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Your Options - Abortion

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An abortion is a procedure to end a pregnancy. It uses medicine or surgery to remove the embryo or fetus and placenta from the uterus. The procedure is done by a licensed physician or someone acting under the supervision of a licensed physician.

The decision to end a pregnancy is very personal. If you are thinking of having an abortion, most healthcare providers advise counseling.

While there are many unwanted pregnancies, there is never an unwanted child. Infertility is at an all time high. There are many couples struggling and praying for children. Please seriously consider placing the life inside of you for adoption before scheduling an abortion.

Abortion is a big decision and we feel it is beneficial for you to have as much information as you need when making these important decisions about your pregnancy.

Abortion is a safe and legal way for women to end pregnancy.

There are two kinds of abortions available in the U.S.

  • The Abortion Pill (Medication Abortion)
    • take medicines to end an early pregnancy
    • safe and effective
    • readily available
    • costs about $350 to $650

  • In-Clinic Abortion Procedures
    • medical procedures end the pregnancy
    • safe and effective in early pregnancies
    • costs about $350 to $900 in first trimester, becomes more costly the further along the pregnancy
    • very few clinics will perform procedures past 18 weeks into pregnancy

Note: If you are under 18 , your state may require one or both of your parents to give permission for your abortion or be told of your decision prior to the abortion. However, in most states you can ask a judge to excuse you from these requirements.

Details of Using the Abortion Pill:

When Is Medical Abortion Used?
Before any abortion can be done, a medical professional must confirm that a woman is indeed pregnant and determine how long she has been pregnant. The length of a pregnancy is usually measured by the number of days that have passed since the first day of the woman's last menstrual period (abbreviated as LMP). Medical abortions can be provided as early as a pregnancy can be confirmed. In fact, the shorter the time that a woman has been pregnant, the better the medications will work. Because they do not work as well later in the first trimester of pregnancy, medical abortion is not usually an option after nine weeks (or 63 days) LMP. After that, surgical abortion is the safest and best option.

How the Medications Work
Mifepristone. Mifepristone (the abortion pill or RU-486) is a medication that was developed and tested specifically as an abortion-inducing agent. It was first licensed in France and China in 1988. Since then it has been used safely by millions of women worldwide. It was approved for use in the U.S. in September, 2000.

Mifepristone is taken in the form of a pill. It works by blocking the hormone progesterone, which is necessary to sustain pregnancy. Without this hormone, the lining of the uterus breaks down, the cervix (opening of the uterus or womb) softens, and bleeding begins.

Methotrexate. Methotrexate has been used in the U.S. since 1953, when it was approved by the FDA to treat certain types of cancer. Since that time, medical researchers have discovered other important uses for the drug. One of these uses is to end unintended pregnancies. Although the FDA did not consider methotrexate for this specific purpose, clinicians may prescribe methotrexate for early abortion.

Methotrexate is usually given to a pregnant woman in the form of an injection, or shot, although it also can be taken orally. It stops the ongoing implantation process that occurs during the first several weeks after conception.

Misoprostol. Within a few days after taking either mifepristone or methotrexate, a second drug, misoprostol, is taken. Misoprostol tablets (which may be placed either into the vagina, between cheek and gum, or swallowed) cause the uterus to contract and empty. This ends the pregnancy.

Mifepristone and methotrexate work in different ways, and so they will have slightly different effects on a woman's body. A clinician can help a woman decide whether medically induced abortion is the right option for her, and which of the two drugs she should use.

How Long Do Medical Abortions Take?

It can take anywhere from about a day to 3-4 weeks from the time a woman takes the first medication until the medical abortion is completed. The length of time depends in part on which medications are taken and when the misoprostol is used. Complete abortion generally occurs sooner with mifepristone compared to methotrexate. The majority of women who take mifepristone will abort within four hours of using misoprostol. About 95% will have a complete abortion within a week. With methotrexate, 80-85% of women will abort within 2 weeks of taking the first medication. Some will take longer and may use additional doses of misoprostol.

During and After a Medical Abortion

Some women will have vaginal bleeding after the first drug. This bleeding may be light, or it may be like a heavy period. After taking the misoprostol, cramping and bleeding usually begin within a few hours, although it may take longer. The cramping and bleeding may be more than with a normal menstrual period. Written and verbal guidelines are given to all women to help them know what to expect, and when to call the clinic for further evaluation.

Most women in the United States use the misoprostol and expel the embryo at home. A woman considering medical abortion will need to be prepared for this. The clinic staff will provide guidance and answer questions about what to expect and how to manage the side effects at home.

The most common side effects of medical abortion are caused by misoprostol. In addition to cramps and bleeding, early side effects may include: headache, nausea, vomiting, diarrhea, fever, chills, or fatigue. If a woman experiences flu-like symptoms or abdominal pain more than 24 hours after using misoprostol, she is advised to call the clinic.

Most women have cramps for several hours, and many pass blood clots as they are aborting. Some women may see the grayish gestational sac. However, the embryo will probably not be seen among the blood clots. At 49 days LMP, the size of the embryo will be about one-fifth of an inch. In an earlier pregnancy, it might be much smaller than that. Cramps and bleeding usually begin to ease after the embryonic tissue has been passed, but bleeding may last for one to two weeks after medical abortion.

Some women report that their first regular menstrual period after a medical abortion is heavier, or longer, or in some other way different from normal for them. By the second period after the abortion, their cycles should be back to normal.

Possible Complications

About 95-98% of women will have a successful medical abortion. Complications are rare. However, a small percentage of women (approximately 0.5-2%) will need a suction aspiration (similar to a surgical abortion) because of heavy or prolonged bleeding. In about half of these cases, this heavy bleeding occurs 3-5 weeks after taking the medications. Rarely, in approximately 0.1-0.2% of cases, a blood transfusion might be required to treat very heavy bleeding. Some women also choose to have a suction aspiration because they would prefer not to wait for the medical abortion to be completed on its own.

In about 1% of cases or fewer, the medications do not work and the embryo continues to grow. In these cases, a suction procedure (surgical abortion) must be done to empty the uterus and complete the abortion. Deciding to continue the pregnancy to term is not an option after taking the first medication because the medications can cause birth defects in the pregnancy.

Seven deaths in North America have been reported in women following the use of mifepristone/misoprostol, out of more than 1.1 million cases. One death was the result of an ectopic pregnancy (a pre-existing condition not related to mifepristone/misoprostol use), and six deaths have been attributed to sepsis. No causal relationship has been established between the medications and these rare fatalities.

There do not appear to be any long-term complications associated with the use of these drugs.

Follow-Up Care

Medical abortion requires a follow-up visit to the clinic or medical office. This return visit is very important to be sure that the abortion has been completed. In addition, a woman should contact her health care provider about any problems or concerns she has during the medical abortion.

Anti-Abortion Propaganda About Medical Abortion

Anti-abortion activists claim that medical abortion is unsafe for women, even though there is no evidence to support this claim. The real goal of those activists is to stop all types of legal abortion - a situation which would put the lives and health of women in danger. When abortion was illegal in the United States (from the late 1800s until 1973), more pregnant women died from complications from self-induced abortions or abortions performed by untrained practitioners than from any other cause. Today, abortion is one of the most common and safest medical procedures. Because earlier abortions are the safest, medical abortion is an important medical advance for women, and an option that many choose.

Details of Surgical Abortions:

Third Trimester Abortions

Despite the claims of some anti-abortion activists, women have access to abortion in the third trimester only in extreme circumstances. Fewer than 2% of abortions are provided at 21 weeks or after, and they are extremely rare after 26 weeks of pregnancy. Very few abortions are provided in the third trimester, and they are generally limited to cases of severe fetal abnormalities or situations when the life or health of the pregnant woman is seriously threatened.

There are many methods of abortion. The procedure used depends largely upon the stage of pregnancy and the size of the unborn child. Dr. J.C. Willke, in his book, Abortion: Questions and Answers (Hayes Publishing Co. Inc, Cincinnati, 1985), has divided the methods of abortion into three main categories: those that invade the uterus and kill the child by instruments which enter the uterus through the cervix; those that kill the preborn child by administration of drugs and then induce labour and the delivery of a dead baby; and, those that invade the uterus by abdominal surgery.

Dilation of the uterus is required in cervical methods of abortion. The usual method of dilation is to insert a series of instruments of increasing size into the cervix. A set of dilators, metallic curved instruments, are used to open the cervix sufficiently to accommodate the instruments of abortion. In contrast with a normal birth, where the dilation occurs slowly over a period of many hours, the forceful stretching by the abortionist to open the cervix takes a matter of seconds. This premature and unnatural stretching of the cervix can result in permanent physical injury to the mother.

Laminaria (dehydrated material, usually seaweed) is sometimes used to reduce damage to the cervix. Inserted into the cervix the day before the scheduled abortion, it absorbs water and swells, gradually pushing open the cervix in the process.

At Eight Weeks

8weeks_196 At eight to nine weeks the eyelids have begun forming and hair appears. By the ninth and tenth weeks the preborn child sucks her thumb, turns somersaults, jumps, can squint to close out light, frown, swallow, and move her tongue.

At this early stage of development, suction abortions are performed using a smaller tube, requiring little dilation of the cervix. This is called "menstrual extraction." However, if all the fetal remains are not removed, infection results, requiring full dilation of the cervix and a scraping out of the womb.

Suction Aspiration

suctionaspiration_161 This is the most common method of abortion during the first 12 weeks of pregnancy. General or local anaesthesia is given to the mother and her cervix is quickly dilated. A suction curette (hollow tube with a knife-edged tip) is inserted into the womb. This instrument is then connected to a vacuum machine by a transparent tube. The vacuum suction, 29 times more powerful than a household vacuum cleaner, tears the fetus and placenta into small pieces which are sucked through the tube into a bottle and discarded.

Dilation and Curettage (D&C)

dilationcurettage_263 This method is similar to the suction method with the added insertion of a hook shaped knife (curette) which cuts the baby into pieces. The pieces are scraped out through the cervix and discarded [Note: This abortion method should not be confused with a therapeutic D&C done for reasons other than pregancy.]

At Twelve Weeks

By the end of the third month all arteries are present, including the coronary vessels of the heart. Blood is circulating through these vessels to all body parts.

The heart beat ranges during this fetal period from 110 to 160 beats per minute. All blood cells are produced by the liver and spleen, a job soon taken over by the bone marrow. White blood cells, important for immunity, are formed in the lymph nodes and thymus.

Vocal chords are complete, and the child can and does sometimes cry (silently). The brain is fully formed, and the child can feel pain. The fetus may even suck his thumb. The eyelids now cover the eyes, and will remain shut until the seventh month to protect the delicate optical nerve fibers.

14 weeks: Muscles lenghten and become organized. The mother will soon start feeling the first flutters of the baby kicking and moving inside.

15 weeks: The fetus has an adult's taste buds and may be able to savor the mother's meals.

16 weeks: Five and a half inches tall and only six ounces in weight, eyebrows, eyelashes and fine hair appear. The child can grasp with his hands, kick, or even somersault.

At Eighteen Weeks

18weeks_225 The fetus is now about 5 inches long. The child blinks, grasps, and moves her mouth. Hair grows on the head and body.

20 weeks: The child can hear and recognize mother's voice. Though still small and fragile, the baby is growing rapidly and could possibly survive if born at this stage. Fingernails and fingerprints appear. Sex organs are visible. Using an ultrasound device, the doctor can tell if the child is a girl or a boy. The one on the left is a baby girl.

Dilation and Evacuation (D&E)

This method is used up to 18 weeks' gestation. Instead of the loop-shaped knife used in D&C abortions, a pair of forceps is inserted into the womb to grasp part of the fetus. The teeth of the forceps twist and tear the bones of the unborn child. This process is repeated until the fetus is totally dismembered and removed. Usually the spine must be snapped and the skull crushed in order to remove them.

Salt Poisoning (Saline Injection):

salt_poistoning_190 Used after 16 weeks (four months) when enough fluid has accumulated. A long needle injects a strong salt solution through the mother's abdomen into the baby's sac. The baby swallows this fluid and is poisoned by it. It also acts as a corrosive, burning off the outer layer of skin. It normally takes somewhat over an hour for the baby to die from this. Within 24 hours, labor will usually set in and the mother will give birth to a dead or dying baby. (There have been many cases of these babies being born alive. They are usually left unattended to die. However, a few have survived and later been adopted.)

6months_260 At Six Months

Seen here at six months, the unborn child is covered with a fine, downy hair called lanugo. Its tender skin is protected by a waxy substance called vernix. Some of this substance may still be on the child's skin at birth at which time it will be quickly absorbed. The child practices breathing by inhaling amnionic fluid into developing lungs.

Prostaglandin Chemical Abortion

prostaglandin_130 This form of abortion uses chemicals developed by the Upjohn Pharmaceutical Co. which cause the uterus to contract intensely, pushing out the developing baby. The contractions are more violent than normal, natural contractions, so the unborn baby is frequently killed by them -- some have even been decapitated. Many, however, have also been born alive.

Hysterotomy or Caesarean Section

Used mainly in the last three months of pregnancy, the womb is entered by surgery through the wall of the abdomen. The technique is similar to a Caesarean delivery, except that the umbilical cord is usually cut while the baby is still in the womb, thus cutting off his oxygen supply and causing him to suffocate. Sometimes the baby is removed alive and simply left in a corner to die of neglect or exposure.

30weeks_312 At 30 Weeks

For several months, the umbilical cord has been the baby's lifeline to the mother. Nourishment is transferred from the mother's blood, through the placenta, and into the umbilical cord to the fetus. If the mother ingests any toxic substances, such as drugs or alcohol, the baby receives these as well.

32 weeks: The fetus sleeps 90-95% of the day, and sometimes experiences REM sleep, an indication of dreaming.

Partial-Birth Abortion

Five steps to a partial birth abortion:

  1. partialbirth_135 Guided by ultrasound, the abortionist grabs the baby's legs with forceps.

  2. The baby's leg is pulled out into the birth canal.

  3. The abortionist delivers the baby's entire body, except for the head.

  4. The abortionist jams scissors into the baby's skull. The scissors are then opened to enlarge the skull.

  5. The scissors are removed and a suction catheter is inserted. The child's brains are sucked out, causing the skull to collapse. The dead baby is then removed.

40weeks_229 At 40 Weeks

The baby, now approximately seven and a half pounds, is ready for life outside its mother's womb. At birth the placenta will detach from the side of the uterus and the umbilical cord will cease working as the child takes his first breaths of air. The child's breathing will trigger changes in the structure of the heart and bypass arteries which will force all blood to now travel through the lungs.

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Many of the amazing pictures shown here were taken from the very excellent Nine Month Miracle CD ROM, by A.D.A.M. Software, Inc., the book A Child Is Born by the famous Swedish photographer Lennart Nilsson, and the handbook When You Were Formed in Secret , by Gary Bergel. Photos appearing on this web site are reproduced under "fair use" terms for the purpose of public education. For permission to use these photos for commercial purposes, please contact the original sources indicated above. Source for much of the above text includes copyrighted material by Terwilliger Web Development Services and is used with permission.