Abortion Clinic South Africa: August 2019

Friday, August 9, 2019

Unsafe abortion

An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both

An unsafe abortion is a life-threatening procedure. It includes self-induced abortions, abortions in unhygienic conditions, and abortions performed by a medical practitioner who does not provide appropriate post-abortion attention.

About 25 million unsafe abortions occur a year, of which most occur in the developing world. Unsafe abortions results in complications for about 7 million women a year.

Unsafe abortions are also one of the leading causes of deaths during pregnancy and childbirth (about 5-13% of all deaths during this period).

Most unsafe abortions occur where abortion is illegal, or in developing countries where affordable and well-trained medical practitioners are not readily available, or where modern birth control is unavailable.

Unsafe abortion was and is a public health crisis. More specifically, lack of access to safe abortion was and is a public health risk. The more restrictive the law, the higher the rates of death and other complications

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Self-induced abortion

A self-induced abortion (or self-induced miscarriage) is an abortion performed by the pregnant woman herself or with the help of other, non-medical assistance.

Although the term includes abortions induced with legal over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, sometimes more dangerous means. Such practices may present a threat to the health of women.

If the abortion does not result in termination of the pregnancy, damage to the fetus can occur. Self-induced abortion is often attempted during the earliest stages of pregnancy (the first eight weeks from the last menstrual period)

In recent years, significant reductions in maternal death and injury resulting from self-induced abortions have been attributed to the growing use of misoprostol (known commercially at "Cytotec"), an inexpensive, widely available drug with multiple uses, including the treatment of post-partum hemorrhage, stomach ulcers, and induction of labor.

The World Health Organization has endorsed a standardized regimen of misoprostol to induce abortion up to 9 weeks of pregnancy. This regimen has been shown to be up to 83% effective in terminating a pregnancy.

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Hysterotomy abortion

Hysterotomy abortion is a form of abortion in which the uterus is opened through an abdominal incision and the fetus is removed, similar to a caesarean section, but requiring a smaller incision.\'

As major abdominal surgery, hysterotomy is performed under general anaesthesia, and is only used in rare situations where less invasive procedures have failed or are medically inadvisable (such as in the case of placenta accreta).

This method has the greatest risk of complications out of all the abortion procedures.[2] Health officials in the United States warned practitioners against performing hysterotomy abortion in an outpatient setting after it led to the deaths of two women in New York during 1971.

The rate of mortality of abortion by hysterotomy and hysterectomy reported in the United States between 1972 and 1981 was 60 per 100,000, or 0.06%

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Intact dilation and extraction

ntact dilation and extraction (IDX, intact D&E) is a surgical procedure that removes an intact fetus from the uterus.

The procedure is used both after late-term miscarriages and in late-term abortions. It is also known as intact dilation and evacuation, dilation and extraction (D&X, or DNX, disfavored term), and, in United States federal law, as partial-birth abortion.

However, partial-birth abortion is not an accepted medical term, and is not used by abortion practitioners or the medical community at large.

In 2000, although only 0.17% (2,232 of 1,313,000) of all abortions in the United States were performed using this procedure,[3] it developed into a focal point of the abortion debate. It was outlawed in most cases by the 2003 Partial-Birth Abortion Ban Act, which was upheld in the case of Gonzales v. Carhart.

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D&E abortion

D&E is performed under anesthesia, most commonly sedation with light general anesthesia, although local paracervical block or regional anesthesia may be used. It may be performed with or without ultrasound guidance. Performance under ultrasound guidance has greatly improved our understanding about what actually occurs during a D&E. Prior to the procedure, the cervix is usually softened and passively dilated using osmotic dilators and/or misoprostol. This facilitates cervical dilation during the procedure without injury to the cervix.

The first step in the procedure itself is dilation of the cervix. The second step is insertion of a vacuum curette through the cervix. Under ultrasound, the tip of that curette is placed up against the fetal chest or abdomen. The suction is turned on. Amniotic fluid is removed and the fetus dies instantly due to removal of the fetal heart, lungs, and abdominal contents.

This leaves the fetal cranium and skeleton with soft tissue to be removed. The thorax, pelvis, cranium, and each arm and leg are removed separately using surgical instruments. The fetal cranium will usually have to be crushed in order to be extracted. Use of ultrasound greatly facilitates this part of the procedure although it may be done safely without ultrasound guidance. In the absence of ultrasound, the tissue will be carefully inspected to ensure all fetal tissue is removed. It is important to recognize that this is the removal of dead tissue to protect the patient from bleeding and infection well after the fetus died instantly. The fetus is almost never dismembered alive.

After removal of all fetal tissue, the uterine cavity is thoroughly curetted to ensure that all placental tissue, blood, and membranes are removed. The uterus will then be massaged to ensure it is firmly contracted to minimize post operative bleeding. The entire procedure usually takes less than 30 minutes and is well tolerated.

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Dilation and evacuation

Dilation and evacuation (D&E) is the dilation of the cervix and surgical evacuation of the uterus (potentially including the fetus, placenta and other tissue) after the first trimester of pregnancy. It is a method of abortion as well as a common procedure used after miscarriage to prevent infection by ensuring that the uterus is fully evacuated.

In various health care centers it may be called by different names:

D&E (Dilation and evacuation)
ERPOC (Evacuation of Retained Products of Conception)
TOP or STOP ((Surgical) Termination Of Pregnancy)

D&E normally refers to a specific second trimester procedure. However, some sources use the term D&E to refer more generally to any procedure that involves the processes of dilation and evacuation, which includes the first trimester procedures of manual and electric vacuum aspiration

Partial-Birth Abortion Ban Act

The Partial-Birth Abortion Ban Act of 2003 (Pub.L. 108–105, 117 Stat. 1201, enacted November 5, 2003, 18 U.S.C. § 1531,[1] PBA Ban) is a United States law prohibiting a form of late termination of pregnancy called "partial-birth abortion", referred to in medical literature as intact dilation and extraction.[2] Under this law, any physician "who, in or affecting interstate or foreign commerce, knowingly performs a partial-birth abortion and thereby kills a human fetus shall be fined under this title or imprisoned not more than 2 years, or both". The law was enacted in 2003, and in 2007 its constitutionality was upheld by the U.S. Supreme Court in the case of Gonzales v. Carhart.

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United States abortion-rights movement

The United States abortion-rights movement (also known as the United States pro-choice movement) is a sociopolitical movement in the United States supporting the view that a woman should have the legal right to an elective abortion, meaning the right to terminate her pregnancy, and is part of a broader global abortion-rights movement. The abortion-rights movement consists of a variety of organizations, with no single centralized decision-making body.

A key point in abortion rights in the United States was the U.S. Supreme Court's 1973 decision in Roe v. Wade, which struck down most state laws restricting abortion,[2][3] thereby decriminalizing and legalizing elective abortion in a number of states.

On the other side of the abortion debate in the United States is the movement to extend rights to the pre-born at the expense of restricting the rights of pregnant women, the United States anti-abortion movement. Within this group, many argue that human life begins at conception.

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Societal attitudes towards abortion

Societal attitudes towards abortion have varied throughout different historical periods and cultures. One manner of assessing such attitudes in the modern era has been to conduct opinion polls to measure levels of public opinion on abortion.

56% said they believed that abortion is wrong even if there is a strong chance of serious defect in the fetus.
70% said they believed that abortion is wrong if done primarily because the parents have low income and may be unable to afford another child.

Abortion and mental health

The relationship between induced abortion and mental health is an area of political controversy, though scientific and medical expert bodies have repeatedly concluded that induced abortion poses no greater mental-health risks than carrying unwanted pregnancies to term.

In 2008, the American Psychological Association concluded after a review of available evidence that induced abortion did not increase the risk of mental-health problems. In 2011, the U.K. National Collaborating Centre for Mental Health similarly concluded that first-time abortion in the first trimester does not increase the risk of mental-health problems compared with bringing the pregnancy to term.[4][6] The U.K. Royal College of Obstetricians and Gynaecologists likewise summarized the evidence by finding that abortion did not increase the risk of mental-health problems in women carrying an unwanted pregnancy.

A 2008 systematic review of the medical literature on abortion and mental health found that high-quality studies consistently showed few or no mental-health consequences of abortion, while poor-quality studies were more likely to report negative consequences.

Despite the weight of scientific and medical opinion, some anti-abortion advocacy groups have continued to allege a link between abortion and mental-health problems.[8] Some anti-abortion groups have used the term "post-abortion syndrome" to refer to negative psychological effects which they attribute to abortion.

However, "post-abortion syndrome" is not recognized as an actual syndrome by the mainstream medical community.[9][10] Post-abortion syndrome (PAS) is not included in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR[11] or in the ICD-10 list of psychiatric conditions.

Medical professionals and pro-choice advocates have argued that the effort to popularize the idea of a "post-abortion syndrome" is a tactic used by anti-abortion advocates for political purposes.

Some U.S. state legislatures have mandated that patients be told that abortion increases their risk of depression and suicide, despite the scientific evidence contradicting such claimsincreases their risk of depression and suicide, despite the scientific evidence contradicting such claims

Abortions safety

The health risks of abortion depend principally upon whether the procedure is performed safely or unsafely. The World Health Organization defines unsafe abortions as those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities.

Legal abortions performed in the developed world are among the safest procedures in medicine.In the United States, abortion is estimated to be about 14 times safer for women than childbirth. CDC estimated in 2019 that US pregnancy-related mortality was 17.2 maternal deaths per 100,000 live births, while the US abortion mortality rate is 0.7 maternal deaths per 100,000 procedures.

In the US from 2000 to 2009, abortion had a lower mortality rate than plastic surgery, and a similar or lower mortality rate than running a marathon.

Five years after seeking abortion services, women who gave birth after being denied an abortion reported worse health than women who had either first or second trimester abortions.

The risk of abortion-related mortality increases with gestational age, but remains lower than that of childbirth.[85] Outpatient abortion is as safe from 64 to 70 days' gestation as it before 63 days

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Abortions and ethnicity

bortion rates tend to be higher among minority women in the U.S. In 2000-2001, due to lower access to health care and contraception, the rates among black and Hispanic women were 49 per 1,000 and 33 per 1,000, respectively, vs. 13 per 1,000 among non-Hispanic white women.

Note that this figure includes all women of reproductive age, including women that are not pregnant. In other words, these abortion rates reflect the rate at which U.S. women of reproductive age have an abortion each year.

While White women obtain 60% of all abortions, African American women are three times more likely to have an abortion.

In 2012, New York City reported abortions (31,328) outnumber live births (24,758) for black children. Black and Hispanic abortions combined (54,245), account for 73% of the total abortions in the city in 2012, according to a report by the New York City Department of Health and Mental Hygiene, Office of Vital Statistics.

In 2004, the rates of abortion by ethnicity in the U.S. were 50 abortions per 1,000 black women, 28 abortions per 1,000 Hispanic women, and 11 abortions per 1,000 white women.

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Legal abortion restrictions

As of 1998, among the 152 most populous countries, 54 either banned abortion entirely or permitted it only to save the life of the pregnant woman.

On the other hand as of 1998, 49 of the 152 most populous countries allowed abortion without restriction as to reason, but 44 of these required specific justification after a particular gestational age: 12 weeks (Albania, Armenia, Azerbaijan, Belarus, Belgium, Bosnia-Herzegovina, Bulgaria, Croatia, Cuba, Czech Republic, Denmark, Estonia, France, Georgia, Greece, Kazakhstan, Kyrgyz Rep., Latvia, Lithuania, Moldova, Mongolia, Norway, Russian Federation, Saudi Arabia, Slovakia, Slovenia, South Africa, Ukraine, Tajikistan, Tunisia, Turkey, Turkmenistan and Uzbekistan) 13 weeks (Italy) 14 weeks (Austria, Cambodia, Germany, Hungary, Romania and Spain) 18 weeks (Sweden) 22 weeks (North Macedonia) 24 weeks (Singapore) viability (Netherlands and to some extent the United States) no limit (Canada, some states in the United States, China, and North Korea)

As of 2011 among those countries that allowed abortion without restriction as to reason, the gestational limits for such abortions on request were: 37 countries set a gestational limit of 12 weeks, 7 countries of 14 weeks, 4 did not set limits, 3 at viability, 3 at 10 weeks, one at 90 days, one at 8 weeks, one at 18 weeks, and one at 24 weeks. In addition, Abortion in Australia, and, to a certain extent, Abortion in the United States, is regulated at state/territory level, and laws vary by region.

In these countries, abortions after the general gestational age limit are allowed only under restricted circumstances, which include, depending on country, risk to the woman's life, physical or mental health, fetal malformation, cases where the pregnancy was the result of rape, or poor socio-economic conditions.

For instance, in Italy, abortion is allowed on request up until 90 days, after which it is allowed only if the pregnancy or childbirth pose a threat to the woman’s life, a risk to physical health of the woman, a risk to mental health of the woman; if there is a risk of fetal malformation; or if the pregnancy is the result of rape or other sexual crime. Denmark provides a wider range of reasons, including social and economic ones, which can be invoked by a woman who seeks an abortion after 12 weeks.

Abortions at such stages must in general be approved by a doctor or a special committee, unlike early abortions which are performed on demand. The ease with which the doctor or the committee allows a late term abortion varies significantly by country, and is often influenced by the social and religious views prevalent in that region. Some countries, like Canada, China (Mainland only) and Vietnam have no legal limit on when an abortion can be performed

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Late termination of pregnancy

Late termination of pregnancy describes the termination of pregnancy by induced abortion during a late stage of gestation.

"Late", in this context, is not precisely defined, and different medical publications use varying gestational age thresholds.

In 2015 in the United States, about 1.3% of abortions took place after the 21st week, and less than 1% occur after 24 weeks.

Reasons for late terminations of pregnancy include when a pregnant woman's health is at risk or when lethal fetal abnormalities have been detected.

These anomalies may include anencephaly or limb-body wall complex where death occurs almost immediately after birth.

Later abortion is not associated with any negative physical or mental health outcomes, and the risk of death following a surgical abortion after 20 weeks is less than that of typical full-term childbirth in the United States.

Late termination of pregnancy is more politically controversial than abortion in general. Most countries in Europe permit abortion in later stages of pregnancy if specific circumstances are present.

The American College of Obstetricians and Gynecologists states with respect to abortion that "politicians should never interfere in the patient-physician relationship".

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Induced abortion

An induced abortion may be classified as therapeutic (done in response to a health condition of the women or fetus) or elective (chosen for other reasons).

Approximately 205 million pregnancies occur each year worldwide. Over a third are unintended and about a fifth end in induced abortion. Most abortions result from unintended pregnancies.

In the United Kingdom, 1 to 2% of abortions are done due to genetic problems in the fetus. A pregnancy can be intentionally aborted in several ways.

The manner selected often depends upon the gestational age of the embryo or fetus, which increases in size as the pregnancy progresses.

Specific procedures may also be selected due to legality, regional availability, and doctor or a woman's personal preference. Reasons for procuring induced abortions are typically characterized as either therapeutic or elective.

An abortion is medically referred to as a therapeutic abortion when it is performed to save the life of the pregnant woman; to prevent harm to the woman's physical or mental health; to terminate a pregnancy where indications are that the child will have a significantly increased chance of mortality or morbidity; or to selectively reduce the number of fetuses to lessen health risks associated with multiple pregnancy.

An abortion is referred to as an elective or voluntary abortion when it is performed at the request of the woman for non-medical reasons.[36] Confusion sometimes arises over the term "elective" because "elective surgery" generally refers to all scheduled surgery, whether medically necessary or not.

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Abortion basics

Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus before it can survive outside the uterus. An abortion that occurs without intervention is known as a miscarriage or spontaneous abortion. When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage".

The unmodified word abortion generally refers to an induced abortion. A similar procedure after the fetus has potential to survive outside the womb is known as a "late termination of pregnancy" or less accurately as a "late term abortion".

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Children after an abortion

A medical abortion does not affect your ability to conceive or bear a child in the future. In fact, if you do not want to become pregnant at this time, it is important to start using contraceptives as soon as you start having sexual relations again. The risks are the same as after a spontaneous miscarriage. Of course prevention of complications is very important.

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Do you need an ultrasound after an abortion

If you do not have symptoms of a complication, it is not necessary to have an ultrasound after a medical abortion.

By having an ultrasound you can determine whether the pregnancy has ended even a few days after the abortion, especially if you are unsure whether the abortion was successful. You can also have a home urine pregnancy test about 3-4 weeks after taking the medicines.

If you take the home urine pregnancy test before waiting 3 weeks, it can show a false result that a woman is pregnant, because there are still pregnancy hormones in her body.

Medical abortion, like miscarriage, is a process that takes place over time and the body might take several weeks to fully expel all the tissues and products in the uterus. This is normal. If you want, you can have an ultrasound about 10 days after taking the medicine just to confirm as soon as possible that the pregnancy has ended.

Even if the pregnancy has ended, many women will still have tissues and blood inside the uterus for several weeks. If you do not have any symptoms of complications like strong pain in the belly, continuous fever, very strong bleeding, smelling vaginal discharge, there is no need for any surgical intervention, like vacuum aspiration, even if the doctors suggest this. One can wait until after the next menstruation or take 2 tablets of misoprostol under the tongue.

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What is a successful abortion

A medical abortion is successful when the pregnancy stops developing and there is no need for additional medical care. Research has shown that 99.5 % of the women who do a medical abortion in the first 9 weeks of pregnancy with mifepristone and misoprostol will have an abortion that ends the pregnancy. Only 3% of the woman will need additional medical care.

In 97% of abortions, women’s bodies will eliminate all the remains naturally and without any other medical intervention. It is important that you understand that an abortion is a process. It takes time for the uterus to empty and for the abortion to be complete. It is normal for the bleeding and clotting to continue for 1-3 weeks or even longer.

Every woman’s body is different. If you have extreme pain, prolonged heavy bleeding, abnormal vaginal discharge or fever, it might be a sign that you have a complication and should go to a doctor. You should also go to the doctor and do an ultrasound after taking the medicines if you have any doubts about whether the abortion has been successful.

Many women can tell when the abortion is successful. They feel the symptoms of pregnancy (nausea, tender breasts, need to urinate) going away or have seen the embryo come out. By having an ultrasound you can learn whether the medicines have worked and if your pregnancy has ended within a few days after the abortion.

An early ultrasound will tell you if the pregnancy has ended, but it is best wait for an ultrasound for 10 days after using Mifepristone, as only 23% of abortions are totally complete after 7 days. 71 The urine home pregnancy test can be done only 3 weeks after taking the medicines, because before 3 weeks, the pregnancy hormones are still in your body and the test might show an unreliable, falsely positive result.

Your body might need several days or weeks (until your next menstrual period) to expel the tissue and blood completely. The ultrasound will show what is still in the uterus. Some doctors will recommend a vacuum aspiration, but if you have no pain or fever or signs of infection, it is better to wait and let your body empty naturally. A vacuum aspiration or a D & C is an invasive procedure that involves risks and can be painful.

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How to get a safe abortion

A medical abortion can be done safely at home as long as you have good information and have access to emergency medical care in the rare case that there are complications.

The doctor can only help you if :

you live in a country where access to safe abortion is restricted
you are less than 10 weeks pregnant
you have no severe illnesses

Before starting the consultation, do a pregnancy test and an ultrasound, if possible. The consultation consists of around 25 questions. All information will remain confidential.

Bleeding during a medical abortion

Mifepristone alone usually does not cause any side effects before taking Misoprostol, although some women may experience light bleeding or nausea.

After using Misoprostol you should expect bleeding and cramps. Bleeding usually starts within four hours of using the pills, but it sometimes starts later.

For some women, the bleeding and cramping and also other side effects like nausea, vomiting, diarrhea, headache, dizziness, and hot flashes or fever may occur shortly after taking Misoprostol.
Bleeding is often the first sign that the abortion has begun.

If the abortion continues, bleeding and cramps become more severe. Bleeding is often heavier than a normal menstruation, and there can be clots. The longer the pregnancy has developed, the heavier the cramps and the bleeding will be. If the abortion is complete, the bleeding and the cramps diminish. The moment of abortion can be noticed with a peak of heavier blood loss and more pain and cramps.

Normally the bleeding will continue lightly for one to three weeks after the abortion, but times may vary. The normal menstrual period usually returns after four to six weeks.

The heaviest bleeding typically occurs 2-5 hours after using misoprostol and usually slows down within 24 hours.

The most intense cramping and bleeding generally lasts for 3-5 hours, but it can last for less or more time. Some women bleed heavily for up to 48 hours and may pass clots days or even weeks after taking the misoprostol.

This is common and is not dangerous, unless you soak through more than two maxi pads per hour for 2 hours or more or when you lose heavy cloths bigger than an orange. It is normal for your body to take time to empty the uterus completely. Every woman’s body is different.
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In-clinic abortion

The in-clinic abortion procedure is available by appointment to women from 4 to 16 weeks of pregnancy. The in-clinic abortion method performed is dilation and vacuum aspiration.

Each abortion patient receives a pregnancy test and an ultrasound prior to the abortion procedure to verify the pregnancy and its stage of development. Our staff will assist patients with calculations to determine the stage of pregnancy at the time of the appointment.

In preparation for the abortion procedure, each patient receives a lab workup and history interview. When making the appointment, the patient should be prepared to discuss her relevant medical history including current medications, previous surgeries and allergies.

The abortion procedure typically lasts no more than 10 minutes. After the procedure, the patient remains in the recovery room for approximately 20 minutes before discharge. Most patients are able to return to their normal activities the next day with minor restrictions.

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Abortion sedation options

Patients may choose one of two options to maximize comfort and relaxation during the abortion. These options are a Valium/Ibuprofen combination taken by mouth or intravenous twilight sedation.

Patients choosing the Valium combination are awake and aware throughout the abortion procedure. The patient's cervix is numbed by injection. The patient is alert and able to drive herself home after the procedure. There is no additional fee for this option.

Twilight sedation is provided intravenously using a combination of medications that alters awareness and produces amnesia. Most patients feel no discomfort during the procedure and may not remember the events that occur while under sedation. The patient's medical history and medical status will be evaluated to determine whether she is a candidate for sedation. There is an additional fee for twilight sedation, and the patient must have a support person with her to drive her home.
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Medical abortion pills

Medication abortion, also called medical abortion, using the oral medications mifepristone (Mifeprex™) and misoprostol (Cytotec™), is available by appointment to patients whose stage of pregnancy is between 4 and 10 weeks.

The patient is given a dose of each medication to induce abortion. After receiving the initial medication, the patient returns home where the process is completed in privacy.

Patients electing medication abortion services must be willing to undergo an in-clinic abortion procedure in the event that the medication abortion is incomplete.

Patients are carefully evaluated to determine their eligibility for the medication abortion option. Medication abortion is not available to patients under 18 years of age.

Patients selecting this option must have access to a telephone and transportation to a medical facility equipped to give emergency care. Medication abortion patients receive a thorough medical screening, lab workup, ultrasound and extensive education and counseling prior to administration of the medication
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Abortion Counselling

A professional counselor is available to patients, at no additional charge, during their visit to our facility to receive abortion services. Counseling is optional for most women and does not increase the length of stay at the facility.

As a component of their counseling session, patients may choose to receive information about fetal development. Our counselors are available to answer questions about the abortion procedure and to assist patients with relaxation techniques or emotional support throughout the abortion procedure. Follow-up counseling is available on request.
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What can I think about to help me decide

Family, relationships, school, work, life goals, health, safety, and personal beliefs — people think carefully about these things before having an abortion. But you’re the only person walking in your shoes, and the only person who can decide whether to have an abortion. The decision is 100% yours.

Here are some things to consider if you are thinking about an abortion:

Am I ready to be a parent?
Would I consider adoption?
What would it mean for my future if I had a child now?
What would it mean for my family if I had a child now?
How would being a parent affect my career goals?
Do I have strong personal or religious beliefs about abortion?
Is anyone pressuring me to have or not have an abortion?
Would having a baby change my life in a way I do or don’t want?
Would having an abortion change my life in a way I do or don’t want?
What kind of support would I need and get if I decided to get an abortion?
What kind of support would I need and get if I decided to have a baby?

Decisions about your pregnancy are deeply personal. You hold the power to make decisions that are best for you in order to stay on your own path to a healthy and meaningful life. There are lots of things to consider, and it’s totally normal to have many different feelings and thoughts when making this decision. That’s why it’s important to get factual, non-judgmental information about abortion. Support from family, friends, partners, and other people you trust can also be helpful. But at the end of the day, only you know what’s right for you.

Why do people decide to have an abortion

If you’re thinking about having an abortion, you’re so not alone. Millions of people face unplanned pregnancies every year, and about 4 out of 10 of them decide to get an abortion. Some people with planned pregnancies also get abortions because of health or safety reasons. Overall, 1 in 4 women in the U.S. will have an abortion by the time they’re 45 years old.

Sometimes, the decision is simple. Other times, it’s complicated. But either way, the decision to have an abortion is personal, and you’re the only one who can make it.

Everyone has their own unique and valid reasons for having an abortion. Some of the many different reasons people decide to end a pregnancy include:

They want to be the best parent possible to the kids they already have.
They’re not ready to be a parent yet.
It’s not a good time in their life to have a baby.
They want to finish school, focus on work, or achieve other goals before having a baby.
They’re not in a relationship with someone they want to have a baby with.
They’re in an abusive relationship or were sexually assaulted.
The pregnancy is dangerous or bad for their health.
The fetus won’t survive the pregnancy or will suffer after birth.
They just don’t want to be a parent.

Deciding to have an abortion doesn’t mean you don’t want or love children. In fact, 6 out of 10 people who get abortions already have kids — and many of them decide to end their pregnancies so they can focus on the children they already have. And people who aren’t already parents when they get an abortion often go on to have a baby later, when they feel they are in a better position to be a good parent. The bottom line is, deciding if and when to have a baby is very personal, and only you know what’s best for you and your family.

Is abortion the right option for me

Abortion is very common, and people have abortions for many different reasons. Only you know what’s best for you, but good information and support can really help you make the decision that is best for your own health and well-being.

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Is it still legal for me to get an abortion

Abortion is still legal in the United States, no matter what state you live in. Abortion has been legal in all 50 states since 1973, when the Supreme Court ruled in favor of abortion rights in Roe v. Wade.

However, across the country, there are different rules in different states about abortion. While abortion is technically legal, it can sometimes be hard to access, and rules like waiting periods and mandatory counseling can make it more difficult to get an abortion.

Our number one goal is taking care of our patients, and no matter what happens, we will continue to do that.
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Abortion decision

Pregnant and not sure what to do? That can be scary, but you’re not alone. The professional, caring staff at your nearest Planned Parenthood health center will give you all the straight-up information you need to help you make the right decision for you. No pressure, no judgment. Just support.

How does the abortion pill work

“Abortion pill” is the common name for using two different medicines to end a pregnancy: mifepristone and misoprostol.

First, you take a pill called mifepristone. Pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone, stopping the pregnancy from growing.

Then you take the second medicine, misoprostol, either right away or up to 48 hours later. This medicine causes cramping and bleeding to empty your uterus.

It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage. If you don’t have any bleeding within 24 hours after taking the second medicine, call your nurse or doctor.

Your doctor or nurse will give you both medicines at the health center. When and where you’ll take them depends on state laws and your health center's policies. Your doctor or nurse will give you detailed directions about where, when, and how to take the medicines. You may also get some antibiotics to prevent infection.
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What is RU-486

RU-486 is the former name of mifepristone — one of the medications that you take to have a medication abortion. RU-486 is now called "the abortion pill" or "Mifeprex" (the brand name for mifepristone).

RU-486 was developed in the 1980s. It's been safely used in Europe since 1987, and in the US since 2000.

RU-486 blocks a hormone that your body needs to continue a pregnancy. It works best when you use it with another medication called misoprostol, which causes bleeding to empty your uterus.

The RU-486 abortion pill is a safe and effective way to end an early pregnancy.
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Can abortion pills be reversed

Here’s the deal: The “abortion pill” is the popular name for a safe and effective way to end an early pregnancy using a combination of two medicines: mifepristone and misoprostol. The first medicine (mifepristone) is given at a health center or your health care provider’s office. After taking mifepristone, you take a second medication (misoprostol) at home 6-48 hours later. This causes cramping and bleeding and empties your uterus.

Claims about treatments that reverse the effects of medication abortion are out there, and a handful of states require doctors and nurses to tell their patients about them before they can provide abortion care. But these claims haven’t been proven in reliable medical studies — nor have they been tested for safety, effectiveness, or the likelihood of side effects — so experts like the American College of Obstetricians and Gynecologists reject these untested supposed treatments.

Studies on the abortion pill do show that if you take the first medicine but not the second, the abortion pill is less likely to work. So if you’ve begun the process of having an abortion using the abortion pill but are having second thoughts, contact the doctor or nurse you saw for the abortion right away to talk about your best next steps and what to expect.
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Why do people choose the abortion pill

Which kind of abortion you choose all depends on your personal preference and situation. With medication abortion, some people like that you don’t need to have a procedure in a doctor’s office. You can have your medication abortion at home or in another comfortable place that you choose.

You get to decide who you want to be with during your abortion, or you can go it alone. Because medication abortion is similar to a miscarriage, many people feel like it’s more “natural” and less invasive.

Your doctor, nurse, or health center staff can help you decide which kind of abortion is best for you.
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When can I take the abortion pill

You usually can get a medication abortion up to 70 days (10 weeks) after the first day of your last period. If it has been 71 days or more since the first day of your last period, you can have an in-clinic abortion to end your pregnancy.

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How effective is the abortion pill

The abortion pill is very effective. The effectiveness depends on how far along you are in your pregnancy when you take the medicine. For people who are 8 weeks pregnant or less, it works about 94-98 out of 100 times. For people who are 8-9 weeks pregnant, it works about 94-96 out of 100 times. For people who are 9-10 weeks pregnant, it works about 91-93 out of 100 times. The abortion pill usually works, but if it doesn’t, you can take more medicine or have an in-clinic abortion to complete the abortion.

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Pain control during and after an abortion

During an early medical abortion, most women will have strong cramping, similar to period pains. There are many ways to lessen the pain: wear comfortable clothes stay in a familiar and relaxing place apply a heating pad or hot water bottle to your lower stomach use pain medicine like ibuprofen, or codeine How to get pain medicine You can buy ibuprofen tablets in either 200mg or 400mg strengths at your local pharmacy.

A healthcare professional will also offer you codeine 30mg, prescribed by one of our doctors, to take home. Codeine 30mg is only available with a prescription. Some products that you can buy at the pharmacy have lower doses of codeine combined with either ibuprofen or paracetamol.

However, they will not give you the same amount of pain relief as the codeine we provide. How to use these medicines Ibuprofen is for mild to moderate pain. Codeine is for moderate to severe pain.

You can start with ibuprofen, adding codeine when you need stronger pain relief. Or, you can just start with codeine. It's up to you. You can also alternate the medicines depending on how you feel. What dose you should take and how often you can take it There are 2 strengths of ibuprofen tablets - follow the directions that apply for the strength you buy: Ibuprofen (200mg): take 3 or 4 tablets by mouth every 8 hours as needed.

Do not take more than 12 tablets in 24 hours. Or Ibuprofen (400mg): take 1 or 2 tablets by mouth every 8 hours as needed. Do not take more than 6 tablets in 24 hours. As well as Ibuprofen you can also take: Codeine (30mg): take 1 or 2 tablets by mouth every 4 hours as needed.

Do not take more than 8 tablets in 24 hours. If you are 12-18 years of age, you may take 1 or 2 tablets by mouth every 6 hours as needed, but should not take more than 8 tablets in 24 hours. Codeine will not be given to anyone under the age of 12.

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Breastfeeding after an abortion

If you are breastfeeding at the time of your abortion, be aware that a small amount of both mifepristone and misoprostol will pass into the breast milk.

However, the amounts are small and not expected to cause any adverse effects for breast fed infants. Breast feeding may continue uninterrupted but if you wish to suspend breast feeding during treatment, please talk to your healthcare professional to work out a plan.

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How to use the misoprostol abortion pill

You can either use misoprostol in the clinic or take it home. If you take it home, you will receive 6 tablets. Place 4 tablets either in your vagina or in your mouth between your cheek and gum Vaginal insertion Insert 4 tablets as high as possible in the vagina.

The exact position of the tablets is not important provided they do not fall out. You can put the tablets in while lying down, squatting, or standing with one leg up - whatever is most comfortable. If you do not feel comfortable doing this, a healthcare professional at the clinic can help you.

In the mouth - between cheek and gum Place 4 tablets in your mouth between the upper cheek and gum (2 on each side) and allow the tablets to dissolve for 30 minutes. If the tablets have not completely dissolved within 30 minutes, you may swallow what is left with water

If you have taken tablets home you will have 2 remaining misoprostol tablets. If you have not had any bleeding, or only a little bleeding 4 hours after the first dose of misoprostol use the additional 2 tablets either in the vagina or between your cheeks and gum. Contact the BPAS clinic where you were treated or the telephone helpline 0300 33 6828 if you have any questions. Do not throw away leftover tablets - please return them to BPAS or take them to a local pharmacy or GP surgery for safe disposal.

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Abortion pills side effects

For most women, medical abortion is like a miscarriage. It is normal for you to have bleeding and cramping. You might also:

feel dizzy
feel nauseous or have to vomit
have a headache
have diarrhoea
have temporary flushes or sweats

A nurse will be with you at all times and will give you medicine to help control any side effects or pain you might have.
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Safe abortion pills

Abortion Pills are tablets that are meant to be swallowed orally or sometimes inserted deep inside your vagina in order to end or terminate unwanted pregnancies.

Studies indicate that women who have terminated their pregnancies with the help of Abortions pills rarely faced any complications compared to the surgical abortion.

Abortion Pills work by temporarily blocking the female hormone called progesterone because without this hormone the womb will contract and cause the lining of the uterus to shed and soften the cervix hence causing an induced miscarriage. You will be require to have at-least two abortion pills in order to have a successful medical abortion.

When you visit our Legal Abortion Clinic in Pretoria a pregnancy test will be done to confirm how many weeks you are.

After we are sure of the pregnancy a nurse or the doctor will get you one pill or two to be swallowed. This pill is meant to block the hormone called progesterone.

After a few hours, another set of tablets will be placed in the vagina. These can be placed either while lying down, squatting, or standing with one leg up whichever way you feel comfortable by yourself or have a health-care professional help you.

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Advantages of Abortions Pills

Medical abortions Pills are safe because the pregnancy will be ended without surgery but with the help of medically approved abortion pills.

Recent studies found that less than 1% of women who use the abortion Pills experience any serious medical side effects.

Women who have used abortions pills in the past don’t suffer long-term psychological trauma either although their hormones and emotions will probably be all over the place even if you are sure of your decision. Therefore in such cases i always recommend to find a confidant who will support – not judge – you and help you move on.

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How an abortion is carried out

In the UK, under The Abortion Act 1967, abortions can only be carried out in a hospital or a specialist licensed clinic.

In most cases, an abortion in hospital will be carried out as a day procedure and you won't need to stay overnight.

However, in some regions, the second part of early medical abortion (tablet) can be arranged to happen at home (see below).
Before the abortion

When you go for your first appointment, you should be given the opportunity to talk about your situation. You'll be informed about the different methods of abortion, and which method is suitable for your stage of pregnancy. You will also be advised about any related risks and complications.

The doctor or nurse will take your medical history to make sure the type of abortion you are offered is suitable for you.

You'll have a blood test to find out your blood group to see if you're anaemic.

You should also be tested for sexually transmitted infections (STIs), and may be given antibiotics to stop an infection developing after the abortion.

Before having an abortion, you may also need to have:
an ultrasound scan (if there is any doubt about how many weeks pregnant you are) a vaginal (internal) examination a cervical screening test for infections (if appropriate)

If you have never had a vaginal examination before, the healthcare professional examining you will be aware you are anxious and will be as careful as possible. You should let them know if you are anxious and have not been examined internally before.

You may also be given information and advice about which method of contraception to use after the abortion. Finally, before having the abortion, you will be given a consent form to sign.
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Methods of abortion

There are a number of different methods of abortion. The method recommended for you will depend on how many weeks pregnant you are.

This is usually calculated by counting the number of weeks from the first day of your last period.

Broadly speaking there are two types of abortion – medical and surgical. A medical abortion is carried out using medication while a surgical abortion involves a minor operation.

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Early medical abortion

Early medical abortion (up to nine weeks of pregnancy)

An early medical abortion involves taking two different medicines 36-48 hours apart. The effect of the medication will be similar to having an early natural miscarriage – this means you will have some bleeding and some pain when the abortion happens.

After your initial visit to see the doctor, you will have two more appointments on different days.

On your first visit you will be given an abortion pill called mifepristone, which blocks the hormone that makes the lining of the womb suitable for the fertilised egg. After taking the first tablet, you will be able to go home and continue your normal everyday activities.

Very little will happen while you are waiting for the second part of the treatment. A few women will have mild cramps and a little bleeding, but most will not. If you have heavier bleeding or significant pain, you should contact the hospital or clinic.

If it is out-of-hours, you should go to your nearest walk-in centre or local hospital's accident and emergency (A&E) department.

Two days later, on your second visit to the hospital or clinic, you will be given the second medicine, prostaglandin. Within four to six hours of taking prostaglandin, your womb lining will break down and be lost, along with the embryo, through bleeding from your vagina. This part of the process can be painful, but you can take a painkiller.

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