Choosing Abortion
Considering abortion? Consider this—whatever you decide will change your life. All of your choices—abortion, adoption, and parenting, bring life-altering consequences. Abortion, like any other medical procedure, should be weighed carefully. Investigating the procedure and its potential side effects, asking questions, and getting second opinions will help you to make a wise decision. A Hope Center is committed to giving accurate abortion education, but does not perform abortions or refer clients to abortion facilities.

A Hope Center peer consultants will help you examine all your pregnancy options. If you’re considering abortion, your career, education, financial stability, and/or relationships are probably
threatened by the pregnancy. Many women in this situation feel stressed, trapped, or out of control. Take back control through education. In confidence, our peer consultants are trained to help you examine personal issues surrounding the desire to end a pregnancy and give education on abortion procedures and their possible physical risks and emotional complications.*

Recognize that the emotions you are experiencing are normal. You are facing an enormous problem and may be experiencing a typical “fight or flight” response—an emotionally charged rush to take care of the problem. Be careful to slow down and think clearly.

Many women especially regret this choice when it is made too quickly or under pressure. This regret can reveal itself in a woman through Post Abortion Stress. Thankfully, you do not have to face it alone. If you decide to have an abortion, A Hope Center can help you deal with possible emotional complications through our support program for past abortions.

Your independence brought you to this web site. Your need for truth has you reading about your choices. Your desire to make the wise choice pushes past the pressure.

* If you would like to consult with a staff person or volunteer who has a personal experience with abortion and/or unplanned pregnancy, please make a special request when scheduling your
appointment.

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Morning After Pill (MAP)
Used within 72 hours of sexual intercourse.
Also known as Emergency Contraception (EC) the Morning After Pill is intended to prevent pregnancy when the usual method of contraception was not used or failed.

Types of EC:
Preven, an early-developed EC, contains high doses of estrogen and a progestin.
Plan B is the current world standard for EC. It contains only the progestin, levonorgestrel. The dosage of plan B is 1.5 mg, taken once (this dosage is about 15 times the dose of a typical low-dose birth control pill) or it may be divided into two smaller doses.

Risks and side effects:
Preven is known to cause nausea and vomiting. Plan B rarely causes nausea because it does not contain estrogen. Both Preven and Plan B can also cause breast tenderness and bleeding.

No evident immediate harmful effects are noted with EC use at this time, but long term effects with occasional or repeated use of EC’s have not been studied. There has never been a placebo-controlled trial of any method of EC, and since women’s estimates of when they ovulate are only accurate 50-60% of the time, true effectiveness of EC is in question.

Use and effectiveness:
If taken in two doses, women are instructed to take the first dose as soon as possible, but not more than 72 hours after intercourse. A second dose is taken 12 hours after the first dose. If used within 24 hours of intercourse, EC is reported to be 95% effective; 24-48 hours, 85%; 48-72 hours, 58% (ACOG @ 2003 FTC OTC hearing).

Is it an abortion?
Emergency Contraception is included on our abortion page because there is scientific debate over this question. The controversy centers on some possible mechanisms the drug may utilize for preventing pregnancy. Those asserting that Emergency Contraceptives can act as abortifacients believe that MAP might interfere with the fertilized egg’s ability to keep growing or with its' ability to implant. These assertions cannot be objectively proven or denied at this time. For those who believe life begins at conception, these possibilities represent probable early abortions.

Emergency Contraception use in a typical cycle:
For this example, an “ideal” 28-day-cycle is used, meaning that menstruation occurs on day 1 and ovulation occurs on day 14:
(Remember- a woman's cycle varies.)

1) If taken anytime up to day 11, MAP probably has no effect, as most sperm will be inactive for fertilization (or dead) by the time of ovulation, day 14.
2) If taken anytime from day 12 to 13.5, MAP will probably delay ovulation for several days, during which time, the sperm will die.
3) If taken after intercourse that occurred more than 24 hours beyond ovulation (day 15.5 to 28) MAP has no effect because the egg is already dead.

A woman's egg must be fertilized within 12 hours of ovulation or it will begin to die. Sperm, which are no longer functional after 48 (and rarely up to 96) hours, must be present with the egg within 12 hours of ovulation for fertilization to occur.

As you can see from this example there is a very small window of time in a woman's cycle where MAP would actually accomplish its intended purpose.

When considering Plan B:
Even though this drug is now widely and easily available, we suggest you think about the following when considering an EC:

1) The Plan B total dosage of progestin is 15 times the normal dose of some low-dose birth control pills. Birth control pills must be prescribed and supervised by a doctor and yet, Plan B does not have the same potential patient-protecting requirements. This inconsistent message about the supervision of your healthcare leads us to recommend that you contact your OB-GYN or family care physician about using Plan B.
2) Plan B's window for effective action against a pregnancy is small relative to the length of your cycle. Ask yourself—Do I want to expose myself to a comparatively large dose of hormone "just in case" I am within the window of possible fertilization?
3) Plan B and other ECs are considered possible abortifacients (drugs with an abortion action) by many in the medical field. Consider your personal feelings on the issue of abortion before going forward.

Abortion Procedures
RU486, Mifepristone:
Used within 4 to 7 weeks after last menstrual period.
Also known as the Abortion Pill, this medical abortion is used for women who are within 28 to 49 days after their last menstrual period. This procedure usually requires three office visits. The RU 486 or mifepristone pills are given to the woman who returns two days later for a second medication called misoprostol. The combination of these medications causes the uterus to expel the fetus.

Early Vacuum Aspiration:
Used within 7 weeks after last menstrual period.
This surgical abortion is done early in the pregnancy up until 7 weeks after the woman's last menstrual period. The cervical muscle is stretched with dilators (metal rods) until the opening is wide enough to allow the abortion instruments to pass into the uterus. A hand held syringe is attached to tubing that is inserted into the uterus and the fetus is suctioned out.

Suction Curettage:
Used within 6 to 14 weeks after last menstrual period.
In this procedure, the doctor opens the cervix with a dilator (a metal rod) or laminaria (thin sticks derived from plants and inserted several hours before the procedure). The doctor inserts tubing into the uterus and connects the tubing to a suction machine. The suction pulls the fetus' body apart and out of the uterus. One variation of this procedure is called Dilation and Curettage (D&C). In this method, the doctor may use a curette, a loop-shaped knife, to scrape the fetal parts out of the uterus.

Dilation and Evacuation (D&E):
Used within 13 to 24 weeks after last menstrual period.
This surgical abortion is done during the second trimester of pregnancy. Because the developing fetus doubles in size between the thirteenth and fourteenth weeks of pregnancy, the body of the fetus is too large to be broken up by suction and will not pass through the suction tubing. In this procedure, the cervix must be opened wider than in a first trimester abortion. This is done by inserting laminaria a day or two before the abortion. After opening the cervix, the doctor pulls out the fetal parts with forceps. The fetus' skull is crushed to ease removal.

Dilation and Extraction (D&X):
Used from 20 weeks after LMP to full-term.
Also known as Partial-birth Abortion, this procedure takes three days. During the first two days, the cervix is dilated and medication is given for cramping. On the third day, the woman receives medication to start labor. After labor begins, the abortion doctor uses ultrasound to locate the baby's legs. Grasping a leg with forceps, the doctor delivers the baby up to the baby's head. Next, scissors are inserted into the base of the skull to create an opening. A suction catheter is placed
into the opening to remove the skull contents. The skull collapses and the baby is removed.

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Possible Physical Risks
of Surgical Abortion

Infection - this could be local or throughout the body, particularly if there is any tissue left in the uterus from the pregnancy (placenta, uterine lining, fetus).

Hemorrhage/shock - excessive bleeding, especially if there is damage to the uterine artery or perforation of the uterus.

Cervical tearing/laceration/overstretching - this may occur from the instruments or equipment used, and may affect the ability of the cervix to remain closed during future pregnancies, resulting in a greater risk of future miscarriage or premature delivery.

Perforation (puncture or tearing) of the uterus - during scraping or suctioning, the wall of the uterus may be perforated by instruments or equipment. This is a complication that requires emergency medical attention and may require major surgery, including hysterectomy.

Scarring of the uterine lining - this may occur in the area where suction occurred or instruments were used, possibly preventing a future pregnancy from implanting in that location. If this scarring occurs at the top of the uterus near the opening on the fallopian tubes, it may partially or fully block this area. This may result in decreased future fertility, or an increased risk of ectopic (tubal) pregnancy, since the egg would have difficulty getting past the scar tissue into the uterus. Ectopic pregnancies become very painful as they develop and can be life threatening. Ectopic pregnancies must be treated and removed to avoid certain major medical complications for the pregnant woman.

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Possible Emotional Risks
Some women and men experience a range of psychological and emotional problems after an abortion experience. Signs of disturbance may include recurrent dreams of the abortion experience, varying degrees of sadness around the anniversary date of the abortion or the baby’s due date, relationship problems, substance abuse, avoidance of emotional attachment, sleep disturbance, feelings of guilt, depression, and suicidal thoughts or actions. There is scientific debate concerning the existence and cause of psychological problems associated with a past abortion experience, but there is a growing body of evidence to support the prevalence of these problems following an abortion, which are often taken together and referred to as "Post Abortion Stress". Negative emotional reactions and other behaviors listed above are commonly expressed by the women who come to our center seeking post-abortion services.
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Patient's Rights at an Abortion Clinic
Legal Rights of an Abortion Patient

If you are seeking an abortion, you should know your legal rights:
• You have the right to insist that only a licensed physician
perform your abortion.
• You have the right to know whether this physician has ever had his or her medical license suspended.
• You have the right to verify that this physician has medical malpractice insurance to protect and compensate you in case you are injured during the procedure.
• You have the right to be immediately transferred by ambulance to the nearest emergency hospital or trauma center if you are injured during the abortion procedure.
• Women considering abortion should NEVER sign a waiver releasing the doctor, abortion clinic or staff from liability for abortion-related injuries.
Source:
www.optionline.org

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