Abortion
What to Think About
If you have had unprotected sex in the last 5 days and don't want to become pregnant, see a health professional about emergency contraception in the form of hormone pills (Plan B—also referred to as the morning-after pill). You can also buy emergency contraception at a pharmacy. If you have had unprotected sex in the past 5 to 7 days, you may be able to use a copper intrauterine device (IUD) for emergency contraception. This will also work for long-term birth control.
Your abortion options are affected by your medical history, how many weeks pregnant you are, and what options are available in your region. Not all medical or surgical choices for an abortion are available in all parts of Canada or around the world. Depending on what clinic or hospital you choose, there may be restrictions such as requiring a waiting period, requiring parental consent for young women under a certain age, or limiting options for pregnancies between 13 and 20 weeks (during the second trimester).
The following table lists some of the differences between the most commonly used medical and surgical abortion procedures.
Comparing medical abortion and surgical abortion12 Medical abortion: Surgical abortion: Usually prevents a need for surgical treatment
Is invasive and/or surgical:
- Manual vacuum aspiration (MVA) uses a tube attached to a hand-held syringe. It draws tissue out of the uterus.
- Machine vacuum aspiration uses a tube attached to an electric pump. It draws tissue from within the uterus.
- Dilation and curettage (D&C) is usually done when another abortion method has failed to completely clear the contents of the uterus. A sharp instrument is used to scrape any remaining tissue from the uterine wall.
- Dilation and evacuation (D&E) uses a combination of vacuum aspiration, forceps, and dilation and curettage (D&C).
Can only be used during early pregnancy (up to 9 weeks)
Can be used from early to mid-pregnancy:
- Manual vacuum aspiration (MVA) can be used as early as 3 to 4 weeks, and as late as 10 weeks after the last menstrual period.
- Machine vacuum aspiration can be used 9 weeks after the last menstrual period, usually not before.
- D&C is usually done when another abortion method has failed to completely clear the contents of the uterus.
- D&E is used between 13 and 20 weeks after the last menstrual period. It uses a combination of vacuum aspiration, forceps, and D&C.
Takes 2 or more medical visits over 3 weeks
Usually takes 1 visit
Takes days to weeks to complete—most of the abortion process happens gradually, at home
Is complete in the time it takes for the procedure
Does not require anesthesia or sedative
Does not require general anesthesia (though it can be used). Local anesthesia, with or without a calming sedative is usually used.
Has a high success rate (about 95%)
Has a high success rate (about 99%)
Causes moderate to heavy bleeding for a short time
Causes light bleeding in most cases
Needs medical follow-up to make sure pregnancy has ended and to check woman's health
Does not always need medical follow-up
Is a multi-step process
Is a single-step process
In extremely rare cases, leads to severe infection and death (about 1 in 100,000), slightly higher rate than after surgical
In extremely rare cases, leads to death (less than 1 in 100,000)
Pain associated with a medical or surgical abortion ranges from mild to severe and depends on each woman's physical and emotional condition.
Some fetal birth defects or medical problems are not commonly diagnosed until the second trimester, when most routine screening tests are done. There are fewer abortion options during the second trimester.
Right after surgery, you will be taken to a recovery area where nurses will care for and observe you. You will probably stay in the recovery area for 1 to 4 hours. You will then be moved to a hospital room or you will go home. In addition to any special instructions from your doctor, your nurse will explain information to help you in your recovery. You will go home with a page of care instructions including who to contact if a problem arises.
Abortion and breast cancer
Research suggests that the hormonal changes during pregnancy may be protective and reduce the risk of breast cancer. In the past, there has been concern that an abortion might interrupt these protective hormonal changes and possibly increase the risk of breast cancer. However, more recent, carefully done studies have led experts to conclude that there is no link between having an abortion and breast cancer.3, 1, 13
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| Author: | Healthwise Medical Writer | Last Updated: March 5, 2008 |
| Medical Review: | Joy Melnikow, MD, MPH - Family Medicine Lori A. Boardman, MD, ScM - Obstetrics and Gynecology Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology | |
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