Abortion

Abortion: what to expect

Abortion is the termination of a pregnancy, either through the use of drugs or through a surgical procedure. In Canada, abortions are generally available up to 20 weeks, with over 90 percent done in the first 12 weeks of pregnancy. Although abortions can be performed up to 20 weeks, they are safer and simpler if done early.

In Canada, abortions can be performed at a hospital, clinic, or doctor's office. Abortion has been legal in Canada since 1969 and in 1988, it was removed from the Criminal Code altogether. Abortions are regulated in the same way as all other medical procedures.

When considering an abortion, talk to your family doctor or to your local public health clinic. If neither of these performs abortions, they can let you know which procedures are available in your community and whether they are available at a hospital, clinic, or doctor's office. In addition, most abortion providers can refer you to counseling services to assist you in making the best decision about your unplanned pregnancy.

There are two main types of abortions: medical abortions and surgical abortions. Medical abortions use drugs to empty the uterus, while surgical procedures use instruments to remove the contents of the uterus. Many factors come into play when deciding which procedure is best for you. You may want to consider:

• whether you want to be awake or asleep during the procedure
• where you would be most comfortable having the procedure (in an abortion clinic or at a hospital)
• whether you want to undergo surgery or whether you'd prefer a drug option

Other factors that will influence your decision include:

• the number of weeks since your last menstrual period (some procedures can only be performed early in pregnancy)
• your overall health (some health conditions may limit your options)
• the procedures available (not all procedures may be available—or legal—in your area)
• whether you are willing to travel to have an abortion
• your preferences, beliefs, and values

Unfortunately, many women have to travel to gain access to an abortion. This can delay the procedure and further limit your options. Talk to your family doctor or to your local public health clinic about which procedures are available in your area. You can also refer to Planned Parenthood or to the Canadian Abortion Rights Action League (CARAL) for more information and for referrals to resources in your area. You can also call CARAL toll-free in Canada at 1-888-642-2725 for names of abortion providers in your area.

The chart below illustrates the four types of abortion and the time (since your last menstrual period) each can be safely performed. The four types of abortion, classed as either medical or surgical, are:

• Medical abortion
• Surgical abortion
  • Manual vacuum aspiration
  • Suction and curettage (also called mechanical or machine vacuum aspiration)
  • Dilaton and evacuation

What about afterward?

Although most women recover quickly, some experience cramping, stomach pain, or bleeding for two weeks following an abortion. See your doctor if these symptoms are severe.

Your menstrual period should return in four to six weeks. You can become pregnant again during this time if you have unprotected sex. As such, you should use some method of birth control to prevent against unwanted pregnancy. You'll also require a post-abortion checkup two to three weeks after your abortion to ensure your body has returned to normal.

Some women find it very emotionally difficulty to cope with having had an abortion. In fact, between 5 and 30 percent report feelings of anxiety, guilt, or mild depression. It's normal to experience a broad range of emotions after an abortion—from relief and happiness to sadness, shame, regret, guilt, grief, and loss. There are as many reactions as there are women and each woman is unique. Most women, however, feel they have made the right decision; it's rare for them to become clinically depressed following an abortion. However, if your feelings are overwhelming and persistent, or if you have a previous history of depression, you should consult a professional therapist. (Refer to Finding and Evaluating a Therapist for more information.) Depression is a very serious illness.

Understanding your emotions and taking care of yourself are important: doing so can help you let go of pain and start to heal. Talk to your partner, friends, or family to let them know what you're feeling. You may also want to consider professional counseling. If you're not sure where to go for counseling, talk to your abortion provider: most providers can refer you to counseling services to assist you in dealing with your feelings.

Why do some women feel distress after an abortion?

After an abortion, a woman's hormones are returning to their pre-pregnancy state. As a result of these chemical and hormonal changes, a woman can feel sad and emotional.

If the decision to have an abortion was not her own—that is, if the woman felt coerced or pressured into having an abortion by someone else—she is more likely to have negative feelings.

Some women receive little or no emotional, economic, physical, or spiritual support from their friends or family.

Because of the social stigma often associated with abortion, many women feel isolated and unable to share their experience. Many women may feel judged.

Although abortion does not interfere with a woman's fertility, she may fear she may never again become pregnant.

Because a couple's relationship can be stressed or undermined by an unplanned pregnancy, women can feel abused or abandoned. (If your partner has become abusive, refer to Domestic violence in pregnancy.)

Seldom do we go through life without having to make difficult choices. When making a difficult life decision, it's natural to have second thoughts. Talking about your negative feelings will help you diminish their impact. Talking to or reading about other women who have had similar experiences can be reassuring, and it can also help make your feelings more clear.

So how can I begin to heal?

The following suggestions are intended to help resolve your feelings about your abortion experience and to help you come to grips with your decision.

• Be kind to yourself rather than beat yourself up. This means talking to yourself in affirmative ways. Do things that make you feel good about yourself.
• Remember why you chose to have an abortion and remind yourself that you made the best decision based on your life circumstances at the time.
• Keep a journal or diary of your feelings.
• Practice meditation or relaxation exercises to help you cope with stress. Set aside some time each day for a "wind down" ritual just before bed or when you get up in the morning.
• You are not alone! Each year in Canada, approximately 110,000 women have abortions.
• Talk to a counselor or therapist about your feelings. Most abortion providers can refer you. Your local Planned Parenthood affiliate, your local public health clinic, or your women's center can also refer you. In fact, some of these may even provide supportive services or counseling themselves.