What Is an Abortion?

• They didn’t intend to get pregnant (Research shows half of people seeking abortion report using birth control in the month before they became pregnant.

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• They no longer want to be pregnant
• They have a medical condition that makes pregnancy life-threatening
• The fetus has a serious medical condition
• They require medical assistance to induce delivery of nonviable fetal tissue after miscarriage

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   or stillbirth

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   (While medical providers would not use the term “abortion” in these scenarios because the pregnancy has already ended, the medications and procedures are the same. However, ongoing abortion restrictions at the state level could prevent women from obtaining this medically necessary care.)

• Not being financially prepared
• Bad timing
• Partner-related issues
• The desire to focus on the children they already had
• Concern that the pregnancy would interfere with future opportunities
• Not being emotionally prepared
• Health-related reasons
• Believing the child deserved a better life
• Not being independent or mature enough
• Influences from family or friends

Most of the women studied reported multiple reasons for choosing to terminate their pregnancy. The authors of the paper concluded that a woman’s decision to seek an abortion is influenced by various factors, such as age, health, socioeconomic status, parity, and marital status.

Abortion Legal Barriers

Medication Abortion

A medication abortion, sometimes referred to as a medical abortion, involves taking medications to end your pregnancy.

The most common medications given for a medication abortion are mifepristone (Mifeprex, RU-486) and misoprostol (Cytotec). Mifepristone blocks the action of the hormone progesterone, which is important for pregnancy. Misoprostol prompts the uterus to contract and empty.

A healthcare provider will give you these medicines at a health clinic. You may take them at the facility or at home, depending on your state laws and your provider’s policies.

You will need to see your provider at least twice: once before taking the medicines and once after you’ve completed the treatment to confirm the medication worked and the abortion was successful.

Medication abortions can take up to 24 hours to complete.

A medication abortion is different than using emergency contraception, commonly known as the morning-after pill. Emergency contraception is used to prevent pregnancy, while a medication abortion is used to terminate a pregnancy.

Surgical Abortion

• Suction Abortion (Vacuum Aspiration) With this technique, gentle suction is used to empty the uterus. A suction abortion can be performed until about 14 to 16 weeks after your last period. This is the most common type of in-clinic abortion.
• Dilation and Evacuation (D&E) Abortion A D&E involves using suction and surgical instruments to empty the uterus. Doctors may recommend this procedure if it’s been 16 weeks or longer since your last period.

Abortion Later in Pregnancy

• Better Health and Less Chronic Pain Women who were denied an abortion and gave birth experienced more life-threatening complications like eclampsia and postpartum hemorrhage. They also reported more chronic headaches or migraine, joint pain, and gestational hypertension compared with people who were able to get a wanted abortion.
• Better Short-Term Mental Health Those who were denied an abortion reported increased anxiety and stress and decreased self-esteem soon after the procedure was denied. About six months to a year after receiving or being denied an abortion, all women reported similar levels of mental health and well-being.
• More Economic Security People who were denied an abortion were 4 times more likely to fall below the federal poverty level than those who were able to get an abortion. Women forced to carry a pregnancy to term were also 3 times as likely to be unemployed, and also reported more debt, lower credit scores, and more financial insecurity for multiple years after giving birth.
• More Likely to Get an Advanced Degree Women denied abortion had similar odds of graduating or dropping out of school compared with those who did get an abortion, but those who got one were more likely to graduate with an advanced degree.
• Better Outcomes for Their Existing Children The already existing children of women forced to carry a pregnancy to term were over 3 times as likely to live in poverty, and less likely to achieve developmental milestones compared with the existing children of people who were able to get an abortion.

The short-term complications you might experience will depend on the type of abortion you have.

Medication Abortion Risks

• Infection
• Heavy or prolonged bleeding
• An incomplete or unsuccessful abortion (which means you may need to have a surgical abortion)

Surgical Abortion Risks

• Very heavy bleeding
• Infection
• Pregnancy tissue left in your uterus
• Injury to your cervix, uterus, or other organs
• An allergic reaction to medications

Before a medical or surgical abortion, your provider may perform a urine test, a physical exam, or a blood test. Additionally, you may need to have an ultrasound to confirm how far along you are in your pregnancy and to rule out ectopic pregnancy.

Your healthcare provider will explain how the medicines or procedure will work, the side effects, and the risks.

• Oral pain medicines, such as Vicodin, Valium, and ibuprofen
• Medicines to soften your cervix, such as misoprostol
• Dilating sticks that are placed in your cervix, such as laminaria or Dilapan
• Antibiotics to help prevent infections
• Sedation drugs

If you take Vicodin, Valium, or other sedation medicines, you’ll need to arrange for someone to take you home from the clinic.

Finding a Provider and Clinic

You should know that healthcare providers aren’t required to perform elective abortions, and different states have certain legal requirements, waiting periods, or age restrictions when it comes to abortions, if they’re legal at all. These laws might make it challenging to find a provider or clinic.

Costs and Insurance Coverage

Some insurance plans cover abortions, but others don’t. Check your policy before scheduling your appointment. If your procedure is not covered, you might be able to work out a self-payment option with the clinic.

Additionally, your local Planned Parenthood health center or another health clinic may be able to provide you with other options or resources for financial assistance.

The process will depend on the type of abortion you have.

Medication Abortion

Then, hours or days later, you’ll be instructed to take misoprostol, usually at home. Your provider may also give you antibiotics to prevent an infection.

About a week later, you’ll meet with your provider to make sure the abortion is complete.

Suction Abortion

• Inject numbing medication into your cervix
• Stretch the opening of your cervix with dilating rods
• Insert a thin tube into your uterus
• Use a small suction device or machine to remove the pregnancy tissue out of your uterus

Additionally, the doctor may use a tool to remove any tissue that’s still left in your uterus or to confirm that your uterus is completely empty.

After the suction abortion is over, you’ll stay in a recovery area for about an hour or until you feel well enough to go home.

While the procedure itself only takes about 10 minutes, your appointment will be longer due to prep and recovery time.

D&E Abortion

You’ll likely be sedated for a D&E procedure.

First, your doctor will prepare your cervix with medicines that help open it. Dilator sticks (laminaria) are often given a few hours or a day before a D&E.

To begin the procedure, a healthcare provider will look at your uterus and examine inside your vagina with a speculum. Then they will do the following:

• Inject a numbing medication into your cervix
• Stretch the opening of your cervix with dilating rods
• Insert a thin tube into your uterus
• Use surgical instruments along with a suction device to remove the pregnancy tissue from your uterus

The procedure typically takes about 10 to 20 minutes, but your appointment will be longer due to the prep and recovery time.

You’ll wait in a recovery room for up to an hour or until you feel well enough to leave.

Most people heal quickly after an abortion, but your recovery might depend on the type of abortion you had and how far along you were in your pregnancy.

Recovery After Medication Abortion

You can usually resume most normal tasks, such as going to work or driving, the next day. However, don’t perform any strenuous activities, such as heavy exercise, for several days.

You might bleed or spot sporadically for several weeks after your medication abortion.

Follow your provider’s instructions carefully. Let them know if you experience nausea, vomiting, diarrhea, or a fever for more than 24 hours after taking misoprostol.

You can have sex as soon as you feel ready (but again, it's important to use contraception if you want to avoid pregnancy).

Your normal periods should resume four to eight weeks after the abortion, but this will depend on your birth control method.

Recovery After Surgical Abortion

The day after a surgical abortion, you can usually resume regular activities, such as driving and working, if you feel up to it. You can also have sex as soon as you feel well enough, though be sure to use reliable contraception if you wish to prevent pregnancy, notes Planned Parenthood.

You’ll probably experience some cramping or bleeding. Pain medicines, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), can help with the discomfort.

You might bleed or spot for several weeks, but some people don’t bleed at all. Your healthcare provider may recommend that you use pads, so you can keep track of how much you bleed.

You should get a normal period about four to eight weeks after your procedure, but this might vary if you use certain birth control methods.

Be sure to follow all your doctor’s instructions after your procedure. Call your provider right away if you experience the following:

• Soak through two pads per hour for two hours
• Have pain or cramps that don’t get better with medicine
• Have a fever of 100.4 degrees F or higher

If you’re considering an abortion, you’re not alone. Many resources are available to help you through the process. Here are some of Everyday Health’s favorites:

Abortion Finder

AbortionFinder.org includes more than 750 health centers and offers a comprehensive directory of trusted and verified abortion service providers in the United States. You can also find information about how the laws in your state may affect your ability to get an abortion.

Guttmacher Institute

The Guttmacher Institute is a nonprofit organization supporting abortion rights. It maintains an up-to-date database of the legality of abortion in all 50 states and the District of Columbia, in addition to other abortion information resources.

Planned Parenthood

Planned Parenthood is a nonprofit organization that delivers vital reproductive healthcare, sex education, and information to millions of people around the world. The website provides a search for clinics in your area and resources for reproductive healthcare screenings along with pregnancy options.

National Abortion Federation

The mission of the National Abortion Federation is to unite, represent, serve, and support abortion providers in delivering patient-centered, evidence-based care. A toll-free hotline provides callers with abortion referrals and financial assistance services. You can also locate a provider in your area right on the website.

National Network of Abortion Funds

The National Network of Abortion Funds aims to remove financial and logistical barriers to abortion access. The organization helps connect people seeking an abortion with organizations that can assist with the costs of having one.

Resources to Avoid: Crisis Pregnancy Centers

However, these clinics do not present the full range of options when it comes to making a decision about an unwanted pregnancy. Oftentimes they intentionally mislead people seeking information, for example by telling them the lie that abortion can cause infertility. Resources like the Crisis Pregnancy Center Map and Expose Fake Clinics have searchable lists of predatory crisis pregnancy centers you can use to make sure the clinic you select is reputable.

Most women can start on hormonal or nonhormonal birth control immediately after having an abortion.

These are some of the options:

• The pill (available in a variety of formulations)
• A progesterone implant (Nexplanon)
• Intrauterine devices (IUDs), with or without hormones
• A progesterone shot (Depo-Provera)

In cases of surgical abortion, providers can insert an IUD in your uterus at the same time you undergo the procedure.

If you’re interested in a birth control method, your provider can walk you through your options.