The decision to terminate a pregnancy is never an easy one, and Planned Parenthood of South Central Michigan offers services to help you in that process. Once you have decided that abortion is the right choice for you, you will then have to decide which type of abortion procedure is better for you.

Planned Parenthood of South Central Michigan provides pregnancy termination through surgical and medication abortion up to 16.6 weeks. The following information on the two types of abortion procedures we offer will help you make an informed decision about which one you’re more comfortable with.

Important Note About Michigan Abortion Law
Please be aware that Michigan law requires a 24 hr. “waiting” period before either procedure. You will be required to review information from the state and sign a form stating that you have done so before the procedure can be done.

We encourage you to streamline this process by taking advantage of the State’s web page where you can view and download all the necessary forms. Please click here to start the State required “informed consent” process.

Surgical Abortion
(aka: Vacuum Aspiration Abortion)

These are the most common benefits, side effects, risks, and alternatives to this type of abortion procedure. We are happy to answer any questions you have.

How it is Performed
Vacuum aspiration ends a pregnancy by suctioning away the contents of the uterus. The way it is done may depend on how long you’ve been pregnant. This is determined by counting from the first day of your last period or by an ultrasound.

We will give you pain medication, including a local anesthetic (to numb the cervix, the opening to the uterus) or other medications that you and your clinician have decided on to decrease pain and discomfort during the procedure. We offer a number of stronger medications that can be given by vein for an additional charge. If you chose any of these stronger medications, you will need to make arrangements for a ride home.

After your pain medication begins to work, the clinician will decide if your cervix is ready. The doctor will gradually stretch the opening of the cervix with narrow instruments called dilators. When the cervix is stretched open enough, a small plastic tube is inserted into the uterus. It is connected to a hand-held syringe or to an electric suction machine. The tip of the tube is moved around inside of the uterus for a few moments in order to remove the pregnancy tissue from the uterus.

You may feel cramping during and after the procedure as the uterus shrinks back to its smaller size. In rare cases, the doctor may also use a curette, a narrow spoon-shaped instrument, to remove any remaining tissue. The tissue is always examined to help make sure the procedure is complete.

Benefits
Vacuum aspiration is a safe and effective way to end a pregnancy.

Side-Effects
Side-effects are usually temporary and require no treatment. Common side-effects include:

• bleeding
• cramping
• fatigue (usually from anesthesia and/or pain medication)
• emotional reaction — Most women report a sense of relief after abortion.  Some women also experience sadness, guilt, or other emotional reactions, although these feelings usually go away quickly. Serious psychiatric disturbances (such as psychosis or serious depression) occur rarely and less frequently after abortion than they do after childbirth, and most often in women who have these problems before becoming pregnant.

Risks
Vacuum aspiration is very safe. However, there are risks with any medical procedure. The risks increase the longer you are pregnant and if sedation or general anesthesia is used. Your overall health is another factor that affects your risk of complications. Your risks increase if you are in poor health. Risks associated with vacuum aspiration abortions include:

• Incomplete abortion — Pregnancy tissue left inside the uterus may lead to excessive bleeding, infection, or both. If this occurs, aspiration may need to be repeated in a clinic or hospital. Other tests or treatment may be necessary.
• Blood clots in the uterus — Clots may cause cramping and abdominal pain. Aspiration may need to be repeated.
• Infection of the uterus — Most infections are easily identified and treated with medications. However, there is a small chance that repeated aspiration, hospitalization, or even surgery may be necessary to treat the infection.
• Failure to end the pregnancy — Sometimes the abortion fails to end the pregnancy. Repeated aspiration is recommended.
• Excessive bleeding (hemorrhage) — This may require treatment with medication, repeated aspiration, blood transfusion, or surgery — including possible hysterectomy (removal of the uterus).
• Injury to the cervix — A cervical tear may be treated with medicine or rarely with surgical stitches in the cervix.
• Injury to the uterus or other organs — An instrument may go through the wall of the uterus, which could damage internal organs such as the intestines, bladder, or blood vessels. Treatment may consist of observation or abdominal surgery. There is a risk of hysterectomy (removal of the uterus). Scar tissue may develop inside the uterus which may require treatment.
• Allergic reaction — Some women may be allergic to the local anesthetic or to other medications used. All medicine and drugs may cause serious reactions alone or with anesthesia. It is important that you tell your clinicians about all drugs you are allergic to or are taking.
• Death — Death from vacuum aspiration abortion is extremely uncommon. The risk of death from a full-term pregnancy and childbirth — about 10 in 100,000 — is greater than the risk of death from an early abortion at eight weeks of pregnancy — approximately 1 in 1 million. However, the risk of death during or after vacuum aspiration (surgical) abortion increase the longer you are pregnant. The risk is less than one in 100,000 up to 13 weeks gestation and is about two in 100,000 between 13-15 weeks gestation.

You will be given instructions on caring for yourself after the abortion and a telephone number to reach the clinic if you have a problem. You will also be asked to return to Planned Parenthood for a follow-up visit.

Medication Abortion

What is a Medication Abortion?
Medical abortion ends a pregnancy by using drugs rather than surgery. In September 2000, the US Food and Drug Administration approved a drug called mifepristone for use in medical abortion. Mifepristone can only be used during the early part of pregnancy — no more than 8 weeks (56 days) after the first day of your last menstrual period. A second drug, misoprostol is used with mifepristone.

How Does it Work?
Mifepristone blocks a hormone called progesterone. Without progesterone, a pregnancy cannot continue and begins to dislodge from the lining of the uterus. The second drug, misoprostol, causes the uterus to contract. Contractions usually cause the pregnancy to be passed out of the uterus.

How Effective is Medical Abortion?
The latest information from Planned Parenthood Federation of America says that this method of medical abortion is 99.6% effective in ending pregnancy. This means that 3-4 women in 1000 have had ongoing pregnancies after using mifepristone medical abortion. In cases where the medical abortion is not successful, a surgical abortion may be necessary.

What Are the Risks?
The rate of reported bleeding events requiring ER treatment has been .12%. This means that 1-2 patients in 1000 are reported to have bleeding severe enough to warrant ER care. Six in 10,000 women have had bleeding severe enough to require transfusion.

What Are the Side Effects?
Medical abortion causes cramping and bleeding, similar to a spontaneous miscarriage, or greater than what you might expect during a heavy menstrual period. Bleeding or spotting usually continues for 9 to 16 days and may last for up to 30 days. Other possible side effects include nausea, vomiting, diarrhea, and headache. These effects lessen after the first few days and are usually gone within 2 weeks.

What Are the Steps Involved in Medical Abortion?
Michigan law requires a 24 hr. “waiting” period before this procedure. You will be required to review information from the state and sign a form stating that you have done so before the procedure can be done.

We encourage you to streamline this process by taking advantage of the State’s web page where you can view and download all the necessary forms. Please click here to start the State required “informed consent” process.

You will do an informed consent consultation with a counselor including an ultrasound. The next step is a visit with the doctor to take the first medication, mifepristone, orally. Also at this visit you may need another ultrasound, labwork, and a pelvic exam. You will be given the additional medication to take home with you. On the day you take the mifepristone, will probably feel normal. Rarely, some women experience nausea and vaginal bleeding this day.
24–48 hours later while at home, you will take the misoprostol by placing 4 pills in your cheeks until they dissolve. You will likely pass the pregnancy on this day. On average it takes 3 to 5 hours but it could take up to 12 hours. You will be given Tylenol with Codeine to take along with an antibiotic for one week to help prevent infection.

In 7 to 10 days following the abortion you need to return for a follow-up visit. A nurse will do an ultrasound to ensure your pregnancy has ended and will again discuss birth control options with you at this time.

Who Cannot Use Mifepristone?
Women cannot use mifepristone if they are over 8 weeks pregnant. Women should not use mifepristone if they have a possible tubal pregnancy or an IUD in place. Women who have been treated with certain steroid medications for a long period of time, have bleeding problems, or are taking anticoagulants (blood thinners) also should not use mifepristone. Some gastro-intestinal disorders could also prevent a woman from doing a medical abortion. It is important to tell Planned Parenthood staff of any medical condition you have or any medications you are taking