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Patient education: Abortion (The Basics)

Patient education: Abortion (The Basics)

What is an abortion? — An abortion is a way to end a pregnancy. It is also called "pregnancy termination."

Why do people have abortions? — There are many reasons why a person might choose to have an abortion. For example:

They have an unplanned pregnancy and do not want to have a baby

They can't afford a baby

They don't have room in their life for a baby

They do not have help from a partner or family member and do not want to raise a baby alone

They have problems with their partner

They find out that something is wrong with the unborn baby

They have health problems that make pregnancy unsafe

People might have other reasons for their decision, too.

Is abortion legal? — The laws depend on where you live. In the US, each state has its own laws about abortion. In states where it is legal, there are different rules. For example, rules vary about how far along in pregnancy you can get an abortion, and if a minor (under 18 years old) needs permission from a parent or guardian. If permission is required, it is often possible to get permission from a judge instead.

In some states, laws prevent doctors and nurses from discussing abortion with you.

If you are not sure about the laws where you live, you can get information from a clinic that provides abortions, like Planned Parenthood (www.plannedparenthood.org). You can also get information from Repro Legal Helpline (www.reprolegalhelpline.org).

How do I decide if an abortion is right for me? — Deciding if you should have an abortion is a very personal decision. If you aren't sure what to do, it might help to talk to someone you trust. This could be a partner, family member, friend, or doctor. Having support can help make the experience easier. But the decision should be yours alone.

How is an abortion done? — There are 2 main ways to do an abortion:

Medication abortion – You take pills to end the pregnancy. This only works until 11 weeks into a pregnancy (that means 11 weeks after your last period). It is also sometimes called "medical abortion." People who have a medication abortion often need to take 2 separate medicines.

Procedural abortion – This is also called "surgical abortion," although it doesn't involve being cut open like in some types of surgery. This can be done in the first or second trimester. The actual procedure takes 15 to 30 minutes, but most people spend a few hours at the clinic.

How is a medication abortion done? — Most people will first take a medicine called mifepristone (brand name: Mifeprex). The medicine is usually given in a clinic or doctor's office, but in some cases, it is possible to take it at home. Then, 1 to 2 days later, you will take another medicine at home. This medicine is called misoprostol (brand name: Cytotec).

The medicines cause your body to end the pregnancy. It might take 4 to 6 hours after taking the second medicine for this to happen. When it does, you will bleed from your vagina. You will probably also see large blood clots or pieces of tissue.

Can I get a medication abortion without seeing a doctor or nurse? — If you are having a medication abortion, you might not have go to a clinic or doctor's office. Other ways to have a medication abortion include:

"Telemedicine" – This means that you do talk to a doctor or nurse, but over the phone or online instead of in person. They will ask questions to make sure you can have a medication abortion. Then, they will arrange a way for you to get the medicines, and explain how to take them. You might pick up the medicines from a pharmacy or get them through the mail.

"Self-managed" abortion – This involves getting the medicines needed for the abortion on your own. It does not involve any direct contact with a doctor, nurse, or clinic.

Will I have symptoms after a medication abortion? — Yes. Common symptoms include:

Pain and cramping in the lower belly – This happens after you take the second medicine (misoprostol). It can last for up to 6 hours. Taking an "NSAID" medicine like ibuprofen (sample brand names: Advil, Motrin) can help prevent or relieve pain.

Bleeding from the vagina – Bleeding can be very heavy for a few hours after you take misoprostol. Light bleeding might go on for a few weeks.

Fever, nausea, vomiting, and diarrhea

How is a procedural abortion done? — The doctor or nurse will give you anesthesia medicine. If you are awake during the procedure, the medicine helps to decrease pain. Or you might have the option to get anesthesia to put you to sleep until the procedure is over.

The doctor will use special tools to remove the pregnancy tissue from your uterus. This is done through the vagina (figure 1), so there will be no cuts or scars on your body afterwards.

Will I have symptoms after a procedural abortion? — Yes. It is common to have:

Pain and cramping in the lower belly – This lasts for a few hours.

Bleeding from the vagina – This is usually lighter than after a medication abortion. The bleeding can last for up to 2 weeks.

What problems should I watch for after an abortion? — Call your doctor, nurse, or clinic for advice right away if:

Your bleeding is heavy enough to soak through 1 menstrual pad each hour, for at least 2 hours, and you are still bleeding.

Your pain is really bad (it makes you double over or makes it hard to move), and you don't feel better with pain medicines, such as ibuprofen (sample brand names: Motrin, Advil).

You have a fever higher than 100.4°F (38°C).

Bad-smelling discharge comes out of your vagina.

In some cases, abortion does not work completely to get rid of all the pregnancy tissue. This is not very common. But if it does happen, you will need to take additional medicine or have a procedure to remove any leftover tissue. Signs that an abortion was not complete include:

Not bleeding after a medication abortion

Still having pregnancy symptoms, such as nausea and tender breasts, 1 week or more after your abortion

Bleeding for more than 2 weeks after an abortion

Not having a period in the first 6 to 8 weeks after an abortion

Is abortion safe? — In general, yes, abortion is very safe. But like any medical procedure, abortion does come with some small risks.

If you decide to have an abortion, the safest option is to go to a doctor or specially trained nurse in a clinic or hospital. Getting an abortion from someone who is not properly trained, or trying to end a pregnancy on your own without accurate information and the right medicines, can be very dangerous.

Never use herbs, chemicals, or objects in the vagina to try to end a pregnancy. These things are unsafe and could cause serious harm or even death.

Is there anything I should do differently after an abortion? — Your doctor, nurse, or clinic might tell you not to have sex or put anything into your vagina for 2 weeks after an abortion. This is to lower the risk of infection.

What if I want to get pregnant again someday? — Having an abortion does not make it harder to get pregnant again. Abortions do not harm your health, and they do not harm the health of your future babies if you choose to have them.

What about birth control? — If you do not want to get pregnant again, talk to your doctor or nurse about birth control options. It is possible to get pregnant very soon after having an abortion, even before your next period. There are many different types of birth control. Your doctor or nurse can work with you to choose the type that is right for you.

More on this topic

Patient education: Choosing birth control (The Basics)
Patient education: Hormonal birth control (The Basics)
Patient education: Long-acting methods of birth control (The Basics)
Patient education: Intrauterine devices (IUD) (The Basics)
Patient education: Permanent birth control for women (The Basics)
Patient education: Emergency contraception (The Basics)

Patient education: Abortion (pregnancy termination) (Beyond the Basics)
Patient education: Birth control; which method is right for me? (Beyond the Basics)
Patient education: Long-acting methods of birth control (Beyond the Basics)
Patient education: Emergency contraception (Beyond the Basics)

This topic retrieved from UpToDate on: Sep 01, 2022.
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