PSA: The Girl’s Guide to the Girl’s Guide to Having an Abortion

Remember the kickass Jezebel post from earlier this week, The Girl’s Guide to Having an Abortion? My good friend (and friend of Shapely Prose) Epiphenomena put on her almost-doctor hat and gave me the following invaluable information. Please bookmark, forward, retweet this post in the interest of having more medically accurate, nonjudgmental information about abortion in the feminist blogosphere. The information below is an expansion and clarification of what you find in the Jezebel post.

Epiphenomena is an MD/PhD student and a member of Medical Students for Choice.

1. A positive home pregnancy test is very reliable, but a negative test is not. Tests can be negative because it is simply too early in the pregnancy for hormone levels to be detectable in your pee, especially if you’re well hydrated. The only definitive negative is your period.

2. It is especially critical that you be available for a followup appointment when you choose the medication method. Both medication and surgery carry a small risk that the uterine contents won’t be completely removed, however the risk is lower with surgery in part because the doctor will check to verify that the procedure is complete. Retained contents can lead to life-threatening infection, so around 2% of women who initially choose the medication method will have to have the surgery anyway, to remove retained tissue. 

3. A medication abortion actually involves two prescriptions, mifespristone and misoprostol. Mifepristone ends the pregnancy and Misoprostol induces expulsion of uterine contents. 

4. There is not medical consensus about how much pain relief to provide during a first trimester surgical abortion. Some clinics actually put the patient out; you should know the risk from the anesthetic is much greater than the risk from the procedure itself. Other clinics offer or require that the patient take a valium, which will require you to have someone to drive you home if the clinic is in a city with no public transportation. My own opinion: if you are offered a valium, take it. 

5. There seems to be a wide variation in how uncomfortable the patients feel during first trimester surgery, but it tends to be reported worse among women who have not experienced labor. The pain comes from intense uterine cramping, which is your body’s method of stanching bleeding. You cannot feel the suction or the instruments. In any case the pain should last no more than about 2 minutes. 

6. A terminology correction: D&C is the first-trimester surgical procedure. It stands for Dilatation (dilation of the cervix) and Curettage (removal of the uterine lining with a curette), but that is a historical misnomer because in fact curettage is no longer performed unless your doctor trained a million years ago and doesn’t keep up. A second-trimester procedure is usually a D&E, which stands for Dilatation and Evacuation. A second-trimester procedure is not a “late term abortion.” Those are for pregnancies past 20 weeks. But in the unlikely event you need one, you’ll have nearly or actually insurmountable obstacles to accessing that procedure anyway.

Thank you to Epiphenomena, Morning Gloria at Jezebel, and to pro-choice doctors everywhere.