Is abortion safe?

Abortions are safe, no matter what option you choose. Many people have an abortion in the United States each year. The rate of complications (bad outcomes) for abortions is very low. The risk of a bad complication is much less than the risk with having a baby.

What are the possible risks of an abortion?

Like any procedure, there are possible risks with abortion. These risks are rare but may include:

• Heavy bleeding
• Infection
• Damage to your cervix or your uterus
• Allergic reaction to a medication

How will I feel after my abortion?

An abortion is a very personal experience. Aside from some cramping like menstrual cramps and some bleeding, most people feel good enough to go back to work or school soon after. There are lots of emotions that you may feel after an abortion, like relief or sadness. It is rare but please call us if you feel hopeless or depressed.

What happens to the fetal tissue after my abortion?

After your abortion, we will look at the tissue to make sure that the pregnancy was removed. Most of the time, the clinic sends the tissue to incinerate – cremate. If you want, you can choose to have a private cremation or burial. If you choose that, the tissue needs to go directly to a funeral home in New Mexico (cannot directly cross state lines). We can give you contact information for funeral homes.

Can I bring someone with me to my appointment?

Yes, you can bring one support person with you. We ask that you don’t bring children.

Can I eat and drink before my visit?

This depends on what you want for pain control if you have a D&C or D&E. If you plan to have pain control by IV (intravenous), please do not eat after midnight the night before your visit. Drink lots of water until 2 hours before your clinic visit.

What about alcohol or recreational drug (like weed, meth, heroin) use?

If you are using alcohol or drugs, please be open and honest so we can plan to keep you safe. Don’t use alcohol or drugs for 24 hours before you have a D&C with sedation (like medicine by mouth or IV medicine) as they can react with sedation medications and cause problems.

Do I need a ride to/from clinic?

This depends on your plans for sedation.

• If you have a medication abortion or a D&C without any sedation you do not need a ride.
• If you have sedation by mouth or IV sedation you NEED a ride home from clinic.
• If you have any sedation (by mouth or IV) you cannot use an Uber or Lyft to go home from clinic.

When can I travel back home if I had to travel a long distance and/or had to fly?

Most people can travel the same day. Some patients having a D&E want to stay close to the clinic until the next day in case there is a problem. If you fly on the same day as your appointment, you should book your flight for 6pm or later. Your appointment could take up to 6 hours and we cannot guarantee you will be done in time for an earlier flight.

What should I wear to my abortion appointment?

If you plan to have a D&C or D&E please dress in comfortable dark clothes like sweatpants. Wear flat shoes, socks, and bring an extra pair of underwear and a sweater.

How soon can I have sex after my abortion?

To protect you from infection, we recommend waiting at least 7 days before having sex or using tampons.

Can I take a bath after my abortion?

You can bathe normally after your abortion.

What if I change my mind during my visit?

That is OK – we are here to help you with whatever choice is best for you, in whatever way we can. If you decide not to have an abortion after talking with the doctor, that is OK.

How much will the visit cost? Is funding available?

Call now to ask about the cost of your care. Our staff can help you with financial issues, including insurance coverage, non-insurance payment options, and assistance funds. Our staff can also help you with resources for travel and lodging if you need. If you need financial assistance, funding for abortion care is available through the National Abortion Federation (NAF) Hotline at 1-800-772-9100. Assistance is also available through the National Network of Abortion Funds and Indigenous Women Rising. Remember if you reschedule your appointment or are unsure of how far along in pregnancy you are, the price may change.

What is a Medication Abortion?

An abortion using pills is safe at less than 11 weeks. You start the abortion process in the clinic with the abortion pill mifepristone. You will swallow this pill in the office. The doctor will give you 4 misoprostol tablets to take after the visit, at a time you plan with the doctor. If you are more than 9 weeks, you will take two doses of misoprostol (8 tablets). Taking the mifepristone and then the misoprostol causes the pregnancy to pass, which is like having a miscarriage. We call you a week after the pills to check in. Then you take a home pregnancy test 4 weeks after the abortion to make sure it is finished.

What can I expect after I take the medications?

After you take the first medicine Mifepristone in the clinic, you probably will not feel any different or have any side effects. Some women have some spotting or nausea.

About 1-6 hours after you place the misoprostol pills (the second medication), you will start to have some cramping and vaginal bleeding. Most of the time, the cramping and bleeding will get heavier until you pass the pregnancy. This usually happens within 12 hours after the misoprostol. After the pregnancy passes, the bleeding and cramping will get lighter. You may see some pink or yellow tissue along with the bleeding. Sometimes, you can also have nausea, diarrhea or chills.

Will I have pain?

During the very heavy part of the bleeding, you will have cramping that will feel like strong period cramps. We will talk about how to use pain medication like ibuprofen and acetaminophen to help ease the pain.

How much bleeding will I have?

You will have bleeding like a very heavy period. You may pass some blood clots and need to change your pad a lot during the process. This very heavy bleeding only lasts 1-3 hours. After the pregnancy tissue passes the bleeding will slow down but you may have mild bleeding for 2-3 weeks.

Are there any long-term side effects?

There are no long-term side effects after medication abortion. It does not affect your ability to get pregnant again in the future.

Do I need to come back for a visit?

We will call to check on you one week after your abortion pills. If everything has gone well you do not need to come back to the clinic. At the phone call with our nurse a week after the abortion, if you or our nurse have concerns, we will schedule you for an in person clinic visit.

You will also take a home urine pregnancy test 4 weeks after the abortion, 3 weeks after the nurse phone call. This is the pregnancy test that we give you at your initial abortion visit. Please call us with your pregnancy test results.

What happens if it doesn’t work?

The two medications work for around 95-99% of pregnancies. Some people may need more medicine to help pass all the pregnancy tissue and some may need a suction D&C procedure to finish the abortion.

Is the medication abortion the same as the “morning after” pill?

No, they are different. The “morning after” emergency contraception pill is not an abortion pill. You take the “morning after” pill 1-3 days after sex so that you don’t get pregnant. The “morning after” pill does not work if you are already pregnant.

Can you change your mind once you start?

Once you take the medicines for a medication abortion, there is no way to stop or reverse the process. The medicines can cause bad birth defects.

Can I get birth control during my visit?

You will talk with the doctor about birth control if you want to. You can start some methods right after you medication abortion. For options and what may be available to you, please ask your doctor during your visit. You can also use resources such as www.bedsider.org to explore options before your visit.

If you are 11 weeks pregnant or less, you have two options:

One option is a “procedural abortion” also often called a suction Dilation &Curettage (D&C) or uterine aspiration, which will happen in the clinic at your visit.

The second option is a “medication abortion,” where you take pills, one pill at the visit and other pills later after the visit.

How do I choose between a suction D&C and a medication abortion?

The choice between a medication abortion and a suction D&C is mostly up to you and which you prefer. Here are some pros and cons for each one.

Medical Abortion

• Pros
  • Don’t need a procedure
  • May feel more private
  • It’s “like a miscarriage” and may “feel more natural.”
• Cons
  • Heavy bleeding and cramping at home
  • Need follow up to make sure it worked, usually a phone call and home pregnancy test
  • Side effects like nausea or fever
  • Some rare risks like bleeding and infection

D&C

• Pros
  • No follow up needed - It’s done when you leave the office
  • The procedure takes a short amount of time
  • Don’t have heavy bleeding at home
• Cons
  • Some rare risks like bleeding and infection
  • Longer time for the office visit (4-6 hours)

What is a suction D&C?

A suction D&C is a simple procedure used for abortion up to 14 weeks. It is safe to do in the clinic for most patients. When you are ready, the doctor will dilate (open up or stretch) the cervix so that a tube can be placed and suction out the pregnancy through the tube. From start to finish, the suction D&C procedure takes about 5-15 minutes.

What will happen during the suction D&C?

We do a time out or “safety check” to make sure you are the right patient, that we know if you have any allergies and that we all agree on the plan. We start in the same way as a pap test. The doctor does an internal exam to feel the size and shape of your uterus. Then, we place a speculum in the vagina to see your cervix. We clean your cervix to help prevent infection. Next, we place numbing medicine around your cervix to help with cramping. Then the doctor will open or stretch your cervix. Once your cervix is open enough, we place a tube inside the uterus and suction will take out the pregnancy. You will have some cramps like period cramps. The suction part takes only a few minutes. When it’s over, the doctor will leave the room to examine the tissue and make sure your uterus is empty.

Will I be awake and feel pain during the suction D&C?

Before the suction D&C, you will take ibuprofen to help ease pain. Also, the medicine we place around your cervix will help with cramping. You will have cramping, like period cramps. We will give you a heat pack to help with cramping.

At CRH we do suction D&Cs with 3 levels of sedation (pain control): no sedation, pills that you take by mouth or medicine you get through an IV. You and the doctor decide together which sedation is best. Even with IV sedation medicine, you will not be completely asleep. You can bring music to listen to during the procedure if you wish. Our caring staff will talk with you and hold your hand if you wish during the procedure. There is more information about sedation options below.

What kind of sedation should I get?

You have the option to take medicine to help you relax and to be more comfortable for your D&C. We make sure the medicines are safe for you.

1. 1) Anti-anxiety sedation: Midazolam (IV) or Lorazepam (by mouth)
2. 2) Analgesia sedation: Fentanyl (IV) or Oxycodone (by mouth)

We will talk to you about these options and the dose at your appointment. To get any sedation you must have a ride home.

How long will I be there?

Your whole visit may last up to 4-6 hours. This may seem like a long time but there are many steps to each visit: vital signs, blood work, ultrasound, review of your medical history, and counseling about options, payment, procedure, etc.

What can I expect after a suction D&C?

The cramping will start to ease up shortly after the suction D&C is over; you will likely have some cramping over the next few days. You may take ibuprofen and acetaminophen to help with the cramping. You will have some bleeding, like a light period, which may last for 2 to 3 weeks. You will often feel ready to go back to work or school the next day. If you need a note for work or school for 1-2 days please let us know and we are happy to provide it.

Do I need to come back for a visit?

Most of the time you do not need a follow up visit after a suction D&C abortion. These are very safe and you only need to come back if you are having problems. We will give you information before you leave and phone numbers to call with problems or questions. We will help you with a follow up appointment if you need.

Will this affect my ability to get pregnant again in the future?

A suction D&C will not affect your ability to get pregnant again in the future. There are no studies that show that getting a suction D&C can make you infertile. In fact, some women can get pregnant again within 7-14 days after the suction D&C.

Can I get birth control during my visit?

We will talk to you about birth control if you want to. There are some methods you can get right after a suction D&C. For options and what may be available to you, please ask your doctor during your visit. You can also use resources such as www.bedsider.org to explore options before your visit.

What happens to the fetal (pregnancy) tissue after my suction D&C?

After your abortion, we will look at the tissue to make sure that the pregnancy was removed. Most of the time, the clinic sends the tissue to incinerate – cremate. If you want, you can choose to have a private cremation or burial. If you choose that, the tissue needs to go directly to a funeral home in New Mexico (cannot directly cross state lines). We can give you contact information for funeral homes.

What is second trimester abortion?

Second trimester abortion is any abortion that happens after 14 weeks.

What are my options for abortion after 14 weeks?

Between 14 to 24 weeks, you may have two options: “labor induction” which is medicine to cause labor while admitted to the hospital, and procedural termination (known as dilation and evacuation, or D&E). At CRH we offer D&E abortion.

What is a D&E?

D&E is a procedure in the clinic or in an operating room to remove the pregnancy. To get ready for a D&E, you will need one or two days of visits for the procedure. We review your medical

and pregnancy history and talk about the whole process from start to end. The D&E process begins by opening your cervix with dilators or giving you medicine. This can sometimes take one day and sometimes 2 days – your doctor will talk to you about timing after your ultrasound. The D&E procedure takes about 30 minutes.

At what point in pregnancy do you need 2 days for the D&E?

Usually after 18 weeks the abortion will take 2 days. You have dilators placed on Day 1 and the D&E procedure is on Day 2.

What pain control options do I have for a D&E?

We work hard to make sure you are as comfortable as possible before, during and after the procedure. You have the same sedation options for all procedures (see above) – no sedation, pills you take by mouth, sedation you get by IV. No sedation is only an option up to about 16 weeks. You must get an IV for a D&E abortion, so many people choose sedation through the IV.

Will I be awake and feel pain during the D&E?

Before the D&E, you will get medicine like ibuprofen through the IV to help ease pain. Also, the medicine we place around your cervix will help with cramping. You will have cramping, like period cramps. We will give you a heat pack to help with cramping.

At CRH we do D&Es with 3 levels of sedation (pain control): no sedation, pills that you take by mouth or medicine you get through an IV. You decide which you want after you talk to the doctor. No sedation is only an option up to about 16 weeks. You must get an IV for a D&E abortion, so many people choose sedation through the IV. Even with IV medicine, you will not be completely asleep. You can bring music to listen to during the procedure if you wish. Someone will be there to talk to you and hold your hand during the procedure. There is more information about sedation options below.

What kind of sedation should I get?

You have the option to take medicine to help you relax and to be more comfortable for your D&E. We make sure the medicines are safe for you.

1. 1) Anti-anxiety sedation: Midazolam (IV) or Lorazepam (by mouth)
2. 2) Analgesia sedation: Fentanyl (IV) or Oxycodone (by mouth)

We will talk to you about these options and the dose at your appointment. To get any sedation you must have a ride home.