There are two basic ways abortions are performed:
- One is called “medical” or “medication abortion,” meaning that you take medicine to end the pregnancy.
- The other is called “aspiration” or “surgical” abortion, meaning that a doctor does a procedure to remove the pregnancy.
A medical abortion uses two medicines to end a pregnancy.
- The first medication, mifepristone, weakens the attachment of the pregnancy to the uterus.
- A second medication, misoprostol, placed in your cheek or into your vagina 1 to 2 days later, makes the uterus cramp and causes bleeding to expel the pregnancy.
- If you are 7 weeks (49 days) pregnant or less, this is effective 95.5% to 98% of the time.
- Between 7 weeks and 9 weeks (63 days ), the effectiveness is 94.2% – 98%.
- Between 9 weeks (63 days) and 10 weeks (70 days) the effectiveness drops to 90% – 95.9%.
With a medical abortion, women often have stronger cramping and heavier bleeding than with a period. Bleeding and spotting usually lasts about 9 – 16 days. A return visit is needed to make sure that the abortion is complete and that you are no longer pregnant. Continuing a pregnancy after taking misoprostol is not safe due to the risk of birth defects from the misoprostol. If early medication abortion does not work in ending your pregnancy, you will need to have an aspiration abortion.
Complications are rare but can include infection and heavy bleeding. An aspiration abortion may be necessary to stop the bleeding.
With valid BC Medical Services Plan (MSP) coverage, the cost of the procedure and medical abortion medication is covered. You will be given a prescription for pain medication that may be covered by an extended health plan, and if not will cost between $20-$30. If you have Fair Pharmacare, the cost of the pain medications could be covered partly or entirely, depending on your deductible. If you have First Nations status the cost is covered. Bringing your card with you (extended health plan card, Fair Pharmacare, First Nations status card).
Without valid BC MSP the procedure will cost about $700 altogether, which includes the medications and one-week follow up appointment.
At the Elizabeth Bagshaw Women’s Clinic, we perform aspiration abortion for women up to the 17th week, 6 days of pregnancy. If your pregnancy is more than 17 weeks, 6 days we will refer you to BC Women’s Hospital.
With aspiration abortion, sometimes called surgical abortion or vacuum aspiration abortion, the cervix is opened enough to pass a small tube into the uterus. Then gentle suction is used to remove the pregnancy.
- The procedure is successful 99% of the time.
- Aspiration abortion takes about 5 to 10 minutes.
During the procedure you will be supported by your nurse and offered “conscious sedation”, a combination of 2 intravenous medications that relieve pain and anxiety. After the procedure, spotting or bleeding like a period may last for a few days or weeks.
Complications are rare, but include infection, heavy bleeding, a tear in the cervix or uterus, incomplete abortion or a continuing pregnancy.
The visit and aspiration procedure are completely covered by your BC Medical Service Plan (Care Card ). If you do not have BC MSP, you will be asked to pay $500.
MEDICATION OR ASPIRATION ABORTION, HOW TO CHOOSE
- Success rate 95 – 98% ( varies with weeks)
- No aspiration procedure in most cases
- Requires at least 2 visits
- Abortion occurs within 24 hours of second medication for most women, but might take longer
- Finger stick blood test, but no IV
- The process happens at home
- Heavy bleeding and cramping at home
- High success rate ( 99%)
- Instruments inserted in the uterus
- Can be done in one visit
- Procedure is completed in 5 to 10 minutes
- IV pain medication
- Supportive nurse during procedure
- Procedure done in our clinic
- Procedure covered by MSP
- You will be asked to not eat for 4 hours before your appointment
- Best to have a ride or someone to accompany you home.
WHAT TO EXPECT WHEN YOU COME TO THE CLINIC
With both medication and surgical abortion, you can expect the following steps:
You will see a counsellor to discuss your decision to have an abortion.
Most women will already know if they prefer a medical or surgical abortion. The risks and benefits of the abortion will be reviewed and the procedure described. This is an important step; if you have any questions or concerns, this is the best time to ask. We will help you feel certain that you are making the best decision. The counsellor will also offer to discuss your options for contraception (“birth control”). After medication or aspiration abortion, you can become pregnant again quickly, even before your next menstrual period. You can start using most methods (pill, patch, vaginal ring, injection, intrauterine device