Abortion: explained

WATCH: What is an abortion and how does it work?

Choosing whether to get an abortion can be one of the hardest decisions a person can make, especially since the discussion around it can be clouded with religious and political points of view.

It’s a topic so controversial that it has divided whole countries, with some places, like Alabama in the U.S., nearly banning it completely.

But controversy can lead to important information being lost, so Global News sought to help people better understand this topic.

READ MORE: Judge extends license for last abortion clinic in Missouri

What is an abortion, and how does it work?

It’s when a pregnancy is ended so that it doesn’t result in the birth of a child, says the British Pregnancy Advisory Service.

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In some places around the world, like in North America, there are two ways to do this: a medical abortion and a surgical abortion.

Medical abortion

Within the first nine to 10 weeks of pregnancy, a person can opt for a medical abortion, which is sometimes known as the abortion pill.

This often involves taking two different types of medications: mifepristone and misoprostol.

The first pill, mifeprostone, blocks the hormone progesterone, which is needed to sustain a pregnancy—without this, the embryo or fetus detaches from the uterine lining.

Misoprostol, the second medication, is taken within the first few days of taking the first pill. It can be taken in a few ways, including orally. This pill causes cramping and bleeding to empty the uterus and to end the pregnancy. People who take it may experience pain that feels similar to menstrual cramping, says gynecologist Dr. Ashley Waddington.

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READ MORE: ‘There is a problem here’: advocates sound alarm over abortion access in Canada

“Things that people have described that they prefer about a medical abortion is, sometimes, it feels to them a little bit more natural, like they’re undergoing sort of a miscarriage,” said Dr. Waddington, who works out of Kingston General Hospital in Kingston, Ont.

“It can be done in the privacy of their own home, so it sometimes requires less intervention with the medical team or … fewer medical people involved in their care.”

WATCH: Having an abortion isn’t illegal in Canada, but there are limitations when accessing free services. 

Access to abortions varies across Canada
Access to abortions varies across Canada

The bleeding people experience usually lasts up to two weeks — it’s usually heavy and painful for about two days, then the heaviness decreases over time until the bleeding goes away completely.

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If the individual is more than nine weeks pregnant and wants an abortion, they will have to go the in-clinic route, which is also known as a surgical abortion.

Surgical abortion

This type of abortion can be done even in the second trimester of pregnancy, which is 14 to 23 weeks after the last period.

In-clinic abortions are very safe when performed by a trained medical professional.

READ MORE: Pro-choice demonstrators grow in numbers outside Kelowna hospital

Before someone undertakes this procedure, a healthcare professional will do a lab test, exam and maybe an ultrasound. The patient will always talk to the medical expert to make sure the person fully understands the choice being made.

Rebecca Thomas, a 33-year-old abortion advocate living in Halifax, N.S., says she had the procedure done in 2008.

“I had to meet with psychological counseling to ensure that I was aware and mentally prepared for what I was going to go through,” said Thomas, “which, when I think back on it, is less stressful than perhaps being 22 and being faced with having to raise a child and go through pregnancy and childbirth.”

READ MORE: The forgotten history of Canadian women who travelled around the world for abortions

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If the decision is to go ahead with an abortion, pain medication is prescribed. Most clinics use a mix, including narcotics and, often, mild sedation, said Dr. Waddington.

They will then use an instrument called a dilator to open the cervix.

The most common type of procedure is called vacuum aspiration, which is also called suction abortion.

The healthcare provider empties a uterus using gentle suction with something that looks like a plastic straw. This will remove the tissue and end the pregnancy.

Julieta Tobon/Global News

For many people who have this done, the pain afterwards feels like strong period cramps.

How early people can get an abortion depends on where they go — some clinics will do it as soon as the patient has a positive pregnancy test. It’s best to try to have the procedure done as early as possible, as the risk of complications goes up the further along the pregnancy is, says Dr. Waddington. Later-term abortions, like ones done after 14 weeks, are rare.

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Let’s now go over what an abortion isn’t.

MYTH: People use abortion as a method of birth control

“I’ve heard these rumours,” said Kerry Bowman, a bioethics expert with the University of Toronto, “and I’m going to say that of all the patients I’ve ever seen and all the people I’ve ever known, I’ve never seen a situation like that at all.”

If abortion was used as the primary method of preventing pregnancies, a typical person would have at least two or three pregnancies per year — 30 or more during a lifetime, according to the National Abortion Federation. Half of all women getting abortions report that contraception was used during the month they became pregnant.

Texas town declares itself a ‘sanctuary city for the unborn’; bans all abortion clinics
Texas town declares itself a ‘sanctuary city for the unborn’; bans all abortion clinics

WATCH ABOVE: Texas town declares itself a ‘sanctuary city for the unborn’; bans all abortion clinics

“I was on the pill … I still got pregnant,” said Thomas. “I was still taking precautions that were needed and it just wasn’t the right time for me.”

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MYTH: Many women regret their abortions later

“When you hear the words regret … do you mean it was a tough decision or you wish you hadn’t done it?” asks Bowman. “I’m sure there [are] people out there but the evidence doesn’t support that that’s a significant amount of people at all.”

In fact, most women who have had an abortion feel they’ve made the right decision for themselves, according to a study called Decision Rightness and Emotional Responses to Abortion in the United States.

READ MORE: PC MPP Sam Oosterhoff says he wants to make abortion ‘unthinkable in our lifetime’

“I was constantly told by teachers and those who were older than me that I would change my mind if it were my pregnancy, and being in that situation didn’t change my mind at all,” said Thomas. “It was not a hard decision. I knew exactly what I was going to do and I did it.”

She continued, “I’m not gutted about the procedure. I’m not distraught. I don’t regret my decision at all, and I’m very thankful that I was able to access this need of mine.”

For some people, abortions are exactly this: a need.

MYTH: People have abortions for selfish or frivolous reasons

Most people base their decision to have an abortion on many factors, including not being ready to start or expand their family and/or lack of money.

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“I was young,” said Thomas. “I didn’t have a degree. I was a summer student, so I had a summer job. My [now] spouse was young as well and he wasn’t finished his school either.”

Ultimately, it’s a big decision, and if you or someone you know is considering having an abortion, there are many places that may give you support, including family planning centres and some private-practice doctors.

The National Abortion Federation warns that there are fake health centres out there and says people should be cautious about where they go before pursuing abortion advice and care.