How to Decide Whether or Not to Get an Abortion

Doing Your Research

See your doctor. If you suspect you are pregnant or have confirmed it with a test, schedule an appointment with your doctor or OB/GYN. They can advise you about your options: abortion, adoption, or keeping the baby. Your doctor should not pressure you in any direction. They should simply provide you with information about what options are available to you. If you are considering an abortion, you may wish to prepare a list of questions to ask your doctor. You may feel embarrassed or shy about talking to someone about an abortion, but your doctor is there to help you. If you feel pressured by the doctor to not have an abortion (for a reason that doesn’t directly pertain to your health), consider looking for another doctor.

Understand your privacy rights. If you are an adult, you do not need to tell anyone about your decision to have an abortion. You may, however, wish to tell a trustworthy friend or family member so that they can help support you during the procedure. If you are under 18 and wish to have an abortion, you may be required to get a parent’s permission, or, if you do not wish to inform your parents, a judge’s permission, before you may have the procedure. This policy varies by state, and most states have parental notification laws. Know your state’s parental consent policies.

Clarify information about abortion complications. Because abortion is a controversial procedure, there is a lot of misinformation floating around about abortion and its effects. Do your research. Talk to your doctor. Look for information from government publications or reputable news sources. Use caution when doing online research. Beware of any website that seems to push an overtly pro-choice or pro-life agenda. Know that abortion is safe. Only one percent of abortions have complications. Know that abortions will not cause breast cancer. Additionally, an uncomplicated abortion will not cause infertility or trouble for future pregnancies. Abortion will not cause “post-abortion” syndrome or other mental health issues. It is, however, a stressful event, and some women find themselves having a more difficult time following the abortion, due to preexisting mental health conditions or a lack of a support network, for example.

Determine if you are eligible for a medical abortion. Medical, or non-surgical abortions, can be done up to ten weeks (70 days) from the first day of the woman’s last period. Your healthcare provider will perform a physical exam, usually including an ultrasound, and then prescribe mifepristone (or sometimes methotrexate) and misoprostol. If you are able and willing to pursue a medical abortion, you will first take the mifepristone, which blocks your body’s production of progesterone, a hormone necessary for pregnancy. After 24-48 hours, you will take the misoprostol, which causes the uterus to empty. You will have cramps and heavy bleeding, usually within 4-5 hours of taking the medication. Once this is complete, you will need to see your doctor to make sure your body has expelled all of the tissue. Follow-up is absolutely necessary, to ensure that the pregnancy was successfully expelled. Failure to expel the pregnancy completely could lead to serious complications and infection. The benefits of a medical abortion are that it can be done at home, and can be done early in the pregnancy (as soon as you know you are pregnant). However, there are also risks of the abortion being incomplete. If it is, then you would likely need a surgical abortion.

Research a surgical abortion. A surgical abortion, also known as suction aspiration abortion, can be performed if you are under 14-16 weeks pregnant (this may vary by provider). The procedure involves dilating the cervix and inserting a small suction tube into the uterus to remove the pregnancy tissue. The actual aspiration, or abortion procedure, takes only a few minutes. Most of the time spent in the clinic or doctor’s office will be spent waiting for pain/relaxation medication to begin to work, as well as dilating your cervix to create an opening large enough for the suction tube to fit through. Your cervix may be dilated with metal rods of increasing thickness, medication, or dilators that expand through fluid absorption. You will spend at least an hour in recovery to ensure there were no immediate complications from your procedure. You may be asked to schedule an additional follow-up appointment. If you are over 16 weeks pregnant, you will have a procedure known as a dilation and evacuation (D&E). This is similar to the aspiration abortion, though it requires more time and equipment. You will likely have a slower recovery than with an aspiration abortion.

Considering Your Values and Emotions

Examine your current situation. As you consider what to do about your pregnancy, think about what is currently going on in your life and consider how a pregnancy or baby would impact it. You may want to spend some time thinking through some issues on your own. Consider your financial situation. Are you able to afford having a baby and raising it? Think about your personal beliefs about abortion. If you do not feel comfortable with abortion, would you consider putting the baby up for adoption? Think about your health. Would being pregnant be harmful to your body or mental state? Would you be able to handle the emotional and physical impact of having an abortion? Think about your support network. Who would help you raise the child? Would the baby’s father be involved? If you had an abortion, who could be there to support you?

Discuss your feelings with others. Talk to your partner, loved ones, or friends who you know won’t judge or influence your decision. Many women feel alone when dealing with an unwanted pregnancy. Talking to trustworthy members of your support network may help you feel less isolated. If the father is present and involved in your life, you may wish to speak to him about what he would like to do. Remember, you do not need his permission to get an abortion. If you feel he may pressure you one way or another, however, you may wish to avoid telling him. Don’t let anyone pressure your decision. If your friend says something like, “If you have an abortion I won’t be able to be friends with you anymore, because I believe abortion is wrong,” you could say, “I’m sorry you feel that way, but please don’t put pressure on me. I need to do what is best for me.” Talk to someone who has had an abortion. If you know of anyone who has had an abortion, ask what their experience was like, and how they look back on it positively or negatively. You could ask, “Are you comfortable talking about your abortion? Could I ask you a few questions about it? I’m pregnant and I’m not sure what to do.”

Talk to a counselor. Your doctor, family planning clinic, or community health agency may know of counseling services that can help you decide what to do. Make sure the resources they give you are unbiased, nonjudgmental counseling services that do not attempt to push the woman toward one option or another. Do your research on any names or agencies you receive to make sure they are unbiased. Look for any affiliations that may seem questionable to you (political or religious). Understand that any reputable agency or counselor will help you explore all your options without judgement or coercion. If you feel pressured into making a particular decision, find someone else to talk to.

Reaching a Decision

Make a timely decision. If you are considering abortion, you do need to make a decision as quickly as possible. While you want to be certain of your decision, also understand that the earlier in the pregnancy you decide to terminate it, the easier your procedure will likely be. You will also have more options available. In most states in United States, you cannot get an abortion after 24 weeks of pregnancy, unless the pregnancy is a risk to the mother’s health.

Make a list. If you are still unsure of what to do, you may wish to write a list of the pros and cons of terminating your pregnancy. Seeing your thoughts and feelings on paper may help you reach a decision more easily. Write down the positives and negatives, no matter how big or small they seem. Compare your lists. You may want to weigh all three options (parenting, abortion, or adoption) or just two if you know you are not ready to be a parent, for example.

Take the next steps. Once you have made your decision, take your next steps quickly. If you are choosing to continue with the pregnancy, you will still want to follow up for prenatal care as soon as possible. If you decide to have an abortion, schedule it as soon as you can. Keep in mind that you may need to travel to a clinic, and factor in some states’ mandatory waiting periods as well. Consider any financial needs you may have in order to pay for the abortion. If you are planning to continue the pregnancy, be sure that you are not smoking, drinking, or using drugs, eating well, and are taking a prenatal vitamin that includes folic acid -- a necessary nutrient for a developing fetus.

Determine your future birth control needs. Consider discussing your future birth control needs with your provider or at your family planning clinic at your next appointment. Research options online and speak to your doctor about options that may work best for you. If you decide to have an abortion, you may be able to have an IUD (intrauterine device) inserted at the time of your abortion procedure. Check with your doctor about this option. While it prevents pregnancy, it does not protect against sexually transmitted infections. If you have a regular sex partner, discuss with them what protection you’d both like to take going forward.