OUR SERVICES – ABORTION CARE
Surgical Abortion
General Info
Equality Health Center provides surgical abortions up to 15.6 weeks into a pregnancy, as measured from the first day of your last normal menstrual period (also known as LMP). It is a safe, one-day procedure performed by caring and highly qualified, board certified Physicians and Nurse Practitioners.
An abortion procedure consists of four steps and from beginning to end, generally lasts about 15 minutes.
The first step is the pelvic exam, where the provider feels the size and position of your uterus. This is similar to those you would have during normal gynecological exams.
The second step is when the provider will numb the surface of your cervix by injecting a local anesthetic into your cervix (the opening to the uterus). This medication, called Lidocaine, is similar to what is used at the dentist’s office.
The third step is a gradual stretching of the opening of your cervix, known as dilation. The provider will open your cervix just enough to insert a sterile tube through the cervix, into the uterus.
The final fourth step is the vacuum aspiration. The sterile tube is connected to an aspiration device, which will create suction to remove the pregnancy.
After the aspiration, you will rest for about 20-30 minutes in the recovery room, where our staff cares for you and provides you with aftercare instructions and medications.
When you call to schedule an appointment for an abortion procedure, please be aware that we will be reviewing a great deal of information with you, so give yourself about 15-20 minutes of private time to speak with us. We will need to determine how far you are into your pregnancy, as measured from the first day of your last normal period (LMP). We will also do a brief medical intake questionnaire. During this time we will discuss which abortion procedure is right for you, medication or surgical.
What to Expect at your appointment
On the day of your surgical abortion, plan to be at the Health Center for approximately 4-5 hours. You will need to have some lab work which includes a urine pregnancy test and blood tests for anemia and Rh typing. An ultrasound test will be done to confirm how far along in the pregnancy you are.
You will then speak privately with a health care worker who will review your health history. At this time, we will discuss pregnancy options with you, answering any questions you may have. It is important that you understand the risks and complications associated with all of your the pregnancy options; and that you have made a choice regarding your pregnancy of your own free will. Your health care worker will provide you with information regarding the abortion procedure, aftercare instructions and answer any questions or concerns you may have about the procedure or your decision to terminate the pregnancy.
Your health care worker will also help you examine the different methods of birth control and other related considerations as you determine which method of contraception is best for you. It is important to remember that all birth control methods try to prevent pregnancy, but very few prevent the transmission of sexually transmitted diseases. If you are sexually active and using a form of birth control, it is important to pick a method that you will remember to use as directed to reduce a possible failure.
All clients will have the option of taking oral analgesics and/or anti-anxiety medication, depending on their personal preference and if they have a driver on that day, as these medications can cause drowsiness. You will also be given an anti-nausea medication, an antibiotic, and Ibuprofen.
If your ultrasound shows that you are over 12 weeks pregnant, you will be required to take medication to help open your cervix, making dilation easier. After taking this medication you will need to stay in the office so bring something to keep you busy during this time.
The abortion procedure itself takes approximately 15-20 minutes, completed by caring, highly qualified, board certified physicians and practitioners. We encourage you to bring a support person bring a friend, partner, parent or grandparent, or other relative if you’d like. This person will be allowed to be with you during procedure and/or during recovery. In addition, a member our staff will be with you for support during the abortion procedure.
Following the procedure, we will make you comfortable in our recovery room where the nurse will give you a heating pad for your cramps, monitor your vital signs take your blood pressure, and check on your general condition. You will be ready to leave after 20 to 30 minutes. Although you may have some mild cramping, you should feel well. Many people drive themselves to and from the appointment without complication. You will be given our Equality Health Center handout Equality Health Center Surgical Abortion Aftercare Instructions which provides detailed information about what to expect after your abortion.
We recommend that you give yourself the remainder of that day and evening following your appointment to relax and recover. Other than avoiding heavy lifting or strenuous exercise for a few days, you will be ready to return to a normal routine the next day.
Follow-Up Care
We want you to call our office two weeks post abortion to check in and let us know how your healing process is going. While a follow-up visit isn’t usually necessary after an abortion, we do recommend taking a pregnancy test three weeks after your abortion. We offer a free three-week post-abortion check-in appointment which includes a pregnancy test and an opportunity to meet with a health worker to discuss how your healing process has been. We also recommend you have a post-abortion check up if you have physical or emotional concerns after your abortion and/or if you still need a method of birth control.
Documents
FAQs
Have you ever noticed that how we experience pain and how we feel about it can be different? It’s affected by things like how confident or nervous we are; what kind of support we have; and whether we are calm or afraid. (Think about getting a tattoo versus getting a shot!) Pain is usually a warning system in the body, but pain with an abortion can actually let you know that your body is working perfectly. As your uterus empties it will cramp, which helps to stop the bleeding and bring the uterus back to its normal shape and size.
Pain is a kind of communication in your body. A signal is sent up the spine through the nervous system and is then evaluated by different parts of your brain. Your brain unconsciously decides what is painful or not, depending on your understanding of what the situation is, your past experiences, beliefs, emotions, etc. The more you understand what to expect, the more confident and relaxed you are, the fewer “alarms” go off and the less pain you feel.
Our emotions also can affect how we feel physical sensation. Our beliefs, emotions, and worries all contribute to how we feel pain. Research has shown that depression, anxiety, and guilt can all contribute to how we experience pain. A positive emotional state, like being confident and relaxed, can make it easier and less painful.
Fear can especially increase the amount of pain we feel. When we are afraid, our muscles tense, the heart begins to race, and we may begin to tell ourselves things like, “I can’t relax, this is really going to hurt, I can’t handle this.” Then, the next thing you know, we can’t relax and every sensation actually does become more painful. Fear triggers the brain to produce chemicals that make it harder for us to relax. In other words, when it comes to pain, the more you fear it, the more you feel it. Fear and negative thoughts can turn “uncomfortable” into “painful,” while confidence and positive thoughts can turn “painful” into “tolerable.”
Exams can make some people feel vulnerable if they have never had a pelvic exam before, or because of past traumatic experiences. For some of us, everything medical is traumatic. If the medical aspects of abortion are frightening to you, be sure to let the staff know so they can give you extra time and support. Your provider wants this to be a safe experience for you.
Clients may perceive a wide range of pain, from none at all, mild, to moderate pain, to even intense pain, but most people say that it’s “nothing they can’t handle”. Talk to us about what to expect and what pain management might work best for you. Medications aren’t the only answer to pain. People who reported feeling relaxed and confident before their abortion also reported less pain regardless of what drugs they received.
To make your abortion procedure less painful, we offer the following medications to take before the procedure at no extra cost. Please let your counselor know if you would like to take any of these medications.
Ibuprofen: This non-steroidal medication (NSAID) is a pain reliever especially good for cramps. Popular brands of ibuprofen include Advil and Motrin. Ibuprofen takes about 30 minutes to become effective, and lasts 4-6 hours. You should not take it if you have ever had an allergic reaction to ibuprofen, aspirin, or naproxen. Please let your counsel know if you have taken ibuprofen, aspirin, or naproxen the day of your procedure. You may drive after taking this medication.
Lorazepam: This is an anti-anxiety medication, often known by the brand name, Ativan. It can make you feel relaxed and drowsy. When swallowed it takes 20-30 minutes to be effective. It can be dissolved under the tongue for a faster effect. It should be taken with a pain reliever. You will need someone to drive you after taking lorazepam.
Vicodin: This is a combination of generic acetaminophen and hydrocodone. Hydrocodone is in a group of drugs called opioid pain relievers. An opioid is sometimes called a narcotic. It is effective in 20-30 minutes and lasts for 4-6 hours. It can cause drowsiness and nausea, especially on an empty stomach. If you have not eaten in the past few hours we can give you crackers before you take the medication and an anti-nausea medication at no cost to you. It is important that you do not eat a heavy or greasy meal before the procedure after taking this medication even if you take the anti-nausea medication. You will need someone to drive you after taking Vicodin.
Other medications given at your surgical abortion appointment:
Antibiotic: To reduce the chance of infection we will give you a single dose of an antibiotic before the procedure. It is not necessary to have an antibiotic script written for you for the days following the abortion.
Zofran: (ondansetron) blocks the actions of chemicals in the body that can trigger nausea and vomiting. When you come in you can ask for this if you feel nauseated. You should not take Zofran if you are allergic to ondansetron or similar medications. Before taking Zofran tell us if you have liver disease or a personal or family history of Long QT syndrome. You may ask for Zofran at the front desk when you come for your appointment.
What else can help?
- MAKE THE BEST DECISION FOR YOUR LIFE. It helps to feel confident about your decision. If you are at all unsure, take more time and get help from clinic staff or from the Pregnancy Options Workbook, Before Abortion (a downloadable audio abortion counseling,) or call Backline (1-800-493-0092). Believe in yourself and your ability to make a the right decision about your pregnancy.
- GET SUPPORT. Talk to people who will support and encourage you. Ignore people who will try to shame you or make you feel bad about yourself for what ever decision you make.
- YOU DON’T DESERVE TO BE IN PAIN. The situation that brings you here is often complicated and can make you feel terrible. Remember that you are doing the best you can in a tough situation. Be kind to yourself.
- CREATE A POSITIVE ATTITUDE. The words that you use can actually influence how your brain perceives pain. Replace thoughts like “I’m so scared,”; and “Ill never get over this” with positive messages like, “I’m strong,” “I’m brave,” “I know this a good decision,” and “I can handle this.”
- RELAX. If you know any relaxation techniques, such as meditation, visualization, or controlled breathing, practice them before your appointment. Reiki or “healing touch” can also be helpful. Be ready to use these tools to help yourself cope during your abortion procedure. Slow breathing is easy to learn today. Inhale to the count of four and exhale to the count of 4; do this several times until you feel your muscles relax.
- DISTRACT YOURSELF. Sometimes a distraction, such as talking or even imagining you are somewhere else can help. Generally, the support staff at the clinic are good at helping you focus on something else.
- SMELL SOMETHING NICE. Studies have shown that pleasant smells (lavender can be a mild mood enhancer) can help to reduce the perception of pain, especially for women. Talk to the staff about putting drop of a favorite fragrance on a cotton ball and breathing in the scent during the procedure.
Other Resources:
Explain Pain by David Butler and Lorimer Moseley, www.Noigroup.com.
Considering Abortion, and various handouts at www.abortioncarenetwork.org.
The Pregnancy Options Workbook at www.pregnancyoptions.info
Before Abortion at www.beforeabortion.com
Backline: a talkline about all pregnancy at www.all-options.org
Lumley, M. A., Cohen, J. L., Borszcz, G. S., Cano, A., Radcliffe, A. M., Porter, L. S., Schubiner, H., Keefe, F. J. (2011). Pain and emotion: a biopsychosocial review of recent research.
Journal of clinical psychology 67(9), 942–968. https://doi.org/10.1002/jclp.20816
If you will not be 18 at the time of your abortion appointment, you will be required to inform your parents/guardian or get permission from a judge to have an abortion. Even if you live in another state, whether or not your home state has such a law, you must comply with the New Hampshire Law. This law applies to both medical and surgical abortions. For a full explanation of this law please read the information under Parental Notification Laws.
If you are struggling with your decision about whether or not to continue your pregnancy, you might decide that you’d like to come in for free pregnancy options counseling. This is a pre-abortion appointment, after which you can schedule a termination if that is your choice.
Usually, you would make one visit to the Health Center for the surgical abortion, however, we encourage you to call us in two weeks to check in and discuss how your healing process is going. While a follow-up visit isn’t usually necessary after your abortion, we do want you to take a pregnancy test 3 weeks after your abortion. If you call us to check-in, let us know if you want to have a free pregnancy test at our office. We also recommend you be seen at our office for a free 3 week post-abortion check up if:
- You are not sure that your recovery has been normal or complete
- You want help with your birth control plan
- You have any physical or emotional concerns after the abortion that you want to discuss
