An overview of how to have a safe abortion and when to use the abortion pill

Every year, around 40% of unplanned pregnancies result in abortions.

Lack of support from a partner or family, financial instability, and health concerns are all factors that influence abortion decisions.

An overview of how to have a safe abortion and when to use the abortion pill - Photo by Cavan Images/Getty Images
An overview of how to have a safe abortion and when to use the abortion pill – Photo by Cavan Images/Getty Images

It is also legal for women who become pregnant due to failure of contraception or rape to terminate their pregnancy.

A new Texas law prohibits abortions after 6 weeks of pregnancy, which is usually when most women discover they’re pregnant. So many Texans will either have to travel out of state for an abortion, or remain pregnant against their will.

Ultimately, the choice is yours. Before having an abortion, it’s important to know where to go for safe services and what to expect during the procedure.

Here we discuss how to safely access these services, what to expect during each procedure, and how much each procedure costs.

Abortion pill

The abortion pill is non-invasive and recommended for pregnancies up to 10-11 weeks.

Note: Emergency contraception, like Plan B, is over-the-counter and won’t work if you’re already pregnant. But it does stop ovulation after unprotected sex.

Major medical organizations worldwide support medication abortion.

Medical abortion, according to OB-GYN Kelly Culwell, MD, is a two-step process.

The first involves taking a single pill called Mifepristone, which blocks the body’s production of progesterone and thins the uterine lining. This pill is usually given at a doctor’s office, but state laws may vary. These medications can be safely taken at home.

After that, you’ll be given Misoprostol pills to take at home. These drugs cause an early miscarriage and can cause heavy bleeding and cramping.

Note: Mifepristone isn’t always available. In this case, only misoprostol is acceptable.

The abortion pill method works 94-98 percent of the time, eight weeks or less. But its efficacy diminishes with time. At 10-11 weeks, it works about 85% of the time.

You’ll need to see your doctor a week later to confirm the abortion worked. Some providers will simply ask you to do a home pregnancy test and follow up by phone or telemedicine.

Abortion via suction

Suction abortions are performed in a doctor’s office, clinic, or operating room. It can be done up to 14 weeks after your last period.

The cervix may need to be dilated before a small tube is inserted into the uterus to suction out the contents.

Pain and anxiety can be relieved with local anesthesia or mild sedation, says Culwell.

Abortion by dilation and evacuation

Dilation and evacuation (D&E) is the most common abortion procedure performed after 15 weeks of pregnancy, according to Culwell. The cervix is dilated and the pregnancy tissue is suctioned out.

“Sometimes it takes two days to make sure the cervix is open enough,” says Culwell. “Dilators may be placed in the cervix for several hours or a day before the procedure.”

Note: Having a surgical abortion requires a ride home. You’ll also need your ID and, if you have insurance, your card.

Who can get an abortion?

Abortion is legal in all 50 states, but eligibility varies.

According to Culwell, some states require parental consent for minors, others mandate waiting periods between the first counseling visit and the abortion, and still others prohibit abortion after a certain week of pregnancy. Most of these restrictions have exceptions (like rape or danger to the woman’s health).

Bausic says that pregnancies under 10 weeks are eligible for medical abortion and those under 14 weeks for surgical abortion.

If you’re under 18, 37 states require parental involvement in a minor’s abortion decision (either consent, notification, or both).

Culwell says many OB-GYNs perform abortions in their offices or hospitals. They can probably refer you to a clinic where you can get one.

If you’re unsure where to get an abortion, Culwell suggests looking up local providers on Planned Parenthood or the National Abortion Federation.

Important: “Crisis pregnancy centers” are not synonymous with abortion clinics. Indeed, it is possible that their goal is to persuade women not to terminate their pregnancy. Additionally, they may provide inaccurate information and are frequently staffed by non-medical personnel.

How much is abortion?

The cost of an abortion varies depending on the procedure, location, and insurance coverage.

In general, medical abortions are less expensive, but the cost increases as the pregnancy progresses.

According to the Guttmacher Institute, women pay around $500 for a surgical or medical abortion at 10 weeks and $1,195 for a 20-week abortion.

In addition, Culwell says that when you call to make an appointment, staff can estimate the procedure’s cost and see if your insurance covers it.

Some state Medicaid programs cover abortion costs, but only if the pregnancy is the result of rape, incest, or is deemed potentially life-threatening.

There are also nonprofit abortion funds that may help pay for the procedure if you don’t have insurance or it doesn’t cover it.

To ensure your safety, Culwell advises seeking an abortion from a reputable facility, clinic, or doctor.

Add resources:

If you are pregnant and considering abortion, it is entirely up to you. While the methods described above are safe and legal, it’s natural to have concerns about what to expect prior to and following the procedure. Here are a few resources to assist you.

  • Exhalation textline
  • Connect & Breathe is a post-abortion support group.
  • Toll-free number for All-Options
  • Post-abortion counseling provided by Planned Parenthood

Observation

How far along you are in your pregnancy determines your eligibility for an abortion, the cost, and whether you choose a medical or surgical abortion. Your OB-GYN can help you choose the best option for your situation.

Abortion is often associated with infertility, but Bausic and Culwell say that’s unlikely. Elective medical abortions do not appear to increase the risk of fertility issues or future pregnancy complications, according to the Mayo Clinic.

If you’re worried about how your abortion may affect future pregnancy chances, talk to a doctor.

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