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Abortion

Is Abortion Legal?

Yes. In January 1973, the Supreme Court stated that the decision to terminate a pregnancy should rest with the woman and her health care provider. In the state of Indiana, only first trimester abortions (the first three months of pregnancy) are permitted in outpatient clin­ics. If a woman is under the age of 18, parental consent or judicial bypass is required.

What procedures are available for first trimester abortion in Indiana?

A woman may choose from two types of first tri­mester abortion procedures. This includes the most common method, a surgical abortion called “vacuum aspiration” or “suction curettage.” The other proce­dure is referred to as a medical or pill abortion and involves taking oral medication. This has been referred to as RU486, or the abortion pill, and now utilizes medica­tion called Mifepristone as well as Misoprostol.

When can an abortion be performed?

It is preferable, both  medically, emotionally and eco­nomically, to have an abortion during the first trimester of pregnancy. A woman should find out as soon as pos­sible if she is pregnant. Pregnancy tests can be done ten days past conception at the IU Health Center. This will allow you to make an appointment within the proper amount of time at a clinic that provides abortion ser­vices. The IU Health Center does not provide surgical or medical abortions. Six to twelve weeks from the first day of the last menstrual period is the safest time for the procedure. For medical abortions, you must be less than 56 days pregnant. Indiana law requires that a woman provide consent at least 18 hours before the procedure. The clinic you contact will give you the details about informed consent.

What do I need to do to have an abor­tion?

You will need to have an intake interview, sign a consent form, give a medical history, have laboratory tests and have a physical exam. You will return to the clinic for the actual procedure. For a medical abortion, you will take the first medication at the clinic. You will be given the Misoprostol to take at home within 24-48 hours.

How much does abortion cost?

Depending on the method, the charges will be between $400-$600. Health insurance sometimes will pay for an abortion; check with your insurance plan and the clinic.

The method of payment varies greatly among clinics. Some accept only cash, while others accept cash and credit cards, and others accept everything but cash. It is best to call and ask specifically about the required method of payment. The cost usually includes the procedure, lab work done at the time of the procedure and post-operative medications. Depending on the clinic, there may be additional charges for optional anesthesia and injectable Rhogam if you are Rh nega­tive. When calling a clinic, ask what procedures are included in the quoted fee in order to avoid any later confusion.

Do I need an appointment?

Yes. You must call the clinic you wish to attend and arrange your appointment ahead of time. Some clinics also require that you bring evidence of pregnancy, such as a note from your health care provider or lab test results. The IU Health Center can provide all paper work that most clinics require.

Is it safe?

Done under sterile conditions by a qualified physician or trained providers, the risk involved in a first tri­mester abortion is far less than the risks associated with pregnancy.

Do I have to go to the hospital?

No. It is an outpatient procedure. First trimester abortions can be performed in licensed clinics or in a private physician’s office.

What if I am more than 12 weeks pregnant? Can I still have an abortion?

In Indiana, an abortion may be performed at or after 20 weeks postfertilization (22 weeks after the woman’s last menstrual period) only if the woman’s life or physical health is endangered, based on the assertion that a fetus can feel pain at that point. For more information regarding late abortion services in Indiana, please see http://www.womensmed.com/.

What is the procedure for a surgical abortion and how long does it take?

The cervix (the opening to the uterus) is dilated (opened up slightly) and a plastic tube about the width of a pencil is inserted. The contents of the uterus are drawn out by gentle suction. This procedure takes anywhere from 5-10 minutes but the woman should expect to be in the clinic approximately 4-6 hours due to lab work, intake and recovery.

Will it hurt?

For a surgical abortion, a local anesthetic is used around the cervical opening. During the procedure, the patient should expect moderate to severe menstru­al-like cramping. Depending on the clinic, additional pain medication, such as nitrous oxide or fentanyl, may be available for an additional fee. These medications will not put you to sleep but will reduce the amount of discomfort during the procedure. If a woman wants a general anesthetic (i.e. to be put to sleep), she must find out which clinics offer that option. Some do; others do not. It does, however, cost more. Your health care provider can give you this information. After the procedure, you may have spotting or bleeding for up to two weeks. You should use pads, not tampons for this spotting. A follow-up visit and exam is usually required approximately 3 weeks post-procedure.

Why do some women prefer surgical abortion?

  • Less likely to have an incomplete abortion
  • Procedure is over in a shorter amount of time
  • You are not alone during the procedure but at the clinic with medical personnel
  • Fewer visits
  • You don’t have to see the blood and tissue of con­ception

What is the procedure for a medical abortion and how long does it take?

There are two steps. You will receive Mifepristone medication to take orally. A few days later you will take Misoprostol in pill form.

About 10% of women will have the abortion before they take Misoprostol. Most others will have it with­in six hours of taking Misoprostol. For others, bleeding begins in 24 hours. The whole process can take about one week.

How does this medication work?

Mife­pristone blocks the hormone progesterone. Without this hormone, the lining of the uterus breaks down, ending the pregnancy. Misoprostol causes the uterus to contract and expel the pregnancy.

Why do some women prefer medical abortion?

  • No anesthesia or surgery
  • Can be done early-can begin treatment as soon as they know they are pregnant.
  • Less cramping than with surgery
  • More control– it may feel less invasive
  • More natural– it may seem more like a miscar­riage. Bleeding may continue on and off for up to three weeks following the procedure. It will be similar to your average menstrual period.
  • More privacy– you may have the abortion at home.

Who can choose medical abortion?

You may choose medical abortion if you are LESS THAN 56 DAYS PREGNANT. But you must agree to have a surgical abortion if the medical treatment fails. You also need access to a telephone, transporta­tion and backup medical care.

What if I am still pregnant after taking the medication?

Your clinician will help you decide. You may wait two to six weeks and check again. You may take more Misoprostol or you will need to have a surgical abortion.

When will I get my period?

Abortion begins a new menstrual cycle. You should have a regular period in four to eight weeks. Plan on starting a reliable method of contraception after the abortion. The clinic or IU Health Center can help you decide what’s right for you.

For further information, pregnancy testing and/or support services you may contact:

  • IU Health Center, Women’s Clinic, 855­6203
  • IU Health Center, Counseling and Psycho­logical Services, 855-5711
  • IU Health Center, Health & Wellness Educa­tion, 855-7338
  • Planned Parenthood of Indiana -Bloomington Health Center, 336-0219

The following websites may also be help­ful: