20 weeks, abortion is much safer than giving birth. Complications from early abortion include:

• Allergic reactions to the drugs--Tell your clinician what medications or recreational drugs you take. It will be strictly confidential.
• Incomplete abortion--This occurs in less than one out of 100 D&C abortions.
• Blood clots in the uterus may occur.
• Infection--Usually antibiotics clear up the infection. In rare cases, a repeat procedure, hospitalization, or surgery is needed.
• Very heavy bleeding--You may need medication, a D&C, or, rarely, surgery. Very rarely, blood transfusions are required.
• A cut or torn cervix--This occurs in fewer than one out of 100 early abortions.
• Organ injury--In about one of 1,000 early abortions, an instrument goes through the wall of the uterus. In even fewer cases, this leads to infection, heavy bleeding, or both. Surgery, or very rarely, hysterectomy, may be needed.
• Death is rare, it occurs in one of 100,000 abortions. Childbirth carries seven times more risk.

_{After the Abortion}
After very early and early abortions, you will rest in a recovery room for about an hour. If you have an Rh-negative blood type, you will receive an injection to protect future pregnancies. You will receive written after-care instructions and a 24-hour emergency phone number. Call your doctor if you have heavy bleeding, pain, or fever. You can discuss birth control with your counselor. You will make a follow-up appointment in two weeks.

_{How Will I Feel Later?}

You may have cramps. You may want to relax for the rest of the day. You may shower as soon as you wish. Do not take baths, douche, or use vaginal medications. You can usually return to work or other normal activities the next day. Recovery after later abortions may take longer.

_{Will I Bleed For a Long Time?}
You may bleed off and on for a couple of weeks. Some women have cramps and pass a few large blood clots for up to 10 days. Use sanitary pads--not tampons.

_{When Will I Get My Period?}
Abortion begins a new menstrual cycle. You should have a regular period in four to eight weeks.

_{When Can I Have Sex Again?}
Don't have vaginal intercourse or insert anything into the vagina for one week after the abortion. You can get pregnant very soon after the abortion. Discuss birth control options with your clinician.

Medication Abortion

_{What is Medication Abortion?}
Medication abortion is a way to end pregnancy without surgery. Instead, medication is taken to induce the abortion process. We provide medication abortion up to 56 days after the first day of your last period.

_{How Does Medication Abortion Work?}
There are three steps. The First, your doctor will give you a dose of mifepristone (prescription drug) in tablet form. The Second step, you will take another medication called misoprostol in tablet form. The Third, you will return to your clinician for a follow-up visit.
Step One
Mifepristone- blocks the hormone proesterone. Without progresterone, the lining of the uterus breaks down, ending the pregnancy.
Step Two
Misoprostol- causes the uterus to contract and empty.
Step Three
Follow-up. Your clinician needs to make sure the abortion is complete. You will need an ultrasound or a blood test.

_{How Long Does it Take?}
About 10 percent of women will have the abortion before they take misoprostol (the second medication). Most others will have it within four hours of taking misoprostol. For others, bleeding begins in 24 hours. The whole process can take about a week. It's important to remember that choosing medication abortion means that you will need to visit your clinician's office more than one time.

_{How Effective is it?}
Medication abortion is from 92-95 percent effective. Misoprostol can cause serious birth defects. If the medication abortion does not work, a surgical abortion must be done.

_{What Do I Need To Do To Have a Medication Abortion?}
During the first visit, you will need to:

• Have an education session
• Download and sign informed consent forms
• Give a medical history
• Have laboratory tests
• Have an ultrasound

You will take the first medication at the clinic. You and your clinician will plan the next step according to what is best for you. You will probably take the second medication at home. After you take misoprostol, you will start to bleed heavily within hours or days. This is the abortion.

_{How Does it Feel?}
For most women, medication abortion is like an early miscarriage. You might:
Feel strong cramps
Feel nauseated or vomit

Acetaminophen -- such as Tylenol® -- can reduce most of these symptoms. Painkillers such as ibuprofen, (found in over the counter brands such as Motrin® or Advil®) can also reduce symptoms. You will also receive pain medications and anti-nausea medications. You may see large blood clots or pieces of tissue at the time of the abortion. You may have some continued bleeding or spotting for up to four weeks after.

Call a clinician if you:

• Soak more than two maxi pads an hour, more than two hours in a row.
• Bleed heavily for more than 12 hours in a row.
• Pass clots larger than lemons for two hours or more.
• Run a temperature over 101.4°F.
• Feel strong nausea or throw up for more than four hours.
• Think you are having an allergic reaction to the medicine.

_{Why Do some Women Prefer Medication Abortion?}
No anesthesia or surgery.
Some feel more control.
Some women feel more "natural". (More like a miscarriage).
Some women feel it offers more privacy. (May have the abortion at home).

_{Who Can Choose Medication Abortion?}
We can provide medication abortion if you are up to eight weeks pregnant. But you must agree to have a surgical abortion if the medical treatment fails. You also need access to a telephone, transportation, and backup medical care.
Medication abortion is not recommended if you:

• Are more than eight weeks pregnant
• Take anti-clotting medication or have blood-clotting disorders
• Have severe heart, liver, or kidney problems
• Have seizures more than once a week
• Take any medicine that should not be combined with mifepristone, or misoprostol
• Cannot return for follow-up visits
• Are unwilling or unable to have a surgical abortion if the medical abortion is incomplete
• Have an allergy to the medications

_{When Will I get my Period?}
Abortion begins a new menstrual cycle. You should have a regular period in four to six weeks.

_{When Can I Have Sex Again?}
Don't have vaginal intercourse or insert anything into the vagina until you return for your follow-up exam. You can get pregnant very soon after the abortion. Discuss birth control options with your clinician.