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Abortion Services

Types of abortion

Medical Abortion

Medical abortion is available for a woman whose pregnancy is less than seven weeks (from the first day of her last period) or five weeks from the day of conception (confirmed by ultrasound). Medical abortion is a doctor’s office procedure in which a medication (Methotrexate) is given to the woman to stop the pregnancy from developing further and another medication (Misprostol) is used later to cause the muscles of her uterus to contract (cramp), causing her uterus to empty. 

Some women choose a medical abortion in order to avoid a surgical procedure, and are comfortable with a process that may take several days, and at least three visits to the doctor’s office before the abortion is considered to be completed. If a medical abortion does not work (one to two per cent of cases), the woman will need to have a D&C (surgical procedure) to empty the uterus.

The CARE Program does not provide medical abortions. Visit http://www.willowclinic.ca or www.prochoice.org for information about medical abortions.

Manual Vacuum Aspiration Abortion (MVA)

This surgical procedure can be done up to nine weeks from the first day of the last period, or seven weeks from conception (confirmed by ultrasound). 

The woman is given mild pain medications and local anesthetic is used to freeze the cervix. A small tube attached to a syringe is used to empty the uterus.

This is also a very safe procedure, requiring two visits to the doctor’s office.

What to expect at your appointment:
  • After checking in you will see a counsellor who will provide information, decision-making counselling (if needed), and birth control information. The counsellor will review the Consent Form with you. After you have signed the form, you will be admitted to the pre-procedure area.
  • A nurse will review your history, and provide pre-procedure medications (a mild pain medication and an antibiotic). You will have a small intravenous tube inserted (for other medications to control pain and anxiety). Blood will be drawn to test your blood type (to check for Rh Factor).
  • In the procedure room, the doctor will review your history and ensure that you are comfortable with going ahead with the abortion.
  • A local anesthetic will be used to numb your cervix and medication to keep you comfortable will be given though the intravenous tube. An ultrasound may be done at this time, to give information about the size and/or age of the pregnancy. Tests for sexually transmitted infections (such as chlamydia and gonorrhea) will also be done prior to the abortion procedure.
  • The opening of your cervix will be gently dilated (enlarged), and a small suction tube will be used to remove the contents of your uterus. This part of the procedure takes about five minutes.
  • Once the abortion is complete, you will be escorted to the recovery room where you will rest for 30 to 60 minutes, following which you will be able to leave the clinic.  
 

CARE Program provides abortions up to the 24th week of pregnancy.picture of brown-haired girl

An abortion after the 12th week of pregnancy (2nd trimester) can involve two to three days of appointments. Depending on how far away you live from Vancouver, you may need to arrange to stay in Vancouver for two to three nights.

Because the pregnancy is more developed after 12 weeks, an additional step is needed to prepare the cervix for the abortion procedure. Depending on the number of weeks of the pregnancy, one or two days prior to the abortion you will check in to the clinic, and see the counsellor as in a first trimester abortion.

  • After signing the Consent Form, you will be given antibiotics, and blood will be drawn to test for Rh factor.
  • In the procedure room, an ultrasound, and tests for sexually transmitted infections (such as chlamydia and gonorrhea) will be done, after which a small device called a cervical dilator will be placed in the opening of your cervix. Cervical dilators absorb moisture and slowly expand, gently dilating (enlarging) the opening of the cervix over the next 24 hours.
  • It is important that you are certain of your decision to have an abortion before cervical dilators are inserted. If you change your mind, there is a risk of miscarriage and infection when these are removed without having the abortion done.
  • On the day of your abortion, you will check in, and a nurse will place a small intravenous tube in your arm (for medication to relieve pain).
  • Because you have had cervical dilators inserted, your cervix will be prepared for the procedure, which involves the use of suction and small instruments to empty your uterus.
  • After you have rested in the recovery room and when you are ready, you will be able to leave the clinic. 
Preparing

Picture of red-headed womanPlease read the following information to help you prepare for your appointment.

Before the Day of Your Procedure

  • Plan to be at the clinic for up to three hours on the day of your abortion, and plan to rest at home until the next day after your abortion is done.
  • Most women find it helpful to take the next day off from work. We can provide a letter stating that you require the day off “for health care reasons”.
  • Do not drink alcohol or use street (recreational) drugs for 24 hours before your appointment.
  • Have a supply of sanitary pads at home (not tampons).
  • Plan to have someone to drive you home or accompany you in a taxi or on public transit.
  • Do not drive for 24 hours after your abortion (medications for pain control cause you to be impaired).

On the Day of Your Procedure

  • Bring two pieces of identification with you. One piece must be photo ID, and the other, your BC CareCard.
  • If you do not have BC Medical Plan coverage or are paying extra fees, please bring a debit card, credit card, or cash in the correct amount (ATM machines are available on site).
  • You may bring one escort only. He or she must have photo ID. Your escort may wait for you in the clinic waiting room, or may leave a phone number to be contacted when you are ready to leave the clinic.
  • Have a bath or shower prior to coming to your appointment.
  • BC Women’s is a scent-free environment. Do not use scented body products. Please also advise your escort.
  • Clothing:
    • Wear a short-sleeved top and regular underwear (no thong-style panties).
    • Wear flat shoes (no high heels).
    • Bring warm socks and a sweater (the clinic is air-conditioned and may be chilly).
  • Cell phones must be turned off while inside the building.
  • You may bring a personal music device such as an iPod, or reading material such as a book or magazine.
  • You may bring a snack to eat following the procedure.
  • Children are not permitted inside the clinic area. If you bring a child, he or she must have a care-giver, and will be able to use our family waiting room (ask clerical staff for directions).
Aftercare

CARE Program provides abortions using conscious (awake) sedation and local anesthesia for managing pain. Your clinic visit may take up to four hours as time is needed to check-in, talk with the counsellor, sign the consent form, have the procedure, and rest in the recovery area.

Please read through the following information to help you take care of yourself after your abortion and to learn about your recovery process.

Taking Care of Yourself
Picture of girl thinking

After you leave the clinic, it is a good idea to rest for the remainder of the day, and avoid strenuous activity for a few days. Many women find it helpful to take the next day off from work or school.

Because the medications you have been given will stay in your system for several hours, you must avoid driving or operating any mechanical devices, and avoid alcohol and street drugs for 48 hours.

You can get pregnant again soon after an abortion. You can start using a birth control method immediately (the Pill, Patch, vaginal ring, Depo Provera® injection, or IUD).

For the Next Two Weeks
  • No swimming pools or hot tubs
  • No tub baths
  • No douches or vaginal sprays
  • No vaginal intercourse (sex)
  • No tampons
Showers and sanitary pads are OK.
 
What you can expect following your abortion:

Bleeding:

You may have bleeding, like a period for about 1 to 2 weeks. The bleeding may be light at first, then it may become heavier after a few days. Some women have very little or no bleeding, which is also normal.

Your period will return in 4 to 6 weeks (sooner if you start birth control pills, the Patch or the vaginal ring). Your period may be delayed if you have a Depo Provera® injection or an IUD inserted.

Cramping:

You may have period-like cramping or pain for 1 to 2 weeks following your abortion. You may use acetaminophen (Tylenol®) or Ibuprofen (Advil® or 
Motrin®) for pain. Do not use Aspirin®.

Body Changes:

Most of your pregnancy symptoms will go away within a few days, but some (such as breast changes) may last longer if you are using birth control pills, the patch or vaginal ring.

Your breasts may leak small amounts of fluid. This is normal.

Changes in your mood may be related to the changes in hormone levels and will be short term. It may take a few weeks for complete physical and emotional recovery.

When to call if you are worried about your recovery:
If you have any of these problems:

Too much bleeding:

  • More than 3 pads soaked in 2 to 3 hours;
  • Blood clots larger than a lemon.

Signs of Infection:

  • Fever higher than 38°C. (100.4°F.);
  • Chills or shivering;
  • Unusual, bad smelling discharge from your vagina

Other:

  • Severe pain (not controlled by medication or comfort measures);
  • Vomiting or nausea that does not go away in a few days;
  • No period by the end of 6 weeks (unless you have had a Depo Provera injection or a Mirena IUD inserted);
  • Pregnancy symptoms that persist after 2 weeks

Call: (604) 875-2161

  • Monday to Friday, 8:00 a.m. to 4:00 p.m. and ask for “Pager 2412”
  • Monday to Friday 4:00 p.m. to 8:00 a.m. and ask for the “CARE Doctor on call”
  • If you cannot reach us or if you live out of town, go to your local hospital emergency room.
Follow Up:

If you have any concerns after your abortion, we recommend a follow up visit in 2 weeks. You may make an appointment to see a doctor at CARE, your family doctor, a youth clinic, an Options for Sexual Health Clinic, or a walk-in clinic.

If you have had an IUD inserted, it is important to have it checked by a doctor in about 6 weeks, to make sure the IUD is still in place.

If you require further counselling, please call us at: 604-875-2022 to arrange a post abortion counselling visit
OR
call the Pregnancy Options Service (POS) at 1-888-875 3163 or 604-875-3163, to speak with a counsellor.

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