What should I expect if I decide to have an abortion?

By Kristen Mark, Ph.D.

You've considered all of your options and have made the decision to get an abortion. Maybe you aren't ready to become a parent (financially, emotionally, etc.), perhaps you're a survivor of rape or incest, or maybe you already have all the children you can handle.

So, what now? Now that you've made up your mind, I'm sure you have a billion and one questions going through your mind. What will it feel like? Will it hurt? Will I be able to tell afterward? Will other people know? How long is recovery? Well, lucky for you, I'm here to alleviate some of those anxieties and let you know what to expect.

Abortion has been around almost as long as pregnancy has. The first record of induced abortion was performed in China around 515 to 500 B.C. Obviously back then, they didn't have the technology we have today, so abortion wasn't very safe and often ended in death. But today, abortion is actually a very safe procedure that nearly 1.3 million women choose to have every year.

There are two different types of abortion: medication abortion and vacuum aspiration. I'll take you through the steps of what to expect for both of these options.

Medication Abortion

A medication abortion uses (surprise, surprise) medicine to end the pregnancy and can only be used if you are early enough in the pregnancy; the limit is between 49 and 63 days. Under a clinician's guidance, you'll receive a dose of one of two drugs that will either block the production of progesterone (mifepristone), which is critical in producing the uterine lining that aids fetal growth, or will stop the growth of the pregnancy (methotrexate). Then, you'll take a second medication (misoprostol), which softens the cervix and causes the uterus to contract and empty. This second step can be done at home and will most likely result in heavy bleeding within a few hours or days (this bleeding is the abortion). In about two weeks, you'll return to the clinic for a follow-up visit to make sure the abortion is complete and to make sure you're healthy. These medications can cause severe birth defects, so if the medication abortion doesn't work, vacuum aspiration must be done.

Vacuum Aspiration

This method of abortion uses moderate suction to end a pregnancy. After 63 days, it is your only abortion option. Once you make an appointment for this type of abortion, your uterus will be examined and a speculum inserted into the vagina (some clinics will offer sedation, some won't). Then the clinician will inject a numbing medication into or near your cervix and your cervix will be dilated. (Dilation can occur with dilating rods, absorbent dilators inserted the night before, or with medication.) Then, a tube is inserted through your cervix into the uterus where a hand-held suction device or suction machine gently empties the uterus. In about two to four weeks, you should have a follow-up appointment to make sure you're healthy. The procedure usually takes 10-20 minutes, but you'll spend more time there getting education, a physical exam, completing paperwork and recovering.

With the medication abortion you should feel better with every day, but you may have bleeding for up to four weeks. You can return to work or to other normal activities in the next day or two. With the vacuum aspiration you may have cramps, but can usually return to work or other normal activities the next day.

Vaginal bleeding is normal, although some people don't experience any. Spotting could last up to six weeks, but heavy bleeding shouldn't last more than a few days.

Some women feel relief after an abortion. However, other women may feel anger, regret, guilt or sadness for a little while, which could have just as much to do with the hormonal changes that are happening as it does the decision. There is no scientific evidence that supports "post-abortion syndrome" or long-lasting emotional problems. However, every woman may experience this differently. Serious, long-term emotional problems after abortion are about as common as they are after childbirth.

For many women, getting an abortion is more emotionally painful than it is physically painful. If you come to terms with your decision before the abortion takes place, you're far less likely to experience emotional distress. And now you're well-equipped to know what to expect.

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