Abortion

There are many myths around abortion. We’re here to give you facts and resources so you can make the best decision for you.

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Planned Parenthood Toronto (PPT) is a pro-choice organization. When you are pregnant, we believe that you have the right to access factual, caring and non-judgmental information and services on all three of your options: abortion, adoption, and parenting. If you need support with decision making, contact PPT to book an appointment.

There are many myths about abortion. Below is some information about abortion and abortion
services in Toronto.

What is an abortion?

An abortion is a safe medical procedure that ends a pregnancy.
Abortions are fully legal in Canada.

Types of abortion

There are 2 categories of abortion: medical (where medication causes the uterus* to expel the pregnancy tissue), and surgical (where a clinician removes the pregnancy tissue from the uterus).
• The options you have depend on how long you’ve been pregnant (gestational age, or GA, calculated by the time since the first day of your last menstrual* period) and what’s offered at the clinic/hospital you go to.
• Medical abortions may feel more private or less invasive for some people, are similar to a miscarriage, can involve heavy bleeding and cramping, and can take longer to complete or require more appointments.
• Surgical abortions may feel more invasive, have more extensive pain management options, and are often available quickly and with a small number of appointments.

Medical abortion (the abortion pill, brand name: Mifegymiso)

• Medical abortion uses medication to stop a pregnancy from developing and make the uterus cramp and expel the pregnancy.
• In Toronto, medical abortion is available until 8-9 weeks GA.
• To get a medical abortion you have a counselling/education session, STI test, blood tests, and ultrasound. Some clinics do this in one visit, but some do different parts at different times and/or send you to another place (e.g. an ultrasound lab) for some things.
• If you and your clinician decide medical abortion is right for you, you get a prescription and plan when to take the medication.
• You take a pill called mifepristone, which detaches the pregnancy from the wall of the uterus. Some clinicians will have you take it during your appointment.
• 24-48 hours after the first pill, at home or wherever is comfortable for you, you take tablets by letting them melt between your cheek and gums for 30 minutes. This medication is called misoprostol, and it makes your uterus contract (cramp) to expel the pregnancy tissue.
• You will likely have bleeding and cramping that is heavier than a period. You may pass large clots or pieces of tissue. Your clinician will plan with you what to take for cramping, and may give you a prescription for pain medication.
• Nausea, diarrhea, fever, chills, or headache can be side effects of misoprostol, so you may have some of these symptoms on the day you take the misoprostol.
• 90% of people have the pregnancy tissue expel within 24 hours after taking the misoprostol tablets. Many have it expel within 4-5 hours.
• You will need a follow-up blood test and/or ultrasound after your medical abortion to confirm that it worked properly, usually 1-2 weeks after you take the first pill (mifepristone).
• A small number of people who get medical abortions need more medication, more blood tests or ultrasounds, or a surgical abortion procedure before the process is finished.

Surgical abortion

• To get a surgical abortion you have a 2-3 hour long appointment that includes a counselling/education session, ultrasound, blood test, and STI test. Depending on the clinic/hospital and gestational age (GA) you may have the abortion procedure in the same appointment.
• Depending on the clinic/hospital, you get general anaesthesia (where you are put to sleep) or local anesthesia, painkillers, and possibly conscious sedation (where you are groggy or calmed, but awake).
See chart for info on which places offer which options.
• The cervix* is gently opened with medication and/or medical instruments. A flexible tube providing gentle suction and/or other instruments are inserted through the cervix and used to remove the pregnancy tissue from the uterus. This can take 2-15 minutes.
• There is no cutting and no stitches are needed.
• For pregnancies of more than 12 weeks GA, you may get medication or laminaria (sterilized compressed seaweed sticks inserted into the cervix to make opening the cervix easier) during your first appointment, and return to the clinic/ hospital the next day for the abortion procedure.
• For pregnancies of more than 19 weeks GA, you may get more medication or laminaria on day 2 and/or day 3 and return on day 3 or 4 for the abortion.
• After the abortion procedure you stay in a recovery area until the medical staff are confident you can go home safely.
• You cannot drive yourself home after a surgical abortion.
• Many providers recommend a checkup 2-3 weeks after a surgical abortion. You can do this at the abortion clinic or hospital, or at a family doctor, walk-in clinic, PPT, or the BCBC if you prefer.

• For hospital procedures past 14 weeks, 3 days GA and up to 24 weeks GA, London Health Sciences Centre Pregnancy Options Program in London, Ontario (519-685-8204) may be able to assist.
• Abortions past 24 weeks GA may require travel to the U.S. The National Abortion Federation (1-877-257-0012, www.prochoice.org) can help with referrals and sometimes costs.

**UHIP = University Health Insurance Plan; IFH = Interim Federal Health; DND = Canadian Military Insurance
• Some clinics have funds to help pay for abortions—call the clinic you’re going to or PPT for more info. If you are getting this kind of funding you may still have to pay administrative fees.
• If you need to travel to get an abortion, Action Canada for Sexual Health and Rights
(http://www.sexualhealthandrights.ca, 1-888-642-2725), or the National Abortion Federation (1-877-257-0012, www.prochoice.org) can sometimes help with costs.
• Fees may change from this list. You can call the individual clinics to confirm their fees and policies before booking with them.

After an abortion

Instructions about abortion aftercare vary between providers. Here is some general information about caring for yourself after an abortion:
• For 1-2 weeks after an abortion (after pregnancy tissue expels for medical abortions), you can reduce risk of infection by:
o not inserting anything into your vagina, including fingers, toys, penises, tampons, menstrual cups, or douches
o not sitting in water: ie. not taking baths (shower instead), not going swimming, not using hot tubs or Jacuzzis
• Signs of infection can include fever, lower abdominal tenderness and vaginal discharge. If you have any of these symptoms, contact your doctor or clinic. Infections that are detected early can be treated easily and effectively with antibiotics.
• Resuming normal activity: Avoid heavy lifting or aerobic activity for 24 hours after the abortion (with a medical abortion, for 24 hours after you expel the pregnancy tissue). While some people return to work the same day as their abortion (or the same day they expel the pregnancy tissue), many may need to rest. Return to normal activities when you feel ready – listen to your body.
• Next Menstrual Period: Unless you are using hormonal birth control, your next period will start 4-6 weeks after the abortion.
• Cramping after an abortion is normal. Some people do not get cramps at all. You may have cramps off and on for 2-3 weeks after the procedure. You may feel pressure or pain in your lower abdomen, lower back or inner thighs. You can use a hot water bottle or ask a clinician about using Advil or Tylenol.
• Bleeding after an abortion is normal. Some people have bleeding similar to a period, pass clots, or have spotting for up to 4 weeks. Drinking alcohol, lifting heavy objects, using marijuana or ―”period” medications such as Midol or Anaprox may increase bleeding.
• You may need medical attention if you are bleeding so heavily that you soak through 2 or more maxi pads per hour for 2 consecutive hours, feel faint or lightheaded, have severe pain that your pain medication doesn’t help with, or if you have diarrhea, vomiting, or a fever over 38°C that lasts more than 6 hours. (Note that diarrhea, vomiting, and fever are side effects of misoprostol and may not require medical care if they happen the day you take the misoprostol, the second medication for medical abortion.)
• Symptoms of pregnancy will end a week or so following the abortion. Nausea is usually the first symptom to end.

Frequently asked questions about abortion

Is abortion safe?
Yes. Both medical and surgical abortions are very safe, routine procedures. The chances of serious complications are very low. There is no evidence that abortion causes long-term health effects.
Is abortion effective?
Yes. Medical abortion with the abortion pill (mifepristone) is 95-98% effective when taken as directed. Surgical abortion is over 99% effective.
Will I be able to have a baby in the future?
Yes. Having an abortion will not prevent you from getting pregnant and having a healthy pregnancy in the future.
Will anybody find out?
No. This medical information cannot be released to anyone but you. No one needs to know unless you wish to tell them. After 2-3 weeks’ time, a doctor or healthcare provider will not be able to tell, even through a vaginal exam, that you’ve had an abortion.
Do my parents/partner/ family doctor have to give permission?
No. In Canada, anyone over 12 years of age can legally have an abortion in a clinic or hospital. You do not need the consent or permission of your parents, partner or your family doctor.
How long will the abortion take?
Medical abortions usually require multiple appointments over about a week, and can require more followup in some cases. The pills are taken 24-48 hours apart, and the actual expulsion of the pregnancy tissue usually takes between 4 and 12 hours (90% within 24 hours), though cramping and bleeding can last longer.
For most surgical procedures, the abortion itself takes less than 15 minutes. However, expect to be in the clinic or hospital for 2-4 hours.
Do I have to take time off work or school?
You may have to take time off for the appointment(s), and for a medical abortion, most people prefer to be at home or in a place they are comfortable when the pregnancy tissue is likely to be coming out and the bleeding and cramping are likely to be heaviest. After an abortion, some people choose to take a day or two off to rest and take care of themselves, but others return to their usual activities immediately or the following day.
Will a surgical abortion hurt?
Everyone has a different experience. Most people get menstrual-like cramps but some have no pain at all. Some people who are awake for the abortion may feel pressure during the procedure. Medication is used to reduce discomfort and help you relax.
What happens if I vomit after taking the abortion pill?
If you vomit less than 1 hour after taking the first pill (mifepristone) for a medical abortion, contact your provider. You may need to get another dose.
What happens if I swallow the misoprostol tablets (the second medication for a medical abortion) before 30 minutes are up?
The misprostol tablets are safe and usually still effective if swallowed intead of melted between the cheek and gums, but can be less effective or have more side effects like nausea, vomiting, or diarrhea when swallowed. If you do not have bleeding or cramping within 48 hours after taking the misoprostol, contact your provider. You may need more screening or another dose of medication.
How do I know when a medical abortion is complete?
You will likely have bleeding and cramping that is heavier than a period and then gets lighter after the pregnancy tissue has come out. You will have a blood test or ultrasound, usually 1-2 weeks after the first pill of the medical abortion, to confirm the abortion is complete. If you do not have bleeding or cramping within 48 hours after taking the misoprostol, contact your provider. You may need more screening or another dose of medication.
Does abortion make me more likely to get breast* cancer?
No. There is no link between having an abortion or multiple abortions and developing breast cancer in the future.
Does abortion cause depression?
No. The most common feeling people report after having an abortion is relief. Some people may feel sadness or grief, which is a healthy response to loss. Having an abortion is not associated with long-term emotional or mental health problems.

Talking about abortion/ support around abortion

Not everybody needs support or has strong feelings about their abortion, but some people do, and being pregnant when you can’t or don’t want to continue a pregnancy can be stressful.
Some people find it helpful to talk to friends, family, community, or other supports in their lives, but not everyone has people they can talk to about it without fear of judgment or shame.
If you would like to talk to someone pro-choice and nonjudgmental about pregnancy options, abortion, or your feelings or experiences around pregnancy or abortion, check out these resources:
• PPT’s Health Services volunteers: in-person education, information, support, and active listening on all pregnancy options and a range of sexual health issues.
• To see a counsellor for more in-depth pre- or post-abortion support, contact PPT, the BCBC (416-351-3700), or Choice in Health Clinic (416-975-9300/1-866-565-9300).
• Teen Health Source: education, information, and active listening on all pregnancy options and a range of sexual health issues by phone, text, email, or chat (contact info below).
• All-Options (1-888-493-0092, toll-free): nonjudgmental peer support for decisions/feelings/experiences with pregnancy, parenting, adoption and abortion.
• Faith Aloud (1-888-717-5010, toll-free): nonjudgmental support from trained clergy and religious counselors for considering pregnancy options or talking about an abortion experience.
wetestify.org: dedicated to increasing the spectrum & building the power of abortion storytellers in the public sphere, especially those who are marginalized.

*We know that these aren’t the words everyone uses for their bodies (eg. trans folks), and support you using the language that feels best for you

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