An ultrasound appointment will first be made to confirm how far along in the pregnancy you are, followed by an appointment for a Nurse Counsel (pre-op visit) and sometimes an appointment with the Medical Social Worker. The nurse will talk to you about your medical history, your thoughts and feelings around the pregnancy, options for birth control (contraception) and explain what to expect depending whether you are having the medical or surgical abortion and will be sent to have blood work done. All information obtained is confidential and the staff at the WHC are here to support you.

The surgical abortion is called a suction D&C (dilation and curettage). The procedure is usually done in one day, and is done using procedural sedation given through an IV, where you are awake, but sedated. On days that abortion services are offered, women can usually be seen into the 14th week of pregnancy and the procedure day is divided into two parts. Sometimes women can be seen in the 15th to 18th weeks of pregnancy, and the procedure is then divided into 2 days.  

Part One of Procedure Day

You will meet with a nurse at the start of your appointment. She will be the one providing medications during the procedure, so that you are as comfortable as possible. She will make sure you had not eaten anything since midnight, make sure you remain firm in your decision, and ask you a few other questions.

You will then meet with the physician who will discuss your decision and have you sign the consent form. The doctor will also discuss birth control options and help you get established on the birth control you choose.

Following this discussion, the doctor will take your medical history and may do a physical exam. A laminaria (a small stick of compressed seaweed) may be inserted into your cervix. Laminaria absorbs fluid from around it, which causes it to swell. This swelling softens the cervix and begins to open it. This makes the procedure easier to perform and reduces the risk of damage to the cervix. The doctor instead may choose to give you a medication called misoprostol, either by mouth or in the vagina, instead of laminaria. The laminaria or misoprostol may cause you to have some cramping or bleeding.

Part Two of Procedure Day

Once the Laminaria or misoprostol has taken effect, the pregnancy is removed by suction D&C (dilitation and curettage) which means removal of the uterine lining. It is done under local anesthetic (freezing in the cervix) and medications to make you feel relaxed and comfortable through an intravenous.

The physician freezes the cervix then dilates it to the diameter of the suction curette, which is only millimeter's wide. Once the suction curette will fit through the cervix the suction is turned on. The physician will gently rotate it removing the tissue from the wall. The suction curette is removed and a metal curette is then used to ensure all tissue has been removed from the uterine wall. The uterus is then suctioned one more time. This part of the process takes six - 10 minutes, however you will be in the procedure room for about 30 minutes.

You will need to stay in the recovery room for about one hour before you are discharged to go home.

Aftercare

You may experience period-like cramps and bleeding for three to 10 days after the surgical procedure. If you are soaking a pad in an hour, three hours in a row, you need to seek out emergency care. You may have bleeding that starts and stops for up to three weeks followig the medical abortion. 

It is important not to put anything in the vagina while you are bleeding, including tampons and having intercourse, to reduce your risk of infection. If you have signs of infection such as foul smelling vaginal discharge, fever over 38 C (100.4 F), severe pain or cramps that are not getting better should access medical care. 

Coping

There is no right way to feel after an abortion. Most women report feeling relieved that it is over and confident that the abortion was their best decision. Most women do not report regret or severe emotional distress, but may feel sadness that the pregnancy occurred at the wrong time. Some women may have feelings of guilt or anger too.

Our Medical Social Worker offers post-abortion counseling for patients experiencing emotional difficulties after the abortion. If you feel it would be beneficial for you to talk to our Social Worker, please call the WHC at 306-766-0586 to make an appointment.

An online resource that may also be helpful  can be found by clicking here.  

A medical termination is caused by taking medications rather than having a surgical procedure. These medications cause the body to pass the pregnancy tissue on its own, which can involve moderate to severe cramping and bleeding. Blood work is needed to confirm the success of the termination. There are two different medications available at the Women's Health Centre for medical termination, methotrexate and mifepristone. A medication called misoprostol is also used to complete the process.

1. There is a greater than 85% - 96% chance of avoiding a surgical abortion.
2. The pregnancy can be terminated as soon as there is a positive pregnancy test. This is earlier than the usual surgical abortion.
3. Aborting the pregnancy at home provides more privacy in some cases.
4. Medical abortion does not use instruments inside the uterus so if it is successful, there is no chance of causing damage to the uterus. 

1. There is a 4%-15% chance the abortion will not be effective or complete and a surgical procedure will be needed.
2. The abortion will take at least 1 week and may (very rarely) continue for up to a few weeks following.
3. Vaginal bleeding may be prolonged and heavy and cramping can be quite uncomfortable.
4. Medication side effects (less than 10%) such as headaches, nausea, vomiting, sore mouth, dizziness or rash may occur.
5. The need for several clinic visits, blood tests and possibly ultrasounds.
6. Uncertainty about whether the abortion was a success.
7. Medical abortion appointments cannot always be accommodated at the Women's Health Center.