Considering and experiencing and abortion can be a confusing and scary place to find yourself in. One of the biggest reasons for fear and confusion is the lack of knowing what to expect. In this article, we hope to help inform you so you can understand the abortion process better.
First, there are two kinds of abortion procedures that are available. There are medical abortions and surgical abortions. Let’s first look at a medical abortion.
Medical abortion is when you take medical pills to terminate a pregnancy. It is often called “the abortion pill” procedure, but you actually take two pills to complete the procedure. The first pill that you take is mifepristone. The second is misoprostol (also known as Cytotec).
You can obtain these medications through doctors and clinics that provide abortion services. You should never buy them online or on the black market. The cost of the medication depends on location and additional tests or follow-ups that may be necessary. Medical abortion procedures can cost up to $800. However, this cost fluctuates depending on the area where you live. Women who are under 10 weeks into their pregnancy are eligible to take the abortion pill. After 10 weeks, women who wish to terminate their pregnancy may opt for a surgical abortion.
Physical Side Effects From A Medical Abortion
Women who undergo a medical abortion should expect bleeding and cramping lasting two to four weeks. The bleeding and cramping may be heavier than a period. Especially in the first few days, the cramping may be severe, and bleeding may be much heavier than a period and include passing blood clots. Other common side effects include:
- nausea and vomiting
- feeling dizzy or having a headache
- short-lasting hot flashes
Most women will abort anywhere from a couple of hours to a day or two after taking the second medication, but it may take several weeks for the abortion to be completed. It is normal to experience light bleeding, spotting, and some cramping for up to four weeks following a medical abortion. Most women will see their doctor within two weeks to be sure the abortion is complete. Medical abortions may require more than one visit to the doctor’s office.
Medical abortions are not 100 percent effective. Failed medical abortions can result in infections, and require women to also undergo surgical abortions to completely remove the pregnancy. Bleeding and cramping may last longer than with a surgical abortion. Potential risks and complications of a medical abortion include:
- an incomplete or failed abortion, where the fetus is viable or remains in the womb (this can cause serious infections)
- an undetected ectopic pregnancy, which can be dangerous and is a medical emergency
- blood clots remaining in the uterus
- heavy bleeding
Emergency symptoms of serious complications include:
- severe pain
- excessively heavy bleeding (defined as going through two or more pads within an hour span)
- strong-smelling vaginal discharge
- passing clots for two or more hours that are larger than the size of a lemon
Recovering From A Medical Abortion
In many cases, you will take the first pill in your doctor’s office and the second pill is taken at home within 24 hours. You may experience symptoms like bleeding and cramping for two to four weeks. Your doctor will schedule a follow-up appointment at the end of this time frame to ensure that the procedure was successful.
After taking the abortion pill, wait at least one week to have sex, even if your doctor has prescribed you antibiotics. This reduces the risk of getting an infection. When you do have sex, use contraception immediately, as you can get pregnant very soon after an abortion.
Another type of abortion that is different from a medical abortion is a surgical abortion. There are two types of surgical abortion: aspiration abortion and dilation and evacuation (D&E) abortion.
Women about 4 to 13 weeks pregnant can have an aspiration abortion. Some doctors will perform aspiration abortions up to 16 weeks. D&E abortions are typically performed after 14 weeks.
The average clinic visit will last up to three to four hours for an aspiration abortion. The procedure itself should take five to 10 minutes.
Aspiration abortions, also called vacuum aspirations, are the most common type of surgical abortion. During this procedure, you’ll be given pain medication, which can include a numbing medication that is injected into the cervix. You may also be given a sedative, which will allow you to stay awake but be extremely relaxed.
Your doctor will first examine your uterus and insert a speculum into the vagina to hold it open. Your cervix will be stretched open with dilators either before or at the time of the procedure. When this is done before the procedure, medications by mouth or placed into the vagina can be used. When dilation is done at the time of the procedure, a series of dilators are inserted into the cervix to increase the size of the opening.
Your doctor will next insert a tube through the cervix into the uterus, which is attached to a suction device. This will empty the uterus. Many women will feel mild to moderate cramping during this portion of the procedure. The cramping typically decreases after the tube is removed from the uterus.
Immediately after the procedure, your doctor may check your uterus to ensure that it is completely empty. You may be given antibiotics to prevent infection.
The actual aspiration procedure takes approximately five to 10 minutes, though more time may be needed for dilation.
A D&E abortion typically takes between 10 and 20 minutes, with more time potentially being needed for dilation.
This procedure starts the same way as an aspiration abortion, with the doctor examining your uterus, inserting the speculum, injecting pain medication, and dilating your cervix. The pregnancy is removed using a combination of suction and forceps to grasp and pull the pregnancy out. Finally, a small, metal loop-shaped tool called a curette will be used to remove any remaining tissue that is lining the uterus. This will ensure that the uterus is completely empty.
The cost of surgical abortions varies depending on several factors. Aspiration abortions are typically less expensive than D&E abortions. It can cost up to $1,500 for a surgical abortion within the first trimester, with second-trimester abortions costing more on average
Recovering From Surgical Abortions
It’s recommended that women rest for the rest of the day after the abortion. Some women will be able to return to most normal activities (except for heavy lifting) the next day, though some may take an extra day or so. The recovery period for a D&E abortion may last longer than that for an aspiration abortion.
Common Side Effects
Immediately after the procedure and during the recovery period, you may experience some side effects. Common side effects of surgical abortions include:
- bleeding, including blood clots
- nausea and vomiting
- feeling faint
Once your healthcare provider ensures that your health is stable, you will be discharged home. Most women experience vaginal bleeding and cramping similar to a menstrual cycle for two weeks.
When to See Your Doctor
Some side effects are symptoms of potentially emergent conditions. You should call your clinic or seek immediate medical attention if you experience the following symptoms:
- passing blood clots that are larger than a lemon for more than two hours
- bleeding that is heavy enough that you have to change your pad twice in one hour for two hours straight
- foul-smelling vaginal discharge
- pain or cramping that gets worse instead of better, especially after 48 hours
- pregnancy symptoms that persist after one week
Menstruation and Sex
Your period should return four to eight weeks following your abortion. Ovulation can occur without noticeable signs or symptoms, and often before you resume normal menstrual cycles, so you should always use contraception. You should wait to have sex for at least one to two weeks after the abortion, which can help reduce the risk of infection. You also should wait for this period of time to use tampons, or insert anything into the vagina.
Seek Help If You Need It
Although serious physical side effects from an abortion are rare they are possible. Emotional side effects are a lot more common and can be the hardest challenge to experiencing an abortion. Make sure you seek medical and emotional health help if you need it. Our clinic is available to be a place of care for you as you walk through this journey. Remember you are not alone.