If a pregnancy has occurred, once youve made one of two choices remaining pregnant, or terminating your pregnancy,

there are three more basic choices to make. Parenthood,abortion or adoption are all equally viable, legal (in most
locations) and valid choices, any of which may be the best choice for someone at a given time, and no one of those
choices is any simpler or easier to make than another. When a person becomes pregnant but does not want to remain
pregnant or become a parent, they have the option of abortion, a medical procedure which terminates a pregnancy.While
opposition to abortion is actually relatively new (even the Catholic church was relatively supportive of early abortion as
little as around two hundred years ago and before that time), abortion itself is not new; we have documentation of
abortions as early as 500 BC, and every reason to strongly suspect it existed well before that time. We also know that even
when abortion is not legal or regulated that many people still (and do still in places where it is not currently legal)
terminate their pregnancies, but they have to endanger their health or their lives to do so.
Legal abortion is performed within a clinic, hospital or doctors office, usually on an outpatient basis, and most often
within the first trimester of pregnancy. Legal abortion procedures are safe: statistically, health risks are far greater for
carrying a pregnancy to term and delivering than for abortion.
There are NO long-term health problems that have yet been validly found to be associated with legal medical or surgical
abortion.
Unloading a Loaded Issue
With abortion still so controversial among many people and politicians, it can be tough to choose it, or even think clearly
and objectively about abortion as a choice.
All sorts of people have had or do have abortions, across all racial, economic, age, marital and other social lines.
According to the Alan Guttmacher Institute:

about 80% of women who abort are over 18 and unmarried

by the age of 45 about one in every three women will have had an abortion
the majority of women who have abortions -- about 6 in 10 -- are already mothers
the majority of women who have abortions do intend to bear and rear children in the future
the majority of women who have abortions subscribe to religious beliefs, and 70% or more of those women are
members of Judeo-Christian and Catholic religions
According to ChildTrends Databank, the vast majority of teenage pregnancies are unintended, and close to half of those
unintended pregnancies end in an abortion. The Alan Guttmacher Institute also points out that the reasons teens give most
frequently for having an abortion are concern about how having a baby would change their lives, inability to afford a baby
now and feeling insufficiently mature to raise a child. Family Planning Perspectives published a 1989 study of teenagers
who sought pregnancy tests which found that, counting from the beginning of pregnancy until two years later, the level of
stress and anxiety of those who had an abortion did not differ from that of those who had not been pregnant or who had
carried their pregnancy to term. No matter what you believe, how you feel about abortion -- especially when the
possibility or event is actual and personal, rather than an abstract idea -- may not be simple or line up predictably with
your beliefs. Some people who generally are not comfortable with abortion as a whole may decide to have one in a given
situation because they simply feel it is best. Some who are comfortable with abortion for others, or who have had
abortions before, may, in a certain situation, feel it is not the right choice for them. Plenty of people who do want children
have an abortion at some point because they just dont feel capable or able to rear their children adequately at any given
time, due to relationship, financial, lifestyle, health or emotional issues. Currently and historically, the reason most people
have abortions is due to the economics of time and money: in other words, because they know or feel they do not have
adequate funds or time to care for a child in the way a child needs to be cared for. If youre choosing abortion, ANY
reason you feel it is the right choice for you is a valid choice, and youre always allowed to change how you feel about
abortion in general when its no longer general, but about your pregnancy: what seems most right for you in that situation
is more important than how you feel, or feel you should feel, about abortion overall. Few reproductive choices are easy,
but right now, it can be more difficult to choose abortion as an option because of all the personal and political biases
against it. For that reason, its important that if you DO choose abortion -- just as is the case if you choose to parent or put
a child up for adoption -- it is because you want to and feel it is the best choice you can make.

Abortion Options
Legal abortions are both safe and effective. At this time, there are two main options for legal abortion in most areas:
medical abortion or surgical abortion.
(SIDEBAR)Do you need help finding a clinic or an abortion fund? If so, we can help you with that. Come on over to
the message boards and just let us know what you need. We're glad to walk you through it, connect you with good
resources, and give you some unbiased support.(/SIDEBAR)
People who want to choose abortion have around six weeks to five months after pregnancy occurs before they are outside
the window for safe, legal abortion. The later that choice is made, the fewer options are available, and the more potentially
difficult or risky an abortion may become.
Following are the bare basics about standard abortion procedures.
Medical abortion is sometimes called RU486, M&M or the abortion pill. It is not as widely available as surgical
abortion but is now available from many abortion providers. Medical abortion is effective up to around 60 days after the
last menstrual period, or up until around 10 weeks of pregnancy. It does not require surgery, but instead, is a combination
of medications (usually mifepristone and misoprostol) given and supervised by a clinician, which cause a termination
identical to a miscarriage. The drugs do several things: they stop embryonic cells from multiplying and dividing as they
need to to continue a pregnancy, block hormones which would support a developing pregnancy, and cause uterine
contractions which empty the contents of the uterus.
(SIDEBAR)Plan B, the Morning-After Pill or Emergency Contraception is not a medical abortion, or any kind of abortion
at all. Emergency Contraception is an after-the-fact form of birth control used to prevent pregnancy, which can only be
effective if pregnancy has not yet occurred. Because pregnancy is not something that happens instantly, but takes a
handful of days, EC can work to prevent pregnancy for up to 120 hours after a risk. For more on EC, click here.
(/SIDEBAR)
An injection or oral medication of one drug is given in the doctor or clinician's office, while the other is inserted a day to a
few days later into the vagina or mouth at home. From a few days to a week after the first dose, the embryo and other
products of conception pass out through the vagina. The experience will be very similar to a miscarriage: there will be
heavy cramping and bleeding, and what is expelled may contain large blood clots and/or the small, grayish-looking
gestational sac created by the blastocyst. It does not contain the embryo: that is so small at the time medical abortion can
be performed that it is unlikely to be able to be seen. Cramps and bleeding are usually stronger and more intense than
during a menstrual period. Side effects can include nausea, headaches, vomiting or bowel problems as well as continued
spotting for a week or two, sometimes more. For a person having a medical abortion, it is vital to arrange for someone else
her partner, a friend, family to be on call, for emotional support, for anything she materially needs during the process,
or to be able to get her to an emergency room quickly should her side effects be profound.
Medical abortions must be coupled with follow-up visits to the provider to assure a complete termination did occur and
that a patient is in sound health afterwards.
Medical abortions are not quite as effective as surgical abortions -- they're around 95 - 98% effective at terminating a
pregnancy -- so occasionally an additional surgical abortion will be necessary to successfully terminate a pregnancy.
(SIDEBAR) Abortion Laws & Minors In many states, certain laws may restrict teen access to abortion either via policies
which require parents be notified of a teens intent to have an abortion (parental notification), or require a parent or
guardians written permission (parental consent) for an abortion to be performed for a teen. Almost all of these policies
have options for judicial bypass: for a teen to get a judges permission for the abortion without parental involvement, and
some states allow physicians to waive parental notification or consent. Too, court orders have prevented some states from
enforcing these laws. If you are or know a minor woman seeking out abortion, you can find out what, if any, legal
restrictions exist in your area, based on age and other issues, either by calling your local abortion provider or sexual health
clinic, or, if in the U.S., by clicking here.(/SIDEBAR)
Surgical abortions -- which are nearly always 100% effective -- can be performed from the time a pregnancy is
confirmed until around the end of the second trimester, but second trimester abortions only account for less than around
10% of all abortions, and it is obviously ideal, for someone who wants to terminate, to do so earlier rather than later,
physically and emotionally. What type of surgical abortion -- manual vacuum aspiration (MVA), dilation and curettage

(D&C) or, more commonly now, dilation and evacuation (D&E) -- depends on the length of the pregnancy and the
specific situation. All are currently legal in the U.S. and Canada.
Manual and/or vacuum aspiration (MVA) or electric vacuum aspiration (EVA) can be done within the first trimester, up
to about 13 weeks of pregnancy. It is what is most often used for abortions now, and manual aspiration can be used as
soon as four weeks from the last menstrual period. During an aspiration, an injection first numbs the cervix with a local
anesthetic.
With some abortion providers, a person can elect to have conscious IV sedation -- to be awake, but very relaxed or
groggy, and some IV sedatives also help reduce pain -- or a general anesthetic -- which will put them to sleep before and
during the procedure -- if they like. Clinics will provide an oral analgesic and often a mild oral sedative in advance of the
procedure for those who do not want conscious sedation or a general anesthetic. Whether or not you want to be asleep,
sedated or alert is usually a matter of availability and personal preference, based on what you want intellectually or
emotionally (some people want to be fully present, others want the opposite), what type of procedure you're having,
and/or if a doctor determines one or the other will be safer for you. For instance, people who feel very nervous or upset in
medical or gynecological situations, or who are already dealing with more than one crisis (such as a rape, domestic
violence or having to terminate a wanted pregnancy due to a maternal or fetal health problem) may feel and do best with
conscious sedation or GA. People who feel like sedation doesn't allow them a wanted awareness or level of control, who
want to be very alert soon after a procedure or who prefer to manage their pain or anxiety in alternative ways may prefer
to go without. Some people may recover or feel back to normal more quickly without sedation and/or general anesthesia
(while for others it makes no difference), just because those have their own set of side effects (including nausea, sore
throat, vomiting or insomnia) and it can take some people longer than others to clear sedation medications from their
bodies. The cervix is dilated -- with slim rods designed to gradually widen the cervical opening -- and then a flexible tube
is inserted through the cervix. That tube is either attached to an aspirating machine with a gentle vacuum, or, for very
early abortions, a hand-held syringe may be used. The contents of the uterus are removed through the tube with gentle
suction. The entire procedure takes around five minutes.
Dilation and evacuation (D&E) can be done from about six weeks after the last menstrual period through the second
trimester. Some abortion providers only use D&E for later term abortions.
Local anesthetic and an oral analgesic are usually used, but conscious sedation or a general anesthetic (being put to sleep)
are also available through some providers. The opening of the cervix is stretched with cervical dilators, just like with the
vacuum aspiration procedure. Another sort of dilator may also be used (called lams or lamanaria), made of soft fibers
which absorb moisture from the womans body, and expand overnight to enlarge the opening in the cervix. Sometimes a
drug, misoprostol, may be used with the dilators to soften the cervix. Depending on what is used, how far along you are
and individual clinic policies and practices, you may be sent home overnight with a dilator or dilators in place, and with
antibiotics to prevent infection. If so, youll need to return the next day for the second part of the procedure.
After the cervical opening is dilated, a suction process will take place. With a suction curettage or dilation and curettage
(D&C), theres a final step, which is to be sure the uterus has been completely emptied by using a curette -- a small metal
loop -- to gently scrape the uterine walls. D&Cs are being used less often now for abortions due to advancements in the
suction tools and machines as well as ultrasound technology to assure the uterus has been emptied completely. D&C
procedures are also sometimes used for other things unrelated to abortion, such as for those with PCOS, after miscarriage,
and sometimes to resolve unexplained vaginal bleeding.
This process -- not including the time it takes for dilation, which can add one or two extra days for dilation -- takes around
ten to fifteen minutes.
Late-term abortions
Late-term abortions - which are very inaccurately sometimes called partial-birth abortions -- are rare. When they are
elective - within the legal window for them to be elective in a given location -- that is generally because a person either
did not realize they were pregnant until very late in the game (which is more common than many people think), because
they were unable to afford or access abortion earlier on, because they were pressured not to have an abortion they wanted
earlier and other related reasons. But overall, late-term abortions are advised by doctors due to health issues of the mother
of fetus in which a continued pregnancy would put the life or health of one or both at a high risk -- and those procedures
are also often done when a fetus is stillborn, to prevent the mother the physical and emotional pain of having to deliver a
child which is no longer alive or who will not live. In the U.S., before the ban on late-term abortions, the procedure was

incredibly rare, only a fraction of a percent of all abortions performed were performed after 24 weeks of pregnancy (most
medical organizations have agreed that fetal viability is only established after 24-27 weeks).
Abortion Costs
Both medical and surgical first trimester abortion cost about the same: currently around $450 - to over $1,000 in the
United States. The later in a pregnancy one has an abortion, the greater the cost.
Some insurance policies, or federal or medical aid may cover some abortion costs, but often only when an abortion is
medically necessary rather than elective, in other words, when a pregnancy puts the life of mother or child in danger.
Some states and countries do, however, provide funds or coverage for elective abortions for low-income people. Many
abortion providers provide abortion services with a sliding fee scale based on your income. There are also some grassroots
sources for financial assistance for abortion for those who want an abortion but cannot come up with all the funds to do so
themselves. For information on abortion funds, see our page for the National Network of Abortion Funds.
(SIDEBAR)Herbal Abortion There are some herbs and supplements which have the capacity to terminate a pregnancy.
There are certainly also other physical ways to attempt abortion. But these methods are neither as safe nor effective as
legal, medical options. So long as medical or surgical abortion remain legal and accessible, those are the methods anyone
seeking an abortion would be strongly encouraged to seek out. Certainly, medical or surgical abortion are costly, but built
into that cost are a lot of safeguards for your health and well-being. Too, in attempting abortion in other ways, you not
only put your health at risk, but given so many of those methods are not very effective, you risk missing the window to get
the abortion you need if and when they do not work.
If you are simply curious or interested from an academic standpoint about herbs which have been used for abortion or
contraception, you can have a look at Willa Shaffers Midwifery & Herbs, or Jeannine Parvatis Hygieia: A Woman's
Herbal. However, in the interest of your health, safety and in you being able to effectively terminate a pregnancy, I
strongly advise you do not use those sources to attempt to self-abort.(/SIDEBAR)If you need an abortion and dont have
the funds for one, sound people to ask to chip in, and places to get funds, are:

the sexual partner who is equally responsible for your pregnancy

your close friends
parents or other supportive adults
by selling or auctioning off like via eBay anything valuable you have which is not as valuable to you as not
being pregnant anymore, or by having a minor garage sale

through odd jobs you can be paid cash for, like babysitting, housecleaning, dogwalking or carwashing
If you gather funds from multiple sources, you may find that getting the cash you need is doable.
It's understandable when you're pregnant and really don't want to be to feel very desperate. But if you're considering doing
something unsafe, either as a way to get the money to pay for an abortion, or in terms of attempting to abort or miscarry
yourself, please put your safety, health and well-being first. There always are sound, safe ways to raise funds or get an
abortion, and there are always people and places who are trustworthy who you can ask for help. Putting yourself or your
health in danger is much more likely to do you harm than good.
What to Expect During an Abortion
You should be treated with care and respect. Your privacy should be respected in every way. Any question you have at
any point in the process should be answered to your satisfaction. Generally, neither of these are problems with abortion
providers: providers and their staff take both of these issues very seriously, and many people will state that the care they
got during an abortion was the best healthcare they ever had in their lives.
Throughout the process you will be given counseling, where all of your procedure will be explained, and you can also
talk about how you are feeling about it or express any special needs or concerns. If you want counseling just to sort
through your options, many clinics provide what is called "options counseling," to help you make your decision. Its
important to be aware that you ALWAYS can opt out of the procedure at any time before it begins, and staff at your clinic
or doctors office should make that clear. If you know from the onset that you want more involved counseling because you
are not sure about abortion yet, you can make an appointment for that options counseling all by itself: you dont have to

schedule an abortion to receive it. Just know that at most clinics, it's standard policy that if you decide on abortion, you
will not be able to get it on the same day you have had options counseling.)
You should be helped to feel as emotionally and physically safe and secure as possible, and that includes security for the
clinic. The office or clinic where you have an abortion should be clean and sanitary. Your counselor, nurse and/or doctor
should explain your entire procedure to you, be willing to answer any -- and I do mean any -- questions you have at any
time before, during or after the procedure. If you want someone with you, you may be allowed that, though because of
health, legal and safety issues, that person may only be permitted to stay in the waiting room.
What an Abortion Feels Like
Abortion should not be highly painful, though everyone's pain threshold differs, and differences will also often be found
based on the specific procedure and what medications are being used to manage pain and/or anxiety.
Medical abortion will cause cramping at home that can be very uncomfortable, though pain medications are generally
given to help manage that pain. During surgical abortion, a person is likely to also experience cramping, usually greater
than menstrual cramps, and may feel some strong pricks, inside the pelvis, not unlike the sensation you feel in your
mouth when a dentist gives you an anesthetic injection. For those having a procedure past 12 weeks who are using
cervical inserts (lamanaria), having them put in can be painful, and it is also common to have cramps or discomfort while
they are in. Those who are more nervous, uncertain, scared or conflicted about an abortion are likely to experience more
pain or discomfort than those who are more relaxed and/or resolved.
So, you'll want to do all you can to be as relaxed as you possibly can (and if you're very nervous or scared, that's one
sound reason to consider sedation or general anesthesia), and to be sure -- and abortion providers will always want to
assure this as well -- that an abortion is what is wanted. Too, the earlier you can have an abortion procedure, the simpler
the procedure, and the less painful it usually is. Be sure to also use your pain medications provided as needed, or, if you
prefer alternate kinds of pain management, like acupressure or acupuncture, be sure those services are arranged in advance
and will be available to you.
Common side effects that many people will experience following abortion procedures include bleeding or spotting,
cramping (and again, you'll usually be given pain meds to help with that), nausea, sweating, feeling faint and, like those
who have given full-term birth, depression. Less frequent side effects may include heavy or prolonged bleeding, blood
clots, infection due to retained products of conception, dilators or infection caused by an STI or bacteria being introduced
to the uterus, which can cause fever, pain, abdominal tenderness and possibly scar tissue. If after an abortion side effects
persist for more than a few days or are severe, call your abortion provider or your doctor immediately. Even if youre not
sure if a side effect is normal, or if you just need your mind set at ease, always feel free to call your abortion provider and
ask anything you need to: dont worry about bothering them. Its their job to care for you throughout.
Abortion Aftercare
Your provider will give you detailed instructions about how to care for yourself after an abortion, including instructions
for any medications (like a standard antibiotic to prevent infection) they may give you, and you will also schedule a postabortion checkup with them, usually for a few weeks after your procedure.
Be sure if youre having an abortion procedure to try and schedule at least a day or two for your recovery, where you can
chill out, and not do anything too taxing. Its often advised that you still stay somewhat active, but this isnt the time to go
run a marathon. If you can arrange to have someone else around to check in on you and run any errands you might need
whether it be getting you more menstrual pads for bleeding, or renting you your favorite movies to cheer you up that can
be a real lifesaver.
Massaging your uterus between your hips, just under your navel can help with cramping and can also help to prevent
clotting. Youll want to avoid tub bathing, hot tubs or swimming, and will also not want to use tampons or menstrual cups
to manage bleeding: have washable or disposable pads handy instead. You will also want to hold off on sexual activity
until after your check-up. Its typical to have some bleeding or spotting for a few weeks, and dont worry if your
menstrual period doesnt show up right when youd expect: its normal for it to take a cycle or two to get back on track.

Its also typical for any pregnancy symptoms you were having to last another few days or so after an abortion, so you
dont need to worry that youre still pregnant because those symptoms didnt pass right away.
Additionally, if you want to take a pregnancy test after an abortion to assure you're not pregnant, know that it'll often be a
while -- from a few weeks to a couple months -- before you get a negative result, even though you are no longer pregnant.
Its very normal, after any pregnancy ends, whether it ends with childbirth or by terminating the pregnancy, for people to
deal with some depression or tough feelings, which can very in degree. Besides any emotional conflicts, pregnancy causes
some pretty big hormonal changes in your body, and when a pregnancy ends, by it by birth or abortion, theres another
bunch of big hormonal changes, and that often causes mood changes, sometimes pretty big ones. Obviously, if you have
any mixed feelings about your abortion or if you have an abortion you really didnt want to have youll likely have to
deal with more sadness than usual. If you dont feel sad or blue, thats okay, too, and it doesnt mean youre insensitive or
that there is something wrong with you. Plenty of people feel -- understandably -- very relieved and at peace after an
abortion, too.
So, just be prepared to give yourself good care, physically and emotionally, and to honor whatever it is that youre feeling.
Abortion Trauma
Many credible journals, like the Journal of American Medicine, have stated that there is no data to support the notion that
abortion is more emotionally traumatic than any other reproductive option. A recent press release from the American
Psychological Association, which has done a thorough review of all studies since 1989 on the matter, found that "there is
no credible evidence that a single elective abortion of an unwanted pregnancy in and of itself causes mental health
problems for adult women."
We have no logical reason, or any sound data, to assume that any one choice is more or less traumatic: in fact, many
studies support that the majority of people who freely choose abortion for themselves have positive, rather than negative,
psychological responses long-term.
There are some factors which are known to increase the possibility of emotional distress and trauma from abortion,
including being of a very young age, lack of support from partners or community (which includes the world-at-large),
pressure or coercion to abort, anxiety or distress before the procedure, moral or religious conflicts with abortion,
preexisting mental illness or depression, having survived sexualabuse or assault, low self-esteem and those whose coping
style involves lack of responsibility.
In other words, the sorts of factors we know to make ANY reproductive choice more likely to be traumatic for a person. In
fact, the factors above are very similar to the at-risk indicators usually listed for those who give birth and are more likely
to suffer from postpartum depression. So, remember, if you or someone you know is pregnant and making a reproductive
choice, it is vital that a pregnant person's choice is just that the option they feel is best for them, first and foremost, and
which they choose on their own and that emotional support throughout is crucial.

http://www.scarleteen.com/article/bodies/all_about_abortion
written 29 Oct 2007 . updated 09 Jan 2014