The chances are high that a woman will have more than one unplanned pregnancy in the course of her lifetime. More than one-third of all U.S. women will have an abortion by the time they are 45 years old. About six million women in the U.S. become pregnant every year. Half of those pregnancies are unintended. Nearly 1.3 million women choose abortion to end their pregnancy each year.
The most common reasons a woman chooses abortion are
- She is not ready to become a parent.
- She cannot afford a baby.
- She doesn't want to be a single parent.
- She doesn't want anyone to know she has had sex or is pregnant.
- She is too young or too immature to have a child.
- She has all the children she wants.
- Her husband, partner, or parent wants her to have an abortion.
- She or the fetus has a health problem.
- She was a survivor of rape or incest.
Deciding If Abortion Is Right For You
Most women look to their husbands, partners, families, health care providers, clergy, or someone else they trust for support as they make their decision about an unintended pregnancy. And many women go to the clinic with their partner. But you don't have to tell anybody. Specially trained educators at women's health clinics can talk with you in private. You may bring someone with you. You will discuss your options — adoption, parenting, and abortion. You may be asked if someone is pressuring you to have an abortion.
Teens are encouraged to involve parents in their decision to have an abortion, and most do have a parent involved. But telling a parent is only required in states with mandatory parental involvement laws. Such laws force a woman under 18 to tell a parent or get parental permission before having an abortion. In most of these states, if she can't talk with her parents — or chooses not to — she can appear before a judge. The judge will consider whether she's mature enough to decide on her own. If not, the judge will decide whether an abortion is in the teen's best interests. In any case, if there are complications during the procedure, parents of minors may be notified.
Here are some things to consider if you are thinking about abortion.
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| True | False |
| 1. No one is pressuring me to choose abortion. | [ ] | [ ] |
| 2. I have strong religious beliefs against abortion. | [ ] | [ ] |
| 3. I look down on women who have abortions. | [ ] | [ ] |
| 4. I'd rather have a child at another time. | [ ] | [ ] |
| 5. I can afford to have another child. | [ ] | [ ] |
| 6. I can afford to have an abortion. | [ ] | [ ] |
| 7. I care about what other people will think. | [ ] | [ ] |
| 8. I can handle the abortion experience. | [ ] | [ ] |
| 9. I'll go before a judge if necessary. | [ ] | [ ] |
| 10. I would do anything to end this pregnancy. | [ ] | [ ] |
Think about whether or not your answers suggest that abortion might be right for you.
You can get abortion information and assistance at Planned Parenthood and other family planning centers, women's health centers, youth centers, and departments of health or social services. Or you can call the National Abortion Federation hotline: 1-800-772-9100.
To make an appointment with the Planned Parenthood center nearest you for information about abortion and your other pregnancy options, call toll-free 1-800-230-PLAN.
Abortion Options
Early in pregnancy, you have two options for ending a pregnancy — medication abortion or abortion by vacuum aspiration. (The information about procedures is presented alphabetically.) Medication abortion is the use of medicine to end a pregnancy. Vacuum aspiration is the use of gentle suction to end pregnancy.
Pregnancy is usually dated from the first day of the last menstrual cycle. You may choose medication abortion if you are early enough in pregnancy — this may be defined as up to 49, 56, or 63 days, depending on how the medicine is taken. After 63 days, vacuum aspiration is your only abortion option during the first trimester, which is calculated as the first 14 weeks after the first day of a woman's last menstrual period.
After the first trimester, dilation and evacuation (D&E) is the most common abortion procedure. In a D&E, the cervix is slowly stretched open. The procedure is completed by emptying the uterus using a combination of suction and medical instruments. Another option, induction — in which premature labor is induced with various medicines — is not widely available.
Abortion Contraindications
Medication Abortion
You should not have medication abortion if you
- are too far along in pregnancy
- are unsure about having the procedure
- are unwilling to have a vacuum aspiration if needed
- cannot return for follow-up visits
- do not have access to a telephone, transportation, and back-up medical care
- have a known or suspected molar pregnancy — one in which the placenta develops abnormally
- have severe adrenal gland, heart, kidney, or liver problems
- take any medicine that should not be combined with the medications used in medication abortion — methotrexate, mifepristone, or misoprostol
- take anti-clotting medication or have blood-clotting disorders
- are unwilling to have your IUD — if you have one — removed before taking the medicine
Special considerations may be necessary if you
- are breastfeeding
- have chronic heart, liver, respiratory, or kidney disease
- have an infection or are sick
- have severe anemia
- have uncontrolled high blood pressure
- have any other serious health problem
Vacuum Aspiration and D&E
You should not have vacuum aspiration or D&E if you
- are unsure about having the procedure
Special considerations may be necessary if you
- are extremely overweight
- are running a fever
- have an infection in your uterus
- have certain kinds of sexually transmitted infections
- have certain serious health problems
- have problems with anesthesia
- have seizures more than once a week
Effectiveness
Medication Abortion
There are two types of medication abortion offered in the U.S. — mifepristone medication abortion and methotrexate medication abortion. Mifepristone and methotrexate affect the body differently. Mifepristone is used more often than methotrexate because it is more effective and more predictable. Mifepristone is 96-97 percent effective. Methotrexate is about 92-96 percent effective.
Some of the medicines used in medication abortion may cause serious birth defects if pregnancy continues. So, if they don't work, vacuum aspiration should be done.
Vacuum Aspiration and D&E
Vacuum aspiration and D&E abortion are more than 99 percent effective. Failure to end a pregnancy can happen due to unusual conditions: there can be more than one chamber in the uterus, or the pregnancy may not be in the uterus. Repeated aspiration or other treatment may be needed if the initial procedure does not end the pregnancy.
Comparing Risks
If you choose abortion, you will also want to compare the benefits, risks, and side effects of each of your options. For example, both medication abortion and early vacuum aspiration are extremely safe. But current data suggest that medication abortion may carry a higher risk of death than early vacuum aspiration abortion. Even so, both procedures are much safer than abortion later in pregnancy or carrying a pregnancy to term.
Some women prefer medication abortion because they feel its benefits outweigh its risks. Other women prefer vacuum aspiration abortion because they feel its benefits outweigh its risks. Your clinician can help you decide, but the choice is up to you.
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