My Options: Abortion

There are several methods of medical abortion available in Canada.

Mifegymiso™ is a combination of two drugs, mifepristone and misoprostol.

The first pill, mifepristone, is taken by mouth. This pill blocks the hormonal support necessary for a pregnancy to continue.

The second drug, misoprostol, is taken buccally (absorbed through the cheek mucosa) one to two days later. Misoprostol causes the uterus to contract, and cramping and bleeding will occur as the embryo and placenta are expelled.

Other types of medical abortion include methotrexate (which stops cell growth) and misoprostol, or use of misoprostol alone.

Medical abortion may take several days to complete. It normally requires one or more visits to the abortion provider. If an incomplete abortion occurs, then a surgical procedure may be required.

With each of the following surgical procedures, the cervix will be dilated (opened) to allow instruments to enter the uterus.

Dilation may be done using misoprostol, laminaria (seaweed sticks), an osmotic dilator (expanding sponge) or metal rods.

A local anaesthetic may be given, as well as medication to reduce pain, blood loss and risk of infection.

The tissue removed from the uterus may be examined to identify fragments of the embryo or fetus and the placenta.

Vacuum Aspiration and Dilation & Curettage: D&C (1st Trimester)

After dilation, abortion is performed by inserting a long tube (cannula) into the uterus. After the contents are removed by suction, a procedure using a loop-shaped instrument (curette) may also be required to scrape the wall of the uterus.

Dilation & Evacuation: D&E (2nd Trimester)

This method requires 2 appointments. After 24 hours of dilation, this procedure is performed with the use of both suction and scraping used in 1st trimester abortions (above), and the use of forceps to remove fetal parts. For abortions in the late 2nd trimester, prior to the procedure, a needle may be placed into the fetal heart with ultrasound guidance and potassium chloride injected to ensure the fetus is not alive prior to evacuation.

Induction of Labour (2nd Trimester)

In the 2nd trimester, as an alternative to D&E, sometimes labour is induced and the fetus delivered. As above, potassium chloride may also be used prior to induction of labour.

• Heavy bleeding
• Infection
• Increased risk of premature births in subsequent pregnancies¹
• Damage to cervix or uterus, including small risk of infection or scarring² that can be associated with infertility or miscarriage

After an abortion, many women feel some relief, while others have negative emotions. Reactions may be immediate, or feelings may arise years later. Women who experience negative emotions after an abortion have reported the following reactions:

• Sadness
• Guilt or shame
• Emotional numbing
• Depression
• Nightmares or flashbacks of the abortion
• Alcohol and drug abuse
• Thoughts of self-harm

Emotional responses vary depending on a woman’s age, stage of pregnancy, religious or cultural beliefs, previous mental health, or whether she is being pressured by others into having an abortion.