If you’re considering abortion, the information in this article exists to clarify essential knowledge regarding your procedure options, eligibility for different procedures, staying safe, and recovering well. 

While abortion is common, that doesn’t make it easy. It’s a choice that should be made based on good information and support. 

In this article, we will explore the 3 main types of procedures used (medication abortion, vacuum aspiration, and dilation & evacuation). 

If you have questions, you can talk to your medical provider. If you are currently pregnant, you can also schedule a telehealth appointment with one of our nurses to have your questions answered. 

Medical Abortion: A Detailed Exploration

Medical abortion is a non-surgical method for terminating an early pregnancy (up to 10 weeks gestation). This approach involves the use of a medication regimen (mifepristone and misoprostol) to terminate a pregnancy instead of a surgical procedure. 

Eligibility

Medical abortion is FDA-approved within the first 10 weeks of pregnancy. It is crucial to consult with a healthcare provider to confirm eligibility, taking into account your health history and specific circumstances. Just because you are less than 10 weeks pregnant does not necessarily mean you are eligible for a medical abortion. While abortion pills are accessible via telehealth, it is strongly recommended to receive an in-person medical evaluation before taking the pills (see section on safety below). 

Procedure

The medical abortion process involves two primary medications:

1. Mifepristone: This medication is taken first. Mifepristone blocks the hormone progesterone, which is necessary for the pregnancy to continue. Without progesterone, the lining of the uterus breaks down, and the pregnancy cannot progress.
2. Misoprostol: Taken 24 to 48 hours after mifepristone, misoprostol induces contractions of the uterus to expel the pregnancy tissue. While everyone has a different experience, this step can be anywhere from moderately to extremely painful and includes heavy bleeding and cramping, among various other symptoms.

If you’re considering a medical abortion, do not miss the following steps:

• In-Person Consultation: Meet with a healthcare provider for an assessment, including an ultrasound, to confirm the gestational age and discuss the procedure.
• Informed Consent: The patient should be made aware of all possible risks, side effects, and alternatives to the medical abortion procedure. 
• Follow-Up: A follow-up appointment should be scheduled within one to two weeks to ensure the abortion is complete and to address any concerns.

Safety

Let’s start with what is NOT safe: 

• It is NOT safe to order the abortion pills online from an unverified source. 
• It is NOT safe to take the abortion pills without first receiving an ultrasound to verify an intrauterine pregnancy and gestational age. 
• It is NOT safe to take the abortion pills if you do not have access to emergency care. 

Medical abortion has a complications rate four times higher than surgical abortion. If you plan to take the abortion pill at home, make sure someone is with you who knows you are taking the pills. While some people do not experience complications, you need to be prepared in case you do. 

Common side effects include cramping, bleeding, nausea, fatigue, fever/chills, vomiting, diarrhea, dizziness, anxiety, and/or fainting. 

Serious complications can include hemorrhage, infection, sepsis, ruptured ectopic pregnancy, ruptured uterus, and/or anaphylaxis. 

Something else to be aware of is that, depending how far along you are, the fetus may be visible and identifiable when passed. For many people, this can cause severe emotional trauma, especially if unexpected. 

“DIY” abortions are unsafe abortions. While we understand that you might feel like you want to handle this situation as quickly as possible, you need to protect yourself and your reproductive health. Having an abortion of any kind without proper medical supervision puts your health and safety at great risk. 

Recovery

Recovery from a medical abortion two-fold, both physical and emotional. 

Physically, it is important to follow any aftercare instructions provided by the healthcare provider and to attend the follow-up appointment to ensure complete recovery. If you see any signs of complications, do not hesitate to seek emergency care. 

Emotionally, recovery can be a bit more complex. Everyone experiences and processes loss differently. Part of you might feel, “I decided this. I wanted an abortion. I don’t need to recover emotionally from a decision I made.” Another part of you might feel, “This was a hard decision. I know whatever happens, it’s going to be hard to get over it.”

Maybe you recently had an abortion, or you have one further in your past, and you have mixed feelings about it. Sometimes, you’re relieved, because at least your life didn’t flip entirely upside down. Other times, you wonder what could have been. You notice days that would have been due dates, milestones, and holidays together. 

If you’re experiencing complex, confusing, or painful emotions after abortion, you’re not alone. Abortion recovery looks different for everyone, but 63% of women and 83% of men reported they would have benefitted from talking to someone after their abortion(s). If you feel this might benefit you too, we are here. Contact us about our free and confidential after-abortion support groups and programs.

Vacuum Aspiration Abortion: A Comprehensive Overview

Vacuum aspiration abortion is one widely utilized method for terminating a pregnancy surgically, typically performed during the first trimester. 

Eligibility

Vacuum aspiration is generally performed to terminate pregnancies up to 14-16 weeks gestation. It is crucial for individuals considering this procedure to consult with a healthcare provider to determine their eligibility based on their specific medical history and circumstances.

Procedure

The vacuum aspiration procedure involves the following steps:

1. Preparation: The patient is given a local anesthetic to numb the cervix, though sedation or general anesthesia may be offered.
2. Dilation: The cervix is gently dilated using a series of graduated rods or medication to allow access to the uterus.
3. Aspiration: A thin, flexible tube is inserted into the uterus through the cervix. A manual or electric vacuum device is then used to remove the pregnancy tissue from the uterus.
4. Completion: The healthcare provider must ensure that the uterus is completely emptied, minimizing the risk of complications.

Safety

Common side effects of a vacuum aspiration procedure may include cramping, bleeding, spotting, nausea, sweating, and feeling faint. 

Less frequent side effects include possible heavy or prolonged bleeding, blood clots, damage to the cervix, Rh sensitization, and perforation of the uterus. Infection due to retained remains of the baby and related tissues, an untreated STI/STD, or bacteria being introduced to the uterus, can cause fever, pain, abdominal tenderness, scarring, infertility and in some cases, death.

Recovery

Healthcare providers often recommend a follow-up appointment to ensure complete recovery and address any concerns. Patients are advised to avoid strenuous activities and to follow any specific aftercare instructions provided by their healthcare provider. 

While the experiences of surgical and medical abortions differ, both can cause grief and lead to emotional pain. Your loss was real, no matter how early or late it took place. Contact us about our free and confidential after-abortion support groups and programs.

Dilation and Evacuation (D&E) Abortion: An In-Depth Guide

Dilation and Evacuation (D&E) abortion is a medical procedure typically performed during the second trimester of pregnancy, usually between 13-24 weeks of gestation. This method is used when someone chooses to terminate their pregnancy after the first trimester.

Eligibility

It is essential for individuals to consult with a healthcare provider to assess their eligibility, taking into account their medical history, gestational age, and specific health considerations before a D&E procedure.

Procedure

The D&E procedure is more complex than first-trimester methods and involves several steps:

1. Preparation: The process often begins a day or two before the actual procedure. The cervix is gradually dilated using medication or osmotic dilators to allow safe access to the uterus.
2. Anesthesia: On the day of the procedure, patients are typically given sedation or general anesthesia to minimize pain.
3. Evacuation: The healthcare provider uses specialized instruments to remove the pregnancy tissue from the uterus. This may involve a combination of suction and surgical tools to ensure the uterus is completely scraped and emptied.
4. Completion: The provider must carefully check to ensure that all tissue has been removed, reducing the risk of complications.

Safety

Most D&E procedures are performed in a hospital setting due to the increased risks of severe complications. The risk of complications increases with the duration of pregnancy. Some risks include incomplete abortion with retained tissue, heavy bleeding, reactions to anesthesia, infection, and organ damage. Although rare, additional risks related to D&E are damage to the uterine lining or cervix, perforation of the uterus, infertility, infection, and blood clots.

As with any medical procedure, it is vital to follow post-operative care instructions and attend follow-up appointments to ensure proper healing.

Recovery

Recovery from a D&E abortion typically involves rest, avoiding strenuous activities, and avoiding inserting anything vaginally. Healthcare providers will offer guidance on managing any discomfort and advise on when to seek medical attention if needed. Again, for emotional support, contact us about our free and confidential after-abortion support groups and programs.

Be Brave! Facing Your Unplanned Pregnancy

You made it this far—good job! Did this feel like a lot of information? It’s okay to feel overwhelmed. It’s necessary to make informed decisions, but it’s not always easy to take it all in. 

Let’s summarize briefly, and then we can tell you what we can offer you (free of charge) at Clearway. 

• If you’re considering a medical abortion, you need to confirm that you have an intrauterine pregnancy less than 10 weeks gestation and have access to emergency care. 
• If you have taken the first abortion medication but change your mind, there’s a chance to reverse the procedure if you act fast enough. See AbortionPillReversal.org for more info.
• If you’re considering a surgical abortion, ensure that your provider has thoroughly informed you of any possible risks and that you have access to emergency care. 
• It’s normal to seek after-abortion emotional support. At Clearway Clinic, we offer both support groups and healing programs. Reach out to clearpast@clearwayclinic.com to learn more. Visit Support After Abortion to learn more about post-abortion healing. 

At Clearway, we offer free pregnancy testing, STI testing, ultrasounds, prenatal health education, and community resource referrals. Our clinic is a safe space to receive support and process your decision in a judgment-free environment. 

If you’re facing a difficult pregnancy decision, reach out for your free consultation. We are here for you. Schedule your appointment today.  

Reviewed by Deana G., BSN, RN

This information is for educational purposes only. It is not a substitute for medical advice. Please contact your doctor for more information.