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Abortion

Terminating your pregnancy is a monumental decision.  A decision you should be fully informed on about what’s happening to your body, your medical rights and abortion options.  Abortion is a medical procedure and should be taken into consideration as such. You wouldn’t go to the dentist to get a tooth pulled without knowing exactly what the dentist is going to do, would you? The same principle applies here. You need to know exactly what abortion procedures are, the risks, and the physical and emotional impact. Although we do not offer abortion services, we feel that it is important to empower and educate you with the knowledge about your pregnancy and your body. We are here to provide you education and information in a loving accepting environment.

There are probably a million thoughts going through your mind right now. What about my future? How will I ever go to college or continue college? I just found the perfect job. Is this going to ruin it? Should keep it? Terminate? This wasn’t supposed to happen. What will my parents think? What will he think? Who is the father? What will my husband think? We see women in all kinds of different circumstances.

What can I expect at my appointment with InnerVisions Health Care?

During your first appointment, you will have the opportunity to take a medical grade pregnancy test to verify if you are pregnant. If it is positive you will be offered an ultrasound. The purpose of the ultrasound is to give you further information about your pregnancy such as placement of a pregnancy in the uterus, and measurement of pregnancy growth. All of this information will be important as you evaluate your options around abortion, parenting, or adoption. You will also have the opportunity at this appointment to have an STD/STI test. At the end of these tests, you will be provided with information specific to your situation to help you make decisions on what your next steps might be.

Are all pregnancies viable? Not all pregnancies are viable. To some, this is good news and to others, it is a disappointment. In the United States, 10-20% of pregnancies will end in miscarriage. If you are leaning towards an abortion, it is important to determine growth of the pregnancy before making a decision for an invasive medical procedure that may not be necessary.

What is an intrauterine pregnancy? Intrauterine pregnancy is a pregnancy that has implanted into a woman’s uterus. There are occasions when a pregnancy can implant into the fallopian tubes known as an ectopic pregnancy. This can be extremely dangerous to the mother and is considered an event that requires prompt medical attention.

Why does the gestational age matter? Gestational age is simply how far along you are in your pregnancy. This is important as it provides valuable information regarding the pregnancy.  How far you are into your pregnancy can impact the options available to you.

How long will the appointment take? Similar to seeing your family physician, please allow at least 45 minutes for STD testing and 1 1/2 hours for a pregnancy appointment. We also encourage you to come 15 minutes prior to your scheduled appointment to complete all necessary paperwork.

Can I make an appointment just to discuss my options? Our staff welcomes you to come in for a discussion on options. We find that the most important part of this process is to first determine if you are pregnant. For this reason, we start all appointments with a pregnancy test. Following the completion of a pregnancy test, you will be provided time where we will listen to you. You can share as much or as little as you like. We will provide you with both education and information on abortion and abortion alternatives, and address any needs or concerns that you may have.

Remember the first step is to confirm your pregnancy, if it’s viable, and get tested for STD/STI here at the center.

Do I Really Need to Get STD/STI testing if I want to have an abortion?

Yes! Can I say it again? Yes! First, it’s super important that you get tested for STD/STI (Sexually Transmitted Disease/Sexually Transmitted Infection) just for your own knowledge. An undiagnosed STD/STI can cause long-term and sometimes irreversible effects if not treated appropriately. At our center we test for Chlamydia, HIV, Gonorrhea, Syphilis, Hep C, Herpes Type 1 & 2.

Secondly, when dealing with a possible abortion, an STD/STI could cause potential complication following the procedure, including Pelvis Inflammatory Disease (PID). PID occurs because of untreated bacterial infections, including chlamydia and gonorrhea (Center of Disease Control). Research states, women who have abortions are more likely to develop PID after their procedure because of the risk of bacterial infection during the procedure. PID can lead to some very serious complication including infertility and ectopic pregnancy (tubal pregnancy). When PID is caused by a chlamydia infection, a woman may be more likely to experience only mild symptoms even when extremely serious damage is being done to her reproductive organs. (source: National Center of Biotechnology Information as the US National Library of Medicine) *More information on STD/STI under STD/STI tab).

Does my partner have to give consent for me to have an abortion? Your confidentiality and individuality are of top importance. Your rights and consent information will be provided to you at your confidential individual appointment.

What do I do if someone is pressuring me to make a decision that I am uncomfortable with? Whether you are being pressured into parenting, adoption, abortion, the morning-after pill or any other circumstance, the decision is always that of the woman. We are your advocate and will support you during this time as you determine the choice that is best for you.

Are there medical risks associated with a medical abortion (RU486) or is that just a myth? If so, what are they? An abortion through the abortion pill, also referred to as the RU-486 pill, is a serious medical procedure or medication. It should be considered seriously.  While there are many myths, there is also a lot of truth to the pros and cons. Our medical staff is trained to answer all of your questions and provide you with additional websites and information for you to review in making decisions you feel comfortable with.

What will it cost for the services at your clinic?  All services are provided at no cost.  This is a free clinic.  Our goal is to empower and educate you about your sexual health as well as be a resource for those difficult moments.

Who would I have to tell about my appointment? Your appointment is scheduled by you and is completely confidential.

What are the risks associated with an STD? The risks associated with Sexually Transmitted Diseases (STDs) can vary depending on the diagnosis. However, all carry risks of numerous short and long-term effects including complications in pregnancy, infertility, Pelvic Inflammatory Disease, and even death, if left untreated.

Why is it important to get STD testing before considering an abortion? Serious infection can spread internally if left untreated.

Is the RU486 permanent?  I changed my mind after taking it, now what?  If you have taken the abortion pill and change your mind, there is support available, please call this 24/7 hotline immediately for help with reversing the effects of the pill. 1-877-558-0333

Do you have counseling available for me? Yes! Whether facing an unplanned pregnancy, sexual assault, sexual trauma, rape, STD/STI concerns, pre or post-abortive, or questions regarding your sexuality, our medical staff is trained to provide comprehensive education and support onsite, at no cost to you. Professional counseling referrals are available depending on your needs.

Can I come alone? Yes! Our Clinic strongly values confidentiality. We will provide you with a safe and completely confidential environment to protect both your privacy and safety. Whether you are pregnant, experienced rape, a victim of sexual assault, date rate, or any type of abuse, we are to here for YOU!

Is having an abortion safe?  How long after conception can you have an abortion?  Are there any long term side effects of having an abortion, the RU486 pill or morning after pill?  How will it make me feel?  What are the side effects of a medical abortion? How will I afford to become a parent? 

Our trained medical staff are available to discuss with you any questions you may have regarding having an abortion, barriers to continuing a pregnancy, as well as abortion procedures and risks associated with abortion.

There are medication and surgical abortion procedures. The types of abortion that may be available depend on factors such as how far along you are in your pregnancy.

There are many things to consider. There is no need to rush this decision.  Take the time you need to equip yourself to make your best decision, a decision you will live with for the rest of your life.

While we do not perform or refer for abortions, we are here to help you understand all your options so that you can make an informed decision. It is your pregnancy, your right to know, and your decision. We are committed to providing you with the knowledge and caring support you need to make an informed decision. Contact us today to schedule an appointment for options counseling.

How much does an abortion cost?

The following information is provided for education purposes only and should not be considered to be diagnosis or treatment of any kind. Please always seek in person professional and/or medical advise before making any decisions.

The financial cost of an abortion ranges from state to state, the type of clinic, the type of doctor’s office and if you have insurance or not. According to Clear Health Costs, here are some ranges on the prices of abortions (these prices may or may not include follow up appointment costs and other fees)

  • Abortion Pill: (non-surgical): $605 (up to 10 weeks)
  • Surgical Abortion (required after 10 weeks gestation) through 11.6 weeks: $648
  • Abortion from 12.1 weeks- 15.6 weeks: $800
  • Abortion from 16 weeks-17.6 weeks: $1,050
  • Abortion from 18 weeks-19.6 weeks: $1,700
  • Abortion from 20 weeks- 21.6 weeks: $2,225
  • Abortion from 22 weeks – and after: $3,275

(Sourced by a Los Angeles Planned Parenthood: https://clearhealthcosts.com/blog/2014/06/much-abortion-cost-draft-theresas/)

For your research purposes here are a list of the most common abortions that you may want to understand better.  We do not offer abortion or termination of pregnancy services.  We believe an empowered woman is an informed woman.  This information is provided to help you as you research your options.

What are the different types of abortion?

There are several different types of abortion. Let’s go through the most common ones them one-by-one so you can have a full understanding of each one.

Ru-486

RU-486 is commonly referred to as the Abortion Pill. It is actually 2 pills taken to terminate an embryo up to 10 weeks gestation. Gestation is referring to how far along you are in your pregnancy. This is why it is so important to know your accurate gestational age. RU-486 is considered a medical abortion although it is not surgical. RU-486 must be properly prescribed and includes a three-step process.

  • First, take Mifepristone. This medication actually blocks your body’s ability to recognize progesterone by the uterus. Progesterone is one of the hormones that your uterus needs to maintain the life of the embryo. By blocking progesterone, the lining of the uterus begins to break down. Then, the life of the growing embryo is ended.
  • Secondly, take Misoprostol. Misoprostol causes the uterus to contract causing the embryo, lining of the uterus, and the embryonic sac to exit the uterus. This process usually takes 24-48 hours and causes extreme bleeding and strong uterine cramping. Do not use tampons during the process, only use pads.
  • Lastly, return to the clinic to confirm that the procedure is complete. Your doctor will ask you a variety of questions from if you were able to see the expulsion of the gestational sac or embryo, to how much bleeding did you experience, and if you think you are still experiencing pregnancy symptoms.
  • This is very important because the Abortion Pill is not 100% effective and you may still be pregnant. If that is the case, then a surgical abortion will be the next step.
  • Your period should return within the next 2 months after the abortion process.

What you need to know: The abortion pill is not taken in a hospital. It is taken at home. Since heavy bleeding and cramping accompany it, it is important that you have someone with you in case of an emergency. Other symptoms during the process can include:

  • Mild fever and chills
  • Light lactation
  • Diarrhea
  • Nausea and sometimes vomiting

Things to be aware about taking ru-486:

  • Do not take it if you are past the 10-week window. The chances for it working decrease.
  • You are using an IUD.
  • You have a blood clotting condition and/or you are taking blood-clotting medication.
  • Determine if you are willing to continue with a surgical abortion if the pill fails.

Please contact your doctor or go the ER if you are experiencing any of these symptoms after taking the abortion pill:

  • Foul smelling vaginal discharge
  • Blood clots that occur for 2 hours or more.
  • Excessive bleeding (fills up more than 2 pads in an hour and happens for 2 hours or more)
  • Extreme depression and suicidal thoughts.
  • A fever of 100.4F or higher.
  • Severe depression and/or suicidal thoughts.

What if I change my mind?

There is a pill called the Abortion Pill Reversal (APR). What it does, is that it essentially counteracts the first pill (Mifepristone) of ru-486. It can only be used if only the first pill is taken. If the 2nd pill has been ingested, APR cannot be used.

The idea is that a major dosage of progesterone will make up for the progesterone being blocked by the Mifepristone. It needs to be taken up to 72 hours after taking Mifepristone. The earlier it is taken the better. One particular statistic states that if taken within the first 24 hours, there is a 55% chance that the pregnancy will continue (americanpregnancy.org).

Aspiration Abortion (first trimester)

Aspiration Abortion is commonly referred to as a suction abortion and considered a surgical procedure. This is a one-day procedure available up to the 14th week of pregnancy. It should entail local anesthesia and oral pain relievers. It is common that this procedure could take between 3 – 6 or more hours. It should only be performed in a medical setting.

The Procedure:

  • You should receive oral pain medications such as Vicodin, Valium, and ibuprofen. If you are more than 12 weeks pregnant, you should also receive misoprostol with causes the cervix to soften and dilation to occur.
  • If you are less than 12 weeks pregnant, you will begin your procedure in about an hour to allow the pain relievers to kick in.
  • If you are over 12 weeks pregnant, the misoprostol needs a few hours to work.
  • After the medications are working, you will go into the procedure room and be asked to undress from the waist down.
  • The doctor will use a tool called the “speculum” to view inside your vagina.
  • Your vagina will be cleaned with soapy gauze and numbing medication applied to your cervix.
  • The use of metal rods will then be used to dilate your cervix.
  • A tube will be inserted into your uterus.
  • The doctor will then apply suction from a machine to the end of the tube and remove the embryo through the tube.
  • The doctor will check to make sure the complete embryo has been suctioned out, and if not, repeat suction.

Side Effects:

  • Cramping
  • Dizziness
  • Bleeding (including blood clots)

What you need to know: Any surgical procedure has risk involved. If you experience any of these symptoms go to the emergency room or call your doctor.

  • Fever (this is usually a sign of infection)
  • Passing clots that are larger than a fist for more than 2 hours.
  • Bleeding that goes through 2 pads in an hour for more than an hour.
  • Vaginal discharge that is foul smelling.
  • Pain and cramping that gets worse over time
  • Continued pregnancy symptoms.

 

Dilation and Evacuation (D&E)

This surgical type of abortion is the most commonly used in second trimester abortion. It takes places usually between 15 weeks and 23 weeks gestation. It takes a couple of days for the entire procedure.

The Procedure:

  • In many cases, your doctor will insert laminaria (or another synthetic dilator) inside your cervix 24 hours before the procedure.
  • When a woman comes back the next day, she should be offered antibiotics to prevent infection and may be administered anesthesia for the procedure.
  • The doctor will then begin to open the cervix using metal dilators and a speculum.
  • Then, the doctor will insert a large suction catheter into the uterus emptying the amniotic fluid.
  • When the amniotic fluid is removed, a sopher clamp (an instrument that allows the doctor used to grasp the fetus) is then used to pull out the fetus.
  • This can take several attempts.
  • After the fetus is removed, the doctor will use a curette instrument to scrape the inside of the uterus, remove the placenta, and any other remaining tissue.
  • All tissue and fetal matter is examined to determine that everything was removed and the procedure is complete.

What you need to know:

  • There may be irregular bleeding and spotting in the first 2 weeks.
  • Don’t use tampons only use pads.
  • There could be some cramping that resemble menstrual cramps which may last for a few hours to a few days as the uterus shrinks to its average size.
  • Antibiotics will be given to prevent infection.
  • Over the counter pain medication can be taken to help alleviate pain.

Contact the doctor or visit the emergency room if you have any of these symptoms:

  • Bleeding heavily for 12 or more hours in a row.
  • Soaking more than 2 pads in an hour, for 2 or more hours in a row.
  • Blood clots the size of a ping-pong ball being passed for 2 or more hours.
  • Signs of infection that include headache, dizziness, fever of 100.4 F or higher that lasts longer than 4 hours.
  • Foul-smelling vaginal discharge
  • Rapid heart rate
  • Sudden abdominal pain
  • Pain, swelling or redness in the genital area.

Risks:

  • Injury to the uterus
  • Infection
  • Moderate to severe bleeding.
  • Blood clots can occur if the uterus doesn’t contract to pass all the tissue (medication can be used to stop the bleeding) and the cervical opening can become blocked and prevents blood from leaving the uterus. This created an enlarged uterus with tenderness, cramping, and nausea.
  • A repeat vacuum aspiration can be used if there is any fetal/tissue remains and to expel blood clots.

 

Late-Term Abortion

Late-term abortion is really directly connected to “fetal viability” or when a fetus can survive outside the womb with our without medical assistance. Some states will say that is 24 weeks of gestation and others will say it’s different. The definition is different from state to state. If you are unaware of your state’s late-term abortion laws, communicate your concerns to the doctor or research your particular states’ abortion laws.

However, in cases where gestation is 21 weeks, Dilation and Extraction (D&X), Intrauterine Cranial Decompression, and Partial Birth Abortion are used.

The Procedure:

  • Two days before the procedure the use of laminaria (a product made of seaweed) is inserted vaginally to dilate the cervix.
  • On the third day, the amniotic sac should break.
  • After returning to the clinic, forceps are to grasp the fetus and pull it out by the legs through the birth canal.
  • Before the head comes completely through the birth canal, a tiny incision is placed at the base of the skull and a suction catheter inside.
  • The catheter suctions the developing brain material until the skull collapses.
  • After that, the fetus is then completely removed.

Contact the doctor or visit the emergency room if you have any of these symptoms:

  • Bleeding heavily for 12 or more hours in a row.
  • Soaking more than 2 pads in an hour, for 2 or more hours in a row.
  • Blood clots the size of a ping-pong ball being passed for 2 or more hours.
  • Signs of infection that include headache, dizziness, fever of 100.4 F or higher that lasts longer than 4 hours.
  • Foul-smelling vaginal discharge
  • Rapid heart rate
  • Sudden abdominal pain
  • Pain, swelling or redness in the genital area.

Risks:

  • Injury to the uterus
  • Infection
  • Moderate to severe bleeding.
  • Blood clots can occur if the uterus doesn’t contract to pass all the tissue (medication can be used to stop the bleeding) and the cervical opening can become blocked and prevents blood from leaving the uterus. This created an enlarged uterus with tenderness, cramping, and nausea.
  • A repeat vacuum aspiration can be used if there is any fetal/tissue remains and to expel blood clots.

Emotional Cost

There is an emotional component that comes with having an abortion procedure. Of course, terminating a pregnancy causes hormonal shifts that effect mood. But, there is more than that. There are many feelings that come with having an abortion that can be complex and, at times, life threatening. It’s important to reach out to someone to share your concerns. Consider contacting a counselor or if you don’t know who to turn to, call us! We are willing and ready to walk alongside you in any part of your journey. Here is a list of possible emotional feelings after having an abortion procedure.

  • Guilt
  • Shame
  • Anger
  • Loneliness or isolation
  • Low self-confidence
  • Problems sleeping
  • Problems dealing with relationships
  • Suicidal thoughts and feelings
  • Possible eating disorders
  • Anxiety
  • Depression

**If you are having suicidal thoughts or long term depression, seek a medical professional immediately.

Why do some women have negative emotional or psychological effects after an abortion?

Many times, the emotional side effects are highly connected to how we view the growing fetus. Some don’t view the fetus as a baby, when others do. Some feel immediate relief and others struggles with the after effects for years. Here are some reasons why some women have a more difficult time after an abortion.

  • Someone who may already have mental health issues.
  • If the abortion felt pressured or demanded.
  • Someone with a religious background that doesn’t support abortion.
  • Someone who has a moral conflict with abortion.
  • Someone who had a second or third term abortion.
  • Someone who doesn’t have a support system.
  • Someone who felt abortion was necessary based off of genetic testing or fetal abnormalities.

You are not alone if you have some of these questions racing through your mind.  We can provide you answers and information to all of these questions and more during your appointment. You can call us or text us at any time to set up an appointment. Text: 515-783-1286 Call: 515-440-2273

The information provided is for education purposes only.  This information should not be considered to be diagnosis or treatment of any kind. Please always seek in person professional and/or medical advise before making any decisions.

Sources:
Center of Disease Control (www.cdc.gov)
Mayo Clinic (www.mayoclinic.org)
C.S. Mott Children’s Hospital (www.mottchildrens.org)
American Pregnancy (www.americanpregnancy.org)
University of California San Francisco Children’s Hospital (www.ucsfhealth.org)