Abortion

The abortion procedure:
What to expect

There are two main ways abortion can be done: the abortion pill (also called medication abortion) and an abortion procedure (also called in-clinic abortion). Whether you have a medication abortion or the abortion procedure will depend on how far along you are in pregnancy, what’s available at the health center where you choose to get an abortion, and also your own preference. We have more information about how to decide between these two types of abortion.

There are also a few different types of abortion procedures and the kind you’ll have will depend on how far along in pregnancy you are (which we’ll calculate for you when you give us the first day of your last period). The further into pregnancy the abortion takes place, the more complicated the procedure itself will be.

Abortion procedures happen safely at hospitals, at doctors’ offices, and at health centers. Even though it’s sometimes called a “surgical abortion,” the abortion procedure doesn’t usually happen in an operating room.

How far into pregnancy can you get an abortion procedure?

Pregnancy can be ended safely at any point. However, an abortion procedure gets more complicated, takes longer, and is more difficult to get later in pregnancy. Different states have different laws about how far into pregnancy you can get an abortion, so when you give us your location information, we’ll give you the relevant state law information. In general though, abortion procedures are available for longer into pregnancy than the abortion pill. The abortion pill is effective until the 11th week of pregnancy (77 days of pregnancy), but many abortion providers stop offering it earlier than 11 weeks.

What happens before the procedure?

First, you’ll fill out paperwork. Then, you’ll have a counseling appointment with a health care provider, who will talk you through your options and next steps, including choosing how you’d like to manage pain. You may also have an ultrasound to figure out or confirm how far along the pregnancy is.

Depending on the laws in your state, you may be able to have the abortion the same day as your counseling appointment. In states that have “waiting periods,” you have to come back another day for the actual procedure. For example, some states have a 24-hour waiting period. That means that once you have the counseling appointment, you have to wait 24 hours to get the abortion.

Keep in mind that some states have laws that allow you to do your counseling appointment virtually, and then do your ultrasound (if it’s required) and abortion at the same appointment, if you have to travel a long distance to get an abortion. These laws prevent you from having to travel a long distance twice or having to stay far from home during the waiting period. If you are going to have to travel a long way for your abortion, ask if virtual counseling is an option when you call to make your appointment.

What happens during the procedure?

During the abortion, you’ll be undressed from the waist down with a sheet over your lap. If you prefer, you can wear a long, flowy skirt or dress, and then you can just remove your underwear and pull the skirt up. (Just keep in mind that if you wear a jumpsuit or romper, you may have to take the whole thing off.) You’ll lie back on an exam table with your feet in stirrups — just like when you go to a gynecologist or other provider to get a Pap smear or a swab for a yeast infection. The health care provider will use a speculum to separate the walls of your vagina in order to get a good view of the cervix, and they will then inject numbing medication into your cervix. For abortions early in pregnancy, the provider will then dilate (open) your cervix. Soon after, the abortion provider will use gentle suction to empty your uterus. The procedure itself typically takes only a few minutes to complete.

If your pregnancy is more than 16 weeks along, you may need an extra step to dilate your cervix more before the procedure to make it easier to complete the abortion. You’ll either take a medication to dilate your cervix, or a health care provider will insert a special dilator called laminaria into your cervix, which will slowly expand and open your cervix gradually. This kind of abortion is called a D&E — dilation and evacuation. The dilators — whether it’s medication or laminaria — may take a few hours or overnight to work. After your cervix is properly dilated, the abortion provider will use suction and some tools to gently empty your uterus.

What happens after the procedure?

Afterward, you’ll spend a little time in a recovery room before heading home. If you’ve been given sedatives, you’ll need someone to help you get home, like a partner, friend, or family member, even if you’re planning on taking public transportation or a cab or other ride service.

You may have some cramping and bleeding in the days after your abortion, but it will taper off over the next week or so. Some people have almost no bleeding, and others have spotting that lasts a few weeks. It varies from person to person, but generally the earlier in pregnancy you have the abortion, the less cramping and bleeding you can expect afterwards. You can go back to regular activities the very next day, and you can have sex again as soon as you feel ready.

Some health care providers prescribe preventive antibiotics for all people having an abortion.

You should get your period 4 to 6 weeks after you have an abortion. But you can get pregnant again before then if you aren’t using birth control and you’re having penis-in-vagina sex. If you’d like to start on birth control after your abortion, here’s how to do that. If it’s been 8 weeks or more since your abortion, and you haven’t had a period, contact a health care provider.

How much does the procedure hurt?

How much an abortion procedure hurts varies from person to person. Some people experience very little pain, like mild period cramps, and some people experience very intense pain, which feels more like the pain of the contractions you’d have when giving birth.

You should be offered pain medication that you can take by mouth, and you may also be offered anti-anxiety medication that you can take by mouth. You will also have a numbing medication injected into your cervix.

You may also be able to have a sedative given to you through an IV. If you have “conscious sedation” administered this way you’ll be awake but very relaxed, and the procedure should be virtually pain-free. If you have general anesthesia, which is a type of IV sedation that puts you to sleep completely, you won’t feel or experience anything during the procedure — you’ll simply wake up and it will be over. Sedation generally costs extra. If you’re not sedated, the painful part of the abortion will usually only last five to ten minutes.

Many people find that any cramping is gone by the time they leave the clinic, but you may experience some cramping or pain after the procedure. A heating pad and over-the-counter pain medications should help reduce pain after the procedure.

When should you contact a health care provider after the procedure?

Your abortion provider should give you information about when and how to contact them after an abortion, but if they don’t, ask them for emergency contact information and for what things to watch out for.

You should always reach out to your provider if something doesn’t feel right to you after an abortion or if you have questions or concerns. And you should definitely contact your abortion provider (or your regular health care provider) after an abortion procedure if you experience:

  1. Excessive bleeding (defined as soaking two pads per hour for two hours)

  2. Fever higher than 100.4 F

  3. Pain that is getting worse or that doesn’t go away with over-the-counter pain medication