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ABORTION /

Abortion is a legal, safe, and common medical procedure. Still, in some states it can be a challenge to find places that perform them. You or your loved ones may have strong feelings or beliefs about abortion, and that’s totally normal. If you’re pregnant and considering an abortion, what matters most is how you feel about it. You deserve a safe space to work through your options and decide what’s right for you.

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types of abortion

Medication

This is an option for most people up to 70 days (10 weeks) of pregnancy. Your health care provider will start counting the days of pregnancy from the first day of your last period. When you get a medication abortion (sometimes called “the abortion pill”), your health care provider gives you different medications to take. You may have the choice to take them at the clinic or at home. The medications first stop your body from making a hormone it needs for pregnancy, then cause the embryo to be expelled from your uterus. The process can take anywhere from a few hours to a few days to be completed.

Procedures

Aspiration: Aspiration abortion (also called suction abortion or vacuum aspiration) is the most common abortion procedure. Depending on the provider, this kind of abortion may be an option up to 14-16 weeks after your last menstrual period. A provider uses gentle suction to remove the pregnancy. Aspiration abortion is done in a clinic, doctor’s office, or hospital and the procedure itself usually takes less than 15 minutes.

Dilation and evacuation (D&E): If it’s been more than 16 weeks since your last period, abortion is usually done through a procedure called dilation and evacuation, or D&E. A provider dilates your cervix and removes the pregnancy using suction and other instruments. A D&E abortion is done in a clinic, doctor’s office, or hospital and may require two visits over two days.

People may not talk about it much, but almost 1 out of every 4 women have an abortion by the time they’re 45 years old.

People of all different backgrounds, ages, religious beliefs, and gender identities have abortions—and each experience is unique. Hearing someone else’s story may be helpful, but you can’t expect your own to be the same. Even if you’ve had an abortion in the past, your emotional or physical experience may be different this time.

Talking to a provider

If you have a health care provider you trust, you can ask them for information about abortion. They may be able to offer you abortion care or a referral. Otherwise you can contact the nearest clinic offering abortion care. When you call, they may ask you about:

  • the date that your last menstrual period started

  • whether you have any medical conditions, like asthma or allergies to medication

  • your height and weight

  • whether you’ve ever had a c-section

This information helps them figure out whether they can safely care for you or whether you need to be seen in a hospital or surgical center. BTW, you can ask questions too. You might want to know:

  • what types of abortion they offer

  • what pain-killers or anesthesia options they offer

  • how much an abortion costs there and what kind of insurance they accept

  • how many times you would need to come to the clinic

  • if you can bring a support person

  • if you need someone to wait with you or to give you a ride home afterward

Clinics are often very busy, but they should still treat you with respect and answer your questions clearly. If you don’t like the first place you call, try another one.

Abortion in the U.S.

Abortion has been legal in the United States for more than 40 years. but it’s still the subject of heated political debate. A majority of Americans believe that abortion should be legal in all or most cases, but because it’s such a political issue, there are major differences in state policies about abortion. Where you live, what kind of insurance you have, how far along you are in pregnancy, and whether or not you are over 18 can all affect how easy or hard it will be to find an abortion provider.

Many states have passed laws that can slow the process of getting an abortion, like laws that require special counseling or that make people wait a certain amount of time between counseling and having the abortion. Some states don’t have many abortion providers, so you might have to travel to get to one, especially if you are further along in the pregnancy. In some cases, you might even have to go out of state. If you’re 17 or younger, your state may require you to involve a parent or guardian in your abortion decision or ask a judge for permission to decide on your own. The Guttmacher Institute has the details about the laws in every state.

There is one general rule of thumb that applies to pretty much every situation: If you’ve decided to have an abortion, time matters. Scheduling the procedure as soon as possible will make it medically easier and more affordable.

Just the facts about abortion

Here are a few things you should know about abortion:

Do your research

It’s always a good idea to double check that any place offering assistance for people dealing with an unplanned pregnancy actually provides all the services they say they do. You can find abortion providers in our health center finder, by checking the box for “show health centers with abortion services available.”

To get an abortion, first you need to make an appointment at a clinic or doctor’s office. In some cases you’ll be able to do everything in one visit to the clinic—in others you’ll need one appointment for paperwork, lab tests, a physical exam and counseling, then another appointment for the procedure itself. Whether you need one appointment or more depends on how many weeks pregnant you are, what the laws in your state require, and how your health care provider usually does things.

Some clinics do have anti-abortion protestors out front. Clinics that have protestors often also have supportive escorts who meet patients outside and accompany them into the clinic. If you’re concerned about your comfort and safety, you can ask about this when you make your appointment.

Medication abortion

When you go to the clinic or doctor’s office, your health care provider will usually draw some blood from your arm and do an exam and an ultrasound to make sure you’re able to get a medication abortion. If you are, you’ll take one medication (called mifepristone) while you’re at the clinic or doctor’s office. Then, you’ll get instructions for how and when to take the second medication (called misoprostol). You may have options about when and where to take the second medication, but people usually take it at home.

Your provider should give you a way to easily get in touch with them for support if you need it. Your provider may also want to make sure that you live within a certain distance of the clinic and that you’ll have someone with you at home who knows you’re having a medication abortion. This is to make sure that you can get help in the unlikely event that you have complications.

Make sure to ask how the provider will confirm that the medication abortion worked. There’s a small but important chance that medication abortion can fail, especially if you take it later in a pregnancy.

Abortion procedures

Both aspiration and D&E abortion procedures are always done in a clinic, doctor’s office, or hospital. For both kinds of procedures, the abortion itself usually takes less than 15 minutes, but between checking in, waiting, talking to counselors and providers, taking any medications, the procedure, and recovery time, the whole thing can take several hours—or even a whole day.

Before the procedure you’ll likely have some blood drawn and a physical exam—usually an ultrasound of your belly too. You’ll also get pain medicine before the procedure. Your provider may use laminaria or give you a medication to help open up (or dilate) your cervix. Sometimes this means you’ll need two appointments so your cervix has time to open up before the procedure.

The physical side

All three types of abortion work pretty much the same way. The pregnancy is removed or expelled through your cervix, which is the opening between your uterus and your vagina.

Most people report strong cramping during and immediately after an abortion. During a medication abortion, some also have nausea, vomiting, or a low fever. It’s common and normal to having some bleeding for up to two weeks after an abortion. It’s also common for bleeding to be anywhere from light spotting to heavier than your normal period. Your health care provider will tell you how to take care of yourself afterward and how to know if you’re having any signs of a possible complication.

The emotional side

Everyone’s emotional experience of abortion is different. Some people feel clear that abortion is the right decision for them while others are uncertain or conflicted. If you’re the one who’s pregnant, the decision should be yours however you’re feeling. No one has the right to pressure or force you to have an abortion—or not to have one—if it’s what you choose.

Even if you’re totally sure that abortion is the right choice for you, it’s normal to feel a range of emotions and for your feelings to change over time. Studies show that the most common feeling women report after an abortion is relief. Of women who say they felt sad after having an abortion, most of them also feel that having an abortion was the right decision. It’s normal to feel sad, happy, relieved, worried, or any other emotion—it’s even normal to feel lots of different things at once. Whatever you are feeling, you deserve support.

Many people pay out of pocket for abortion care, but depending on your individual situation and where you live, you may be able to get help from your health insurance, Medicaid, or an abortion fund.

Paying cash

The price of an abortion before 12 weeks ranges from $350-$1,800, depending on what medications or anesthesia you need and where you receive care (a clinic, doctor’s office, or hospital). After 12 weeks, the price goes up each week, ranging from $400-$4,200 or more. Most clinics require payment up front and accept credit cards but not checks.

If you can’t afford to pay for an abortion or you have confidentiality concerns, you may be able to find help from an abortion fund. Abortion funds help people pay for the cost of abortion care and sometimes for transportation or other related costs.

Medicaid, Medicare, Tricare, and Indian Health Service

Since 1976, the Hyde Amendment has banned the use of federal funds to pay for abortion care unless the pregnancy is the result of rape or incest or would endanger the woman’s life. This ban affects:

  • people with Medicaid in many states and Washington, DC

  • people with disabilities who have Medicare

  • individuals or families who are insured through the federal government, military, or Peace Corps

  • people who are insured through the Indian Health Service

Some states cover abortion for people who are on Medicaid through state funds. If you live in one of those states and qualify for Medicaid, you may be able to get an abortion for free or at a very low cost.

Private health insurance

Some private health insurance plans cover abortion—and many don’t. In a number of states, plans aren’t allowed to cover abortion. In the state insurance marketplaces set up by the Affordable Care Act (also called ACA or Obamacare), abortion can only be covered by buying a special “rider.” (A rider is like an add-on and you have to purchase it before getting pregnant.) For more detail on Federal and State laws related to abortion coverage, check out this site. The practical result of this is that as few as 18 states (plus D.C.) even have one plan on their insurance marketplace that covers abortion.

The best way to find out what your plan covers is to call your insurance company directly. If your plan is through a family member or spouse and you don’t want them to know you’re having an abortion, you may also want to talk to your insurance company about how they’ll protect your privacy.

If you trust your health care provider, you may be able to ask them for information about abortion and/or ask them for a referral. If you don’t have a health care provider or don’t feel comfortable talking to your provider about abortion, look for a clinic in your area.

For support in making your decision, these resources may help:

  • The American Congress of Obstetricians and Gynecologists has a resource that covers all the options called “Pregnancy Choices: Raising the Baby, Adoption, and Abortion.”

  • All-Options, which supports people through all their decisions, feelings, and experiences with pregnancy, parenting, adoption, and abortion, at 1-888-493-0092.

  • The Pregnancy Options Workbook has questions and exercises to think about the way you feel about pregnancy, parenting, adoption, and abortion.

  • Faith Aloud offers free counseling by phone for women who have spiritual concerns about pregnancy or abortion.

There are a few different places where you can find accurate information about abortion and referrals to abortion providers. Contact all to make sure you find out about all the clinics in your area:

For help paying for an abortion, visit the National Network of Abortion Funds website, or call the National Abortion Federation at 1-800-772-9100.

If you need support after an abortion, Exhale has a support line. You can call them at 1-866-439-4253 to talk about your feelings and experiences.

Having an abortion is an incredibly personal decision—and the only right choice is the one that feels right to you. Here are some questions to think about as you’re making the decision. It might help to write down your answers in a journal or to discuss the questions with people you care about or someone who can offer impartial support.

  • When you think about having an abortion, what comes up for you? What have you thought about abortion in the past?

  • If you’re already a parent, could you see yourself having another child now or in the future? If you’re not a parent, do you want to be one someday? Could you see yourself becoming a parent now?

  • What do you think about adoption? How do your feelings about adoption relate to your feelings and thoughts about abortion?

  • What’s your relationship with the other person involved in the pregnancy? Do you know how they feel about abortion and other options?

  • What are your values when it comes to parenting, adoption, and abortion? If you’re religious, are there resources (teachings or people) you think could be helpful in considering your options?

  • What questions do you have about abortion? Where can you find honest and unbiased answers to your questions?

  • What kind of emotional and practical support do you need for making this decision? Where can you find the support you need?

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