Onlinecare - pregnancy and post-abortion support.
 

Abortion

You may be in a situation where you believe abortion is your best or only option. Women who have had abortions commonly report that if their circumstances had been different they would not have had an abortion.

Some common reasons for choosing an abortion are:

  • Relationship difficulties with the father of the baby
  • Not prepared for parenting responsibilities
  • Concerned about financial provision
  • Fear of making lifestyle changes
  • Apprehension about the response of others to the pregnancy
  • External pressure to have an abortion
  • Concerns about being too young or too old to have a baby

By knowing the facts of abortion (informed consent), one is able to make a more informed choice.

There are various abortion procedures available during different stages of pregnancy. In Canada 90% of abortions are done in the first 12 weeks of pregnancy, avoiding the added risk associated with later term abortions. For information on possible risks see physical and emotional risks.

You may be given an ultrasound before an abortion to determine your stage of pregnancy and also afterwards to determine if the abortion is complete.

Depending on the type of abortion, the procedure may take between 5–30 minutes, with the entire process being generally less than 2–3 hours.

Abortion Procedures

Medical Abortion – usually up to 7 weeks

Typically, Methotrexate is given by injection or orally followed by Misoprostol which may be self-administered by vaginal suppositories or oral pills. Methotrexate is a chemotherapy drug which stops cell growth. Some cramping and bleeding will occur as the uterus contracts and as the embryo is expelled within 2 days. This procedure usually requires 3 visits to the abortion provider. Incomplete abortions are followed up with a surgical procedure.

Surgical Abortion – 6 weeks and beyond

With each of the following surgical procedures the cervix will be dilated (opened) to allow instruments to enter the uterus. Dilation may be done using osmotic dilators (e.g. laminaria) prior to the procedure or metal rods during the procedure. A local anaesthetic may be given as well as medication to reduce pain, blood loss and risk of infection. Occasionally, general anaestheic may be used. After each surgical procedure the fetal and placental tissue will be examined to determine if all the products of conception were removed from the uterus.

Vacuum Aspiration – usually between 6-14 weeks

After cervical dilation, abortion is performed by inserting a long tube (cannula) into the uterus. This cannula is connected to a hand or machine operated pump. The contents (embryo/fetus and placental tissue) are then suctioned out of the uterus.

D&C: Dilation & Curettage – usually between 6-14 weeks

After cervical dilation, abortion is performed by using a loop-shaped instrument (curette) to scrape the wall of the uterus and remove the embryo/fetus and placental tissue. This procedure may be used on its own or as a follow-up to incomplete abortions after other procedures.

D&E: Dilation & Evacuation – usually 14-21 weeks

This method requires 2 appointments. After 24 hours of cervical dilation, this procedure is performed by removing fetal parts and placental tissue from the uterus with the use of forceps. Vacuum suction or a curette may also be used to assist in the complete evacuation of the uterus.

D&X: Dilation and Extraction – after 21 weeks

A variation of dilation & evacuation is intact D&E, also referred to by some as dilation and extraction (D&X) or “partial birth abortion”. This is a rare procedure involving cervical dilation, breech delivery (pulling the fetus down legs first), then decompressing the skull (e.g. with scissors) to allow delivery of the fetal head.

The Canadian Medical Association recommends that doctors not perform abortions after 20 weeks gestation, as the fetus may be viable.

Physical and Emotional Risks

Thousands of abortions are performed every year in Canada, and are considered to be a safe medical procedure. However, as with any medical procedure there are potential risks to consider.

Physical:

  • Heavy bleeding
  • Infection
  • Increased risk of premature births
  • Cervix or uterus damage, including small risk of infection or scarring that can be associated with infertility or miscarriage

Emotional:

Many women feel some sense of relief immediately following an abortion. On the other hand, many women encounter strong, negative emotions. Such emotions may be immediate or occur years later. Women who have had an abortion may report the following reactions:

  • Sadness
  • Depression
  • Anger
  • Guilt
  • Anxiety
  • Emotional numbing
  • Anniversary grief
  • Nightmares or flashbacks of the abortion
  • Increased risk of alcohol and drug abuse
  • Relationship problems
  • Suicidal thoughts

Emotional responses vary depending on a woman’s age, stage of pregnancy, previous mental health, religious or cultural beliefs, or whether she is being pressured by others into having an abortion.

Please connect with an online peer counsellor if you wish to discuss your options further.