The Abortion Choice
The option of abortion may be the right choice for you if you do not feel you can parent at this time in your life, you are not comfortable with adoption or you do not wish to be pregnant.
Some people think abortion is a choice that people only choose in certain situations, i.e. the person is young or doesn’t have the income to support a child. The truth is there isn’t one “type” of person who this choice is right for – just like there isn’t one “type” of parent. People of all ages could choose to have an abortion for many reasons. This decision belongs to the individual and you don’t need to justify it to anyone.
The main questions are “Is this the right time for me to have a child?” and “What are my beliefs about abortion?” The following self-questionnaire may help you explore some of your values and feelings about abortion. You might also want to re-read the Options — Deciding What To Do section.
1. What were my views on abortion before I became pregnant?
2. Have my views of abortion changed now that I am pregnant?
3. Do I have spiritual or moral beliefs that may impact my decision?
4. Do I have people in my life that would support me with an abortion choice? Do I feel I need other people to support my choice?
5. How do I think I might feel after an abortion?
6. Do I feel pressured to make this choice in any way?
7. How would making this choice impact my life both in the short and long term?
8. What would make this the best choice for me?
Think about your answers and what they mean to you. You may want to discuss your answers with a family member, your partner, a friend or a counselor.
For Men
Although it is a woman’s right to choose whether or not she will have an abortion, many men have feelings about abortion and wonder how best to support their partners through the procedure. How involved should I be? What should I do for her? How will this change our relationship? Is the unintended pregnancy my fault?
In general, the best thing you can do is be actively involved in the entire process. Talk about your feelings and listen to her without trying to resolve her feelings for her. Show initiative by educating yourself about abortion and be prepared to support your partner physically and emotionally. You can accompany your partner to the hospital or clinic and make sure she is well taken care of after the abortion procedure. Some men experience a lot of feelings before and after the abortion procedure. It can help to talk with your partner, but she may be dealing with her own feelings. If you want to speak with someone talk to someone you trust such as a sibling, good friend or parent, or contact us at 403-283-5580 email: generalmail@calgarysexualhealth.ca
Accessing an Abortion
In Canada, abortion is legal. Access to abortion procedures varies from province to province. The large majority of abortions take place in the first trimester of pregnancy or up to 12 weeks from the date of her last period (LMP). In Calgary, a woman can access abortion until 20 weeks past the LMP. After 20 weeks, you will need to travel to Ontario or outside of the country. If you think you are past 20 weeks of pregnancy please call the Calgary Sexual Health Centre or Canadians for Choice.
Before abortions were legal in Canada, folks tried various methods to give themselves abortions or went to unqualified people. These “back-alley” abortions were very dangerous because they were often performed under inadequate and unsanitary conditions, and many women died from bleeding or infection. Today abortions are performed either at a hospital or a clinic by qualified doctors. It is a safe procedure with very few physical health risks.
Importance of a Test for Sexually Transmitted Infections (STIs)
If you are considering abortion, it is wise to be checked for sexually transmitted infections (STI) before having the procedure. Abortion involves dilating or opening the cervix and if an STI is present, it could move up into the uterus. This may cause more serious complications like infection or pelvic inflammatory disease (PID). STIs can be present with few or no symptoms so you may not be aware you are infected.
STI tests are available at STI Clinics, your doctor’s office and at many health units. Because individual clinics may require other tests before the procedure, and may offer some tests at the time of the procedure, you may want to inquire about testing beforehand.
Consent
Consent for an abortion in Alberta is based on a person’s capacity to understand the procedure. There is no age limit for access to abortion. If the doctor or clinic staff feels you understand the procedure and its risks, you may sign your own consent form.
It’s a good idea for young people to talk with their parents prior to the procedure if they are able to. Most often parents are sympathetic and supportive and feel glad that their daughter came to talk to them. A counsellor can help you plan the conversation.
If you are reluctant to talk with a parent, you do not have to. You may want to think about bringing a partner, friend or other family member for support. People 12 or younger who don’t have a supportive parent they are communicating with will be connected with a community social worker for support.
Abortion Methods
Surgical Abortion
Vacuum aspiration is the most common and safest abortion procedure. It is performed up to 20 weeks from the first day of your last period (LMP).
A surgical abortion will take between 10 to 15 minutes. A doctor will start an intravenous (I.V.) with a small needle in the arm or hand and give some medication to make her feel sleepy and relaxed. You will be drowsy but not completely asleep during the procedure. Once these drugs have taken effect, the doctor will put some freezing in the cervix and gently dilate (open) the cervix.
There are two methods that are used to dilate a cervix: rod dilation and laminaria dilation.
1. Rod dilation is early in the pregnancy, generally 13 weeks and under. Just prior to the abortion, tapered metal rods are inserted into the vagina and used to gradually open the cervix.
2. Laminaria dilation is used for later term abortions. This will require two visits to the clinic or hospital. A laminaria (it looks like a small stick) is inserted in the cervix usually the day before the procedure. The laminaria absorbs moisture in the body and gently opens the cervix. You return to the clinic the next day for the procedure.
Once the cervix is opened the doctor will then insert a small tube to gently remove the contents of the uterus (womb). You may notice a feeling of pressure and some cramps in her lower abdomen. Most do not feel any pain at all. Afterwards, most people do not remember very much about the procedure because they will be very drowsy from the medication.
Medical Abortion
If your pregnancy is 7 weeks or less, counting from the first day of your last normal menstrual period, you may wish to consider a medical or medication abortion. Medication abortion is done using a combination of medications, together called Mifegymiso.
Before you receive the medication you will receive an ultrasound to confirm you are no more than 7 weeks (49 days) pregnant. If you are eligible for a medication abortion, you will meet with our counsellor to discuss the procedure in detail. You will then meet with the physician who will take your medical history and start the treatment. It is essential that you are able to return to the clinic for a follow-up ultrasound or go to a laboratory for a blood test that will determine if the abortion is complete. You must also be willing to have a uterine aspiration procedure (D&C) if the medication fails to end the pregnancy, as there is some evidence that the medications can cause fetal damage.
Day 1: You will take the first medication, mifepristone, in the clinic. Mifepristone will destabilize the lining of your uterus and end the pregnancy. Once you take this medication these effects are not reversible. You will be given the misoprostol tablets to take home with you along with other medications to help you with possible side effects. You will be given an appointment to return to the clinic for an ultrasound in 10-14 days or a requisition to have a laboratory test to determine if your pregnancy has ended.
Day 2-3: You will insert the misoprostol tablets into your vagina or into the cheeks of your mouth. You may choose the time of day you take the misoprostol, but be aware that you will start to bleed within 1-4 hours. As you can expect to have heavy bleeding and strong cramping you should choose a time when you are able to stay home for the rest of the day. The bleeding and cramping may continue for several hours. After that, lighter bleeding may continue off and on for 1-2 weeks or more.
Day 7-14: You will either return to the clinic for an ultrasound or go to a lab for a blood test to determine if your pregnancy has ended. If it is determined that the abortion is complete, then no further treatment or appointments are necessary. There is a 2% failure rate with these medications and if they have failed to induce an abortion it is recommended you return for a uterine aspiration to complete the procedure as the medications are known to cause fetal damage..
Side Effects: Most women will need pain medications such as ibuprofen and Tylenol to help with the pain associated with medication abortion. Heavy bleeding resulting in soaking 1-2 large pads every hour may occur for several hours. Nausea, vomiting, diarrhea, fever, chills, headaches and fatigue are common side effects of the medications. Some women will find these side effects can be intense. If you are unsure you are can manage these symptoms at home, you should choose an aspiration abortion instead.
Medication Abortion vs Aspiration Abortion
There are pros and cons to each type of procedure. You are at home for a medical abortion so this may seem more private or feel more natural to you. As well, you can choose to have someone with you or you can be alone if you prefer. You also avoid shots, anaesthesia or instruments in your body.
On the other hand, an aspiration abortion is over in a few minutes, can be done later in the pregnancy and medical staff are with you during the abortion. However, the provider will put instruments inside the uterus and you will be given anaesthetics and other pain medications which may cause side effects. You must have someone to drive you home as you will be legally impaired by the medications.
Although there is bleeding and cramping with both aspiration and medication abortions, bleeding and cramping will be more intense and of greater duration with a medication abortion. Please consider carefully which type of procedure best suits you. Our staff will be happy to assist you and answer your questions and concerns before you make your appointment. However, if you book for a medical abortion and change your mind and decide you would prefer an aspiration abortion when you get to the clinic, you will have to rebook an appointment on another day.
Source: Kensington Clinic Website http://kensingtonclinic.com/abortion-procedure/medical-abortion/
Before You Leave the Clinic
When the abortion is done, a client can expect to remain at the clinic for about 30 to 45 minutes until the effects of the drugs wear off. You can expect to be at the clinic for 2 to 3 hours in total for the procedure. A nurse will check blood pressure and give her something small to eat and drink. As soon as you feel well you can go home. It is important to arrange a ride home from the clinic (either from a support person or a taxi). DO NOT drive yourself home; the drugs from the procedure may affect your ability to drive for up to 24 hours following the procedure.
What to Expect After the Procedure
Some clients feel light-headed and tired on the day of the abortion.
Signs of pregnancy (such as nausea or breast tenderness) should stop within about 4 to 5 days.
You can expect to have vaginal bleeding similar to a period for about one week. Small blood clots may also be passed. Use sanitary pads until bleeding stops. Avoid using tampons as this can lead to an infection.
Some people experience abdominal cramps. Medicine such as an acetaminophen or an ibuprofen product can be taken to alleviate any discomfort.
Because of the medication given during the procedure, judgment and memory may be affected for up to 24 hours. Do not drive for 24 hours.
Most people feel well enough to go back to work or school the next day. It is recommended that people try to avoid strenuous exercise for a few days and try to get lots of rest.
You can shower or bath after the procedure. It is recommended to use plain soap, not bubble bath and do not douche as this could lead to infection.
To avoid an increased risk of infection and to give the body time to heal, avoid having sexual intercourse for three weeks after the abortion.
A check-up should be arranged with a doctor 2 weeks after the abortion.
You can expect to get their next normal period in about 4 to 6 weeks.
A pregnancy test may remain positive for about 2-4 weeks after an abortion while the body readjusts.
Although surgical abortion is a safe and relatively short procedure, it can be stressful and emotionally draining. Some people have lots of support while others keep the abortion very private. Regardless of your circumstances, we suggest you take some time to rest and take care of yourself after having an abortion.
Potential Risks
Abortion is a very safe procedure, but all medical procedures have some risk. The most common problems are hemorrhaging (bleeding), infection and drug side effects. This happens to fewer than 1 in 100 women.
Warning Signs
If someone experiences any one or more of the following symptoms within a few days of an abortion, you should call the clinic where she had the abortion performed, a doctor or go to an emergency department.
Fever over 37.8 degrees Celsius (100 degrees Fahrenheit).
Pain in your abdomen that is worse than period cramps.
Bleeding heavier than a normal menstrual period (i.e.: soaking a large pad in less than one hour).
Discharge from the vagina that smells bad.
Prolonged signs of pregnancy such as continuing sore breasts or nausea.
No period after 6 — 8 weeks
Birth Control
It is possible to get pregnant soon after an abortion. It is wise to plan for birth control and have the supplies needed before having intercourse again. If you plan to start using birth control pills, you should take her first pill the day after the abortion. Condoms are also recommended to prevent sexually transmitted infections (STIs).
Your Feelings
People generally have a lot of different feelings both before and after an abortion. You might feel sad, relieved, angry, happy or all of these feelings at once. It is important to honor your feelings and acknowledge them. They are normal. It also helps to realize that after an abortion, the body’s hormones are rapidly adjusting to the new reality of non-pregnancy. If you would like to talk about your feelings, speak to someone you trust, or contact us at 403-283-5580 or email: generalmail@calgarysexualhealth.ca
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