What is Abortion?
Abortion is ending a pregnancy by choice. There are two primary methods for abortion available, the medical abortion (with medicine) and the surgical abortion (through aspiration or dilation and evacuation, D&E). These options may change or become limited depending on the length of the pregnancy or the state you live in.
To obtain an abortion you must contact your nearest clinic and schedule an appointment. If you aren't sure where that is, click here. Appointments can last anywhere between 3-6+ hours, depending on a number of factors such as the type of procedure and where you live in proximity to the clinic. You will also need to locate transportation and secure payment for the abortion. Most clinics require payment at the time of the appointment, but are also able to accept insurance or financial assistance.
Which method is right for me?
Both the surgical and medication abortion methods are very safe and effective, so the choice between surgical and medication abortion is often made for more personal personal reasons.
If you are considering abortion and are not sure if it is the decision that is right for you, or are undecided between the medication or the surgical option, please visit the Pregnancy Options Workbook - an excellent online resource to help navigate through your feelings.
Medication abortion, sometimes called RU-486 or 'the abortion pill," is a way to end a pregnancy without surgery. Medication abortion is available early in pregnancy, from about 4 weeks through 10 weeks from your last menstrual period, and can be used at home. Texas does have a special law that prevents women with pregnancies over 7 weeks to obtain this medication, and all pills must be taken in the presence of the physician.
Two medications are used over a span of time to end the pregnancy and assist the body in passing the pregnancy. Medication abortion is approximately 95-98% effective in early pregnancy.
Advantages to the Medication Abortion
- The pregnancy can be passed at home, which some women feel is more private. This can be especially helpful for women who are afraid of doctors, medical facilities, or needles.
- It can be done without surgery, which some women feel is more natural or less invasive to the body.
What can I expect if I choose to have a medication abortion?
To obtain a medication abortion in Texas, plan on three visits to the clinic over four days.
Visit 1 will include standard preoperative work including an ultrasound to determine the size and location of the pregnancy, lab work, and complete necessary paperwork.
Visit 2 will involve taking the first medication, Mifeprex, to stop the production of the pregnancy hormone and cause the pregnancy to detach from the uterine wall. Some women report a little nausea after taking Mifeprex, but most women don't report any side effects at all.
Visit 3 involves taking the second medication, Misoprostol or Cytotec, to cause your uterus to contract and your cervix to open slightly, allowing your body to expel the pregnancy. The medication is ingested in the clinic office, however the pregnancy is passed in the comfort of your home. This can be accompanied by mild to intense cramping and heavy bleeding and it is recommended to have someone around who can help should you need it (even if only to get you a glass of water).
Very strong cramping is a normal part of this process, and cramping typically starts about one to four hours after you take the Misoprostol or Cytotec, The doctor may prescribe medication to alleviate your cramps. Generally the whole abortion is done within 24 hours. Heavy bleeding and clotting is also normal, and your clinic will schedule a free check-up 7-14 days after your abortion to ensure you are doing well and your abortion is complete.
The type of surgical abortion procedure performed can change depending upon the length of the pregnancy.
Many clinics offer additional sedation options for your added comfort, although they are not usually necessary to have the abortion. If you choose to use IV sedation during the procedure you will be very relaxed and near sleep. The IV medication cannot take away all the pain, but it helps many women feel more comfortable. Local anesthesia (awake) is also commonly used to numb the cervical area, although you may still feel some cramping (like heavy menstrual cramps) during the abortion.
Early Surgical Abortion (Aspiration)
For most pregnancies under 14 weeks from the last menstrual period, the doctor will perform a vacuum aspiration abortion. The doctor will place a speculum inside the vagina to hold the vagina walls apart and then will dilate the cervix (the opening to the uterus). Lastly, a suction canula will remove the pregnancy from the uterus.
Dilation and Evacuation (D&E)
After about 14 weeks, the abortion is completed using dilation and evacuation (D&E). This is procedure still uses the vacuum aspiration, but also requires further dilation of the cervix. This may be achieved by taking medication, Misoprostol, to help dilate and soften the cervix, or by also using sterile absorbent fiber rods called laminaria, which are inserted into the cervix often the day before the procedure.
This procedure can take anywhere between 10 to 45 minutes and may require additional medical instruments to remove the pregnancy. In the state of Texas, clinics are able to perform abortion procedures to 22 weeks from the last menstrual period.
Advantages to the Surgical Abortion
- It is a quicker process overall - when the woman leaves the clinic on the second appointment day (or first if you live over 100 miles from a clinic), the surgical abortion has been completed.
- For many women, there is less cramping and bleeding than with the pill.
- It is done under medical supervision, which many women find reassuring. This is especially helpful for women who live far from the clinic.