What do I need to know about abortion?
You may be faced with an unplanned pregnancy and feel overwhelmed by your options. Or maybe you feel alone in your decision and don’t know what’s next. We are here to help you with your nest steps and inform you as much as we can. It’s important to know that abortion is a serious medical procedure with potentially significant side effects and risks. Make sure you are fully informed and explore your options before you settle on a plan.
Abortion is not a simple procedure. Abortion involves health risks that you should be aware of. There are two types of abortions: surgical abortion (performed by a medical professional at a surgical clinic or hospital) and medical (also known as “medication abortion”, “chemical abortion”, or “the abortion pill”). Each abortion procedure aims at terminating a pregnancy. Both come with side effects and health risks.
General Side Effects of Both Surgical and Medical Abortion Include:
- Bleeding, including blood clots
Increased Health Risks Associated with Medical Abortion (“the abortion pill”)
Scientific literature as well as the National Institute of Health point to the increased health risks of medical abortion compared to surgical abortion. One peer-reviewed study published in the ACOG journal Obstetrics & Gynecology placed the complication rate for medical abortion at 20 percent. The risks are 4 times greater for medical abortion than for surgical abortion. More common complications include infection and the need for a surgical procedure following the medical abortion to remove retained fetal and pregnancy tissue. Another published study demonstrated that women had a 400% increased risk of requiring emergency medical intervention following a medical abortion.
Why is Medical Abortion Riskier than Surgical Abortion?
There are a number of factors contributing to the increased health risks associated with medical abortion, including:
- Relaxed Governmental Regulation
Initial Regulation: The abortion pill regimen was originally approved by the FDA for use up to 49 days (7 weeks) after the first day of a woman’s menstrual cycle. Studies conclude that Mifepristone, “the abortion pill”, decreases in efficacy after 6 weeks gestation, becoming less effective each successive week. The FDA later extended the approval to 7o days (10 weeks) ignoring evidence of reduced efficacy. The drug was approved with what is known in the pharmaceutical industry as a “black box warning” reserved for a small group of drugs containing the highest level of health risk to patients. The corresponding “REMS” (Risk Evaluation and Mitigation Strategy) lays out protocols to be strictly followed in order to mitigate the known elevated risks. These REMS included a requirement for the drug to be administered in-person by a physician who has examined the patient. Physician exams serve several critical needs: (1) confirm pregnancy and pregnancy viability, (2) determine the gestational age of the fetus, (3) rule out the possibility of an ectopic pregnancy, and (4) screen patients for other contraindications for medical abortion. A post-procedure follow-up appointment was also required to ensure that there was no retained fetal or pregnancy tissue.
Current Regulation. As part of the Covid-19 pandemic response, the FDA removed many of the safeguards for women taking this drug. There is now no requirement to see a physician in-person before or after a medical abortion. Physician consultations are permitted online without a physical exam, lab work or ultrasound which could rule out ectopic pregnancy and accurately date the pregnancy. The chances of a woman misdating her pregnancy are very high, which adds significant risks for women taking this medication. There is no longer a requirement for a post-abortion follow-up with a physician to mitigate the risks of infection, needed surgery or even death. The FDA also removed the requirement for physicians or medical facilities to report non-fatal complications from medical abortions, making it impossible to ascertain the true level of risks associated with medical abortion.
- Alleged FDA Mishandling
The FDA is currently being sued for illegal handling of the original approval of the drug, Mifepristone, for use as an abortion-inducing drug. A federal court of appeals has ruled against the FDA in this case. In August 2023 a federal appeals court also ruled that the FDA illegally eliminated protections for women prescribed the drug. (We will keep this section updated as legal cases progress.)
- Unregulated Sources for Abortion Pills
Many women are lured into purchasing abortion pills online, often from sources outside the U.S. This is illegal in the United States. Nonetheless, in doing so, women are forfeiting even the most basic protection of seeing a physician online. It cannot be overstated how dangerous the practice of purchasing abortion drugs online is. Illegally obtained pills cannot be verified to have the correct medication, the correct dose, nor to be free of harmful contaminants. This illegal market has also made it very easy for human sex traffickers to keep the pregnancies of their victims concealed.
Important Considerations for Managing Abortion Risks
Viability, Ectopic Pregnancy, STIs, and Gestational Dating
Viability. Before you consider abortion or another option, you must confirm your pregnancy. After taking an at-home pregnancy test, confirm your pregnancy through a lab-quality pregnancy test. It is estimated that up to 26% of all pregnancies spontaneously end in miscarriage. It is possible for a pregnancy test to show positive after a miscarriage while the hCG hormone (pregnancy hormone) is still elevated in your system. An ultrasound will verify whether or not your pregnancy is viable.
Ectopic Pregnancy. It is also extremely important to rule out an ectopic pregnancy. An ectopic pregnancy occurs when the pregnancy develops in the fallopian tube rather than the uterus. Ectopic pregnancy is rare but poses serious and potentially fatal complications if not discovered early and treated. An ultrasound will reveal whether your pregnancy is located in your uterus. The abortion pill will not end an ectopic pregnancy, and can leave a woman at serious undetected risk.
STIs. Before a planned abortion it is important to ensure that you do not have a sexually transmitted infection (STI). Any abortion procedure can easily introduce infection into the uterus which can cause complications and health risks. Some STIs are asymptomatic, meaning you will not know that you have it without first being tested. Do yourself a favor and get tested (and treated, if necessary) before progressing with an abortion plan.
Gestational Dating. Before a woman can obtain a surgical abortion a sonogram is performed to assess the age of the fetus. This dating will determine which method of surgical abortion will be required. Accurate gestational dating is also very important for those considering a medical abortion, as the “abortion pill” is only prescribed up to 70 days following the first day of a woman’s last period. Without ultrasound dating, a pregnancy can be easily miscalculated due to several factors which can include irregular cycle, implantation bleeding misconstrued as a period, or simply a poor memory.
Cleburne Pregnancy Center’s team of medical professionals is committed to your health and safety. We provide lab-grade pregnancy tests, STI testing and ultrasounds to verify your pregnancy, to determine the viability of your pregnancy, to accurately assess the location and date of your pregnancy and to help you consider your next steps. Our services are provided free of charge, and we can often schedule a same-day appointment.
Make an appointment with us today to discuss these procedures, side effects, and risks or to confirm your pregnancy. Cleburne Pregnancy Center is a judgement-free zone where you can safely talk about all of your options.
Cleburne Pregnancy Center does not provide or refer for abortion services. We are, however, committed to providing accurate information about abortion procedures, risks and outcomes.