Abortion Control Law

Medical abortion purposely ends a pregnancy with medications:

• Mifepristone (Mifeprex) – blocks the hormone progesterone which is needed to maintain pregnancy.
• Misoprostol – causes contractions to empty the uterus.

Medical abortion only can be done early in the pregnancy (a woman must be no more than ten weeks pregnant). A medical abortion does not require surgery or anesthesia. Generally, Mifepristone will be taken orally in the clinic on the first day and Misoprostol will be taken buccally (between cheek and gum of mouth) 24-48 hours later. Usually, the pregnancy will end within a few hours or days, but bleeding may continue for several weeks. Bleeding, passing of blood clots and cramping are expected. Patients should follow up with their health care provider approximately 7 to 14 days after the administration of MIFEPREX. This assessment is very important to confirm that complete termination of pregnancy has occurred and to evaluate the degree of bleeding

Vacuum aspiration is the most common method of early abortion (performed up to 16 weeks gestation). In preparation for the procedure, a local anesthetic will be used to numb the cervix and the cervix is usually dilated to a width of less than one centimeter. A cannula – a hollow tube – will be passed through the cervical opening and suctioning through the cannula will empty the uterus. Medications to reduce discomfort may be available during and after the procedure. The procedure takes approximately five to 10 minutes, in addition to preparation and about 30 minutes of recovery time. Some bleeding and cramping will be expected for a few days.

Dilation and curettage is no longer a common method of abortion but may be required if spontaneous abortion (miscarriage) or other abortion methods fail to entirely empty the uterus. A local anesthetic will be used to numb the cervix. The procedure generally involves a wider cervical dilation after which the inside of the uterus will be scraped with a curved curette. A D&C procedure usually takes five to 10 minutes. Because most patients who undergo a D&C are given general anesthesia (medicine to put you to sleep), recovery time is about 24 hours. In certain situations, other forms of anesthesia can be used.

Dilation and evacuation can be performed after 14 weeks gestation. The cervix may be dilated by an absorbent material placed in the cervix for several hours or overnight. Medications may be given for several reasons – to ease discomfort, to prevent infection, to induce contractions and to limit bleeding. Vacuum aspiration will be used to empty the uterus, and if necessary a curette or forceps also may be used. The procedure usually takes 10 to 15 minutes followed by a couple hours of recovery time.

This procedure is generally used after 16 weeks of pregnancy. Medicines will be used to start labor. These medicines can be put in the vagina, injected in the uterus (womb) or given into the vein (intravenously or IV). The medicines used cause the uterus to contract and labor to begin. Sometimes more than one medicine will be used. This procedure may take from several hours to several days. Your doctor may use instruments to scrape the uterus and make sure that the fetus, placenta and other contents of the uterus have been completely removed.

Infection in the genital tract for any reason is associated with future fertility problems. It can cause internal damage if untreated. In some cases, antibiotics may be given at the time of the abortion to prevent infection or will be prescribed if symptoms develop after the abortion. The risk of infection is less than 1% for medical abortions and between .1 and 2% for surgical abortions

In about 2% of abortion procedures, the uterus may not be completely emptied during abortion. This is called an incomplete abortion. When this occurs, heavy or irregular bleeding, infection or continued pregnancy may result. Incomplete abortion may require an aspiration or dilation and curettage to empty the uterus. Sometimes a medical intervention is not necessary because the woman passes the small amount of remaining tissue on her own. It is slightly more common after medical abortion than after vacuum aspiration, and it is more common in labor induction abortions than other types of abortions.

Hemorrhage is heavy bleeding that can happen during or after abortion. Some bleeding will be expected after all abortion procedures, but heavy bleeding is not normal and is not common. If it occurs, aspiration or medications may be used to treat it. It is estimated to occur in less than 1% of abortions. Surgery or blood transfusion is rare.

Damage to the cervix or uterus may occur during abortion and can range from a self-healing surface cut to a deep tear requiring stitches or surgery. Uterine perforation and cervical injury are estimated to occur in approximately .4 to 2% of abortions. The risk is lower for medical abortions. Uterine rupture is a rare complication of late abortion.

Any medication carries a risk of an allergic or adverse reaction. Medications associated with abortion may cause minor side effects such as diarrhea, nausea, vomiting, headache, dizziness or tiredness. A serious allergic reaction is rare. Local anesthetics (the kind that numb one area) are safer than general anesthetics (the kind that “put you to sleep”). Local anesthetics commonly are used in aspiration and early surgical abortion. General anesthetics are almost never used in first trimester abortions but are more commonly used in second trimester abortions.

Uncomplicated abortion does not interfere with future fertility or pregnancies. Complications from an abortion such as infection and structural damage can make future pregnancies more difficult if they occur. The earlier abortions are performed, the less likely it is that complications will occur.

Findings from some studies suggest there is no increased risk of breast cancer among women who had an induced abortion, while other studies suggest there is an increased risk; hence, differing professional opinions exist. Three professional organizations, the American Congress of Obstetricians and Gynecologists, the National Cancer Institute, and the American Cancer Society, have reviewed the various studies and have released statements concluding no relationship between induced abortion and an increase in breast cancer risk.

Because every woman is different, one woman’s emotional reaction after an induced abortion may be different from another’s. Feelings can be both positive and negative. Some women may be comfortable with their decision and feel relief that the procedure and pregnancy are over. Others may experience sadness, grief, guilt, have feelings of loss or experience depression or anxiety. Age, religion, financial situation, support network, gestational age at the time of abortion, past coping experiences and mental health before the abortion all can affect how a woman feels about her decision. It is important that all women’s experiences be recognized as valid and that a woman feels free to express her thoughts and feelings regardless of whether those feelings are positive or negative.

The risk of death as a direct result of legal induced abortion in the United States is less than one per 100,000.