If you are less than 9 weeks pregnant from the first day of your last normal period you can choose a Medication or Surgical abortion.
Unsure which one to choose? Here are some considerations when making a decision:
·How they work
·The client experience (how much will it hurt?)
·Recovery (scheduling considerations)
HOW THEY WORK ----------------------------
·You take one medication at the clinic, called Mifepristone, & another medication at home 24h – 48h later, called Misoprostol
·Mifepristone is an anti-hormone. It blocks the effects of progesterone, needed for the pregnancy to continue
·Misoprostol is a prostaglandin. It causes contractions of your uterus & relaxes cervix which helps push out the contents of your uterus
·Your cervix is dilated, opened up slowly, to gain access to your uterus
·A plastic tube called a cannula is inserted into your uterus through your cervix (there is no cutting involved)
·A suction machine or hand-held pump is attached to the end of the plastic tube. This suction is used to take out the contents of your uterus
THE CLIENT EXPERIENCE (How much will it hurt?) ----------------------------
·One trip to the clinic to start the abortion. This appointment will take on average 4 hours
·A process to end the pregnancy – bleeding starts often within 4 hours and lasts for about 10-16 days
·Bleeding takes place outside of clinic and is more “like a miscarriage”. You may see pregnancy tissue and pass clots. This bleeding is usually heavier than a period
·Significant cramping (like contractions) happens during the heaver bleeding, after taking the medication at home. It doesn’t usually last longer than 1 to 2 days; this is when you can expect to see clots and/or pregnancy tissue. You may need 1-2 days off work/school/caregiving, etc., during this time
·More pain than a surgical abortion. Overall, we have a 6/10 pain score (of course some find it more or less painful than others)
·More blood work and phone contact or a possible return to the clinic will take place. For some clients there will
be multiple trips to a lab to have blood drawn
·Mild medication side effects including some symptoms like nausea, fatigue, headache, low fever (for less than 24h), vomiting, dizziness, diarrhea, chills
·One trip to the clinic to end the pregnancy. The appointment will take on average 4 hours
·Time for the actual procedure is 5-7minutes (clients spend a bit longer in the procedure room)
·Cramps during some part of the procedure. (We give a generous amount of pain medications to control the pain but you will still likely feel some cramping)
·Less pain than a medication abortion. Overall, we have a 4/10 (of course some find it more or less painful than others)
·Mild medication side-effects like nausea or dizziness, and sometimes fatigue for the rest of the day
·Less blood work (often none) than with medication abortion
·Your choice to see pregnancy tissue, if you request
·Some clients have very little bleeding after they leave the clinic, or it might be a bit like a period. Bleeding may increase a bit three days after the procedure.
PAIN MANAGEMENT ----------------------------
·Heat on lower abdomen or back
·Massage the lower abdomen frequently
·Take the pain meds we provide – Tylenol 3
·Pain is managed by a narcotic and monitored at the clinic
·At home; Tylenol or Advil
·Heat to abdomen or back
·2-5% chance that you will need a surgical procedure to complete the abortion because
the medications didn’t work
·1-2% chance you will require surgical procedure to manage on-going heavy bleeding
·0.1-0.2% risk of requiring a blood transfusion
·Serious, untreated, infections are very rare but could be life threating
·Retained tissue or continued pregnancy may require another abortion procedure called “respiration”.
·Infection of the uterus; this risk is lowered by a dose of antibiotic we give you
·Heavy bleeding – most often resolved at the clinic
·Injury to the uterus or other internal organs. Major surgery like the removal of the
uterus is one in 10,000 abortions (this is less that after childbirth)
·0.001% death (all of North America) including later term pregnancies and severe
allergic reactions to general anesthetic (being put to sleep for the
RECOVERY (Scheduling Considerations) ----------------------------
-Outside of your appointment date there may be 1 or 2 days where going to work or taking care of small children will not be possible.
-You may be asked to make multiple trips to a lab of your choice to have blood drawn (these dates will be scheduled by the nurse at the time of your appointment after an assessment)- this is to ensure the medication is working effectively.
-You are advised to take the day of your procedure to recover. Clients are generally able to return to their normal work/school schedule the day following their procedure.
-If you are under 6 weeks into your pregnancy and the pregnancy tissue is not identifiable after the procedure you will be required to do blood work the following day at a lab of your choice.