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Abortion. Almost everyone has strong feelings about it. No matter what your beliefs are, it’s important to know the facts. Here’s everything you need to know about the different types of abortion, along with important resources.

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Illustration by Wenzdai

You’re not alone

  • About 862,320 abortions were performed in the United States in 2017.
  • The ratio of abortions to live births was 186 to 1,000 in 2016.
  • 1 in 4 women will have an abortion before they’re 45, according to 2014 statistics.
  • In 2014, 51 percent of women who had abortions had used a form of birth control. The most common birth method was condoms, at 24 percent. Accidents happen.

In the United States, abortions are legal during the first and second trimesters. They’re not offered during the third trimester unless the woman’s or fetus’s life is in danger.

Most abortions occur during the first trimester. The rules get more complicated during the second trimester. Some states allow abortions up to the 24th week of pregnancy. Other states ban it after 20 weeks.

What’s a trimester?

A pregnancy is broken up into three trimesters:

  • First trimester: Weeks 1 to 12
  • Second trimester: Weeks 13 to 27
  • Third trimester: Weeks 28 to delivery (usually about 40 weeks)

There are multiple safe forms of abortion available. The kind you get depends on your stage of pregnancy, local laws and resources, and other important factors.

Types of abortion:

  • Medical abortion
  • Surgical abortion
  • Induction

You can have a medical abortion until the 10th week of pregnancy.

A lot of people call this the “abortion pill.” You take the medications mifepristone (Mifeprex) and misoprostol (Cytotec). The two work together to end the pregnancy.

Mifepristone blocks the hormone progesterone, preventing the embryo from implanting or growing. Misoprostol makes the uterus contract, pushing out pregnancy tissues.

Your doctor may not recommend this method if you:

Procedure

A medical provider gives you mifepristone, which you usually take in their office. Then they prescribe misoprostol, which, in most cases, you can take at home. You can either swallow the pills or insert them into your vagina.

Recovery

In many cases, this method works within about 4 hours, but it can take up to 2 days. You may want to take some time off from work due to the possible side effects. You should expect heavy cramping and bleeding 1 to 4 hours after taking misoprostol.

Additional symptoms include:

  • headache
  • sweating
  • dizziness
  • tiredness
  • nausea and vomiting
  • diarrhea
  • passing of small blood clots

Afterward:

  • Don’t have sex for a week or two.
  • Your period should go back to normal within 4 to 6 weeks.
  • You’ll start ovulating in about 3 weeks.
  • It shouldn’t hurt your chances of getting pregnant in the future.

Cost

The cost of a medical abortion varies from place to place. On average, it ranges from $300 to $800, and some insurance plans will cover the cost.

MTX can be used in the first 7 weeks of pregnancy.

Methotrexate is a cancer drug that stops cancer cells from growing, and it can also stop embryo cells from multiplying. Misoprostol works by contracting the uterus, helping it release its contents.

MTX takes longer to work than mifepristone and misoprostol, and it’s almost never used for planned abortions. It’s mainly used to end a pregnancy that’s outside the uterus — an ectopic pregnancy can be life threatening.

Don’t use methotrexate and misoprostol if you:

Procedure

An MTX abortion is broken up into two phases. First, you take methotrexate at the doctor’s office or clinic as a pill or shot. Then, you take misoprostol pills 4 to 6 days later. You can take them at home, either orally or by inserting them into your vagina.

The abortion starts within 1 to 12 hours after you take the meds. Research from the 1990s suggests that this method of abortion is more than 90 percent effective, but if it doesn’t work, you might need a surgical abortion.

Recovery

You may need to take a few days to reset after this procedure. Bleeding usually lasts 4 to 8 hours and can be heavy.

Possible MTX side effects are:

  • chills
  • diarrhea
  • dizziness
  • headache
  • bad cramps
  • low grade fever
  • nausea and vomiting

Afterward:

  • Wait a week or two to have sex.
  • Your period should return in a month or two.
  • It shouldn’t hurt your chances of getting pregnant in the future.

Cost

Methotrexate and misoprostol can cost anywhere from $300 to $1,000, and some insurance companies cover it.

Vacuum aspiration (aka suction aspiration) can be performed during the first 16 weeks of pregnancy.

Some folks choose this method as option A, but others may fall back on it if a medical abortion has failed.

Procedure

A doctor uses suction to gently remove the fetus and placenta from your uterus. You might feel some cramping, because your uterus will contract during the procedure.

You can get a vacuum aspiration at a doctor’s office, clinic, or hospital. The procedure usually takes only 5 to 10 minutes, but you might be asked to stay at the clinic for a few hours to make sure your body is bouncing back the way it should.

Your doctor may need to perform this procedure in a hospital if you have:

  • a pelvic infection
  • a history of blood clots
  • serious health problems
  • an unusually shaped uterus

Recovery

The procedure itself shouldn’t be painful. But discomfort is normal during the healing process.

Side effects can include:

  • cramps
  • nausea
  • sweating
  • dizziness
  • bleeding or spotting

Afterward:

  • Avoid sex for at least a week.
  • Your period should return in 4 to 6 weeks.
  • It shouldn’t hurt your chances of getting pregnant in the future.

Cost

The price of suction aspiration ranges widely, depending on location and stage of pregnancy. Some insurance plans will cover some or all of the cost.

D&E is used after the 14th week of pregnancy.

This method is recommended for those who were delayed in getting another type of abortion. It’s often used in situations where the fetus has a medical problem or severe abnormality.

Procedure

D&E is a combo of forceps, vacuum aspiration, and dilation and curettage (D&C).

Here’s what happens: Your doctor widens (dilates) your cervix to make it easier to remove the tissue. The next day, they use forceps to remove more tissue and placenta. They may also use suction. Then they use a scoop-like tool (a curette) to gently scrape the uterine lining.

This procedure has to be done in a hospital or medical clinic. It can be painful, but your doctor can give you a numbing medication to prevent extreme discomfort.

The procedure itself takes less than 30 minutes, and you can go home the same day. But usually you’ll rest in the office for a few hours after the procedure.

Recovery

D&E recovery will typically take longer compared to other abortion types. If you can, you may want to take a few days off from work. Side effects can last for 2 weeks after the procedure.

Symptoms can include:

  • nausea
  • bleeding
  • cramping

Afterward:

  • Don’t have sex for at least 2 weeks.
  • Avoid intense exercise for at least 1 week.
  • Your period should return in 4 to 8 weeks.
  • Ask your doc how long you should wait to try to conceive again.
  • It shouldn’t hurt your chances of getting pregnant in the future.

Cost

A D&E abortion can cost $1,500 or more, depending on where you’re having it done and how far along you are. Some health insurance plans will cover some or all of the cost.

An induction abortion is done during the second trimester.

Induction abortion might be an option if you’re past 24 weeks and you can’t get a D&E, but it’s rarely used in the United States.

Procedure

Your doctor gives you a medication that puts you into labor. This makes your uterus contract and release the fetus. Your doc may also use a curette to gently remove tissues from your uterus.

Induction abortions are done only in hospitals or specialized clinics, and they can last several hours or even a day from start to finish.

You’ll most likely be given sedatives or an epidural for this type of procedure, as intense cramps and discomfort are common.

Recovery

You might have cramps and feel uncomfortable for a day or two. You’ll likely want take some time off from work, if you can.

Side effects from an induction abortion can include:

  • nausea
  • vomiting
  • diarrhea
  • pain
  • bleeding
  • cramping
  • chills
  • headache

Afterward:

  • Avoid sex for 2 to 6 weeks. The exact timing depends on how far along you were and other medical factors.
  • Don’t do heavy exercise for 2 weeks.
  • Your period should come back in 4 to 8 weeks.
  • Ask your doc before trying to conceive again.
  • It shouldn’t hurt your chances of getting pregnant in the future.

Cost

This procedure is done when you’re further along, so it will be more expensive than other abortion types. It can cost $3,000 or more, but some health plans will cover some or all of the cost.

Later-term abortion” can mean different things to different people. Some consider an abortion later-term when it’s performed after the 20th week of pregnancy. Others believe it’s only considered later-term when it’s done during the third trimester.

Most states ban or restrict later-term abortions. They’re rare in the United States but may be necessary for many reasons.

You can get two types of abortion in the third trimester — induction abortion and D&E.

Some good news: Complications from later-term abortion are rare. The procedure shouldn’t hurt your chances of conceiving in the future.

The morning-after pill (e.g., Plan B) is a type of emergency contraception, not a type of abortion. You can take the morning-after pill up to 5 days after unprotected sex. It prevents pregnancy and won’t end an existing pregnancy.

You can get the morning-after pill at most pharmacies and family planning clinics without a prescription, and there’s no age requirement to buy it.

An abortion ends a pregnancy, but you’ll likely be able to get pregnant again. Talk to your doctor about contraception choices, since there are many options out there. You’ll find a method that works for you.

Abortion is legal is every state, but that doesn’t mean it’s always easy to find a provider. Not all doctors offer abortion services.

There’s a chance you’ll have to travel to another state. To date, 45 states allow individual healthcare providers to refuse an abortion. Forty-two states allow institutions to refuse the service.

Unsure of your area’s restrictions?

The Guttmacher Institute can help. They keep an updated list of abortion laws in each state.

If you’re in the U.S., you can give Planned Parenthood a call. Their website offers lots of resources, and they can help you find your closest location.

You can also search for an abortion provider using these resources:

Mental health resources

It’s normal to feel a lot of different emotions before or after an abortion. Don’t let anyone tell you how you should feel. You can’t prevent other people from judging, but you don’t have to judge yourself.

Talk to a therapist, psychologist, or social worker if you’re having a tough time after your abortion. If you’d feel more comfortable, you can reach out to an organization that will have your back.

Some supportive groups include:

Talking to your partner

Getting an abortion is your decision, but it can still affect your partner. It’s a good idea to include them in the discussion — but only if you feel safe to do so.

Choosing to have an abortion can bring on many different emotions, and sometimes an emergency situation may leave you feeling like you don’t have much choice.

Remember:

  • You know yourself best.
  • You know your situation best.
  • You know your life goals best.

Don’t feel obligated to share your abortion with friends or family if you don’t want to. There are tons of resources available that will help you get through it. Please be kind to yourself. And remember, you’re not alone. ❤️