We’ve all heard that if you get pregnant you have three possible choices: have the baby and become a teen mom, have the baby and place it for adoption or end the pregnancy by having an abortion. What happens when a woman chooses to have an abortion? Why do some women choose to have abortions in the first place? What’s the difference between a surgical and a medical abortion? And are they safe? I’ve wondered about all of this and never been brave enough to ask—until now.

January 22nd is the 36th anniversary of Roe v. Wade, the U.S. Supreme Court decision that legalized first-trimester abortion. I couldn’t imagine a better time to speak with Dr. Katharine O’Connell, a gynecologist at New York-Presbyterian Hospital, to get the facts on abortion.

Sex, Etc.: What are some common reasons why women choose to have an abortion?

Dr. O’Connell: While some women have abortions because they are too sick to be pregnant or because the fetus has an abnormality, the most common reason is that a woman realizes she is not ready to become a mother at that time. There are many reasons for this: She can’t afford a child (or another child); she wants to finish school; she doesn’t have support from her partner or her family. Becoming a parent is a big decision, and the vast majority of women take that decision very seriously.

Sex, Etc.: What’s the difference between a medical abortion and a surgical abortion?

Dr. O’Connell: In the first nine weeks of pregnancy, a woman may choose between a medical abortion and a surgical abortion. A surgical abortion is also called a dilation and curettage (D&C) or a vacuum aspiration. Her cervix is dilated (opened) so a thin plastic tube (that looks like a soda straw) can fit inside. The tube is connected to either a hand-held vacuum pump, or to an electric vacuum, and the pregnancy is removed. The whole procedure takes between 5 and 10 minutes. The procedure is over fairly quickly, and afterwards at home the woman may bleed like she has her period for a week or two.

A medical abortion happens in two steps. First, a woman swallows a pill in the doctor’s office or clinic that stops the pregnancy from growing. In the next one to three days, she takes a second set of pills at home, which causes her uterus to begin cramping, and she passes the pregnancy at home. A medical abortion looks like a very heavy period; you don’t actually see any of the pregnancy tissue.

Sex, Etc.: Are there risks involved with abortion?

Dr. O’Connell: Yes there are, but it’s important to remember that there are also lots of risks involved in pregnancy. The most common risks with a surgical abortion are excess bleeding, infection, perforation (where the instruments poke a hole in the uterus, that usually heals on its own) or retained tissue (where a woman requires a second procedure).

The risks of a medical abortion include very heavy bleeding (that may require a trip to the emergency room or a blood transfusion), infection, or failure of the abortion (where a woman still has pregnancy tissue in her uterus and requires more medication, or even a surgical procedure).

Sex, Etc.: Is there a risk of death for either procedure?

Dr. O’Connell: The risk of death for both types of abortion is very, very small. The risk of dying during pregnancy is 10 times higher.

Sex, Etc.: After the procedure, how long does it take to heal?

Dr. O’Connell: After the surgical procedure, a woman is feeling like herself the next day (the bleeding is period-like), and the cramps are going away (most women need medication for cramps on and off for a few days). But her body is ready to get pregnant again 10 days after a first-trimester abortion, so she and her partner need to be sure they’re using some kind of birth control by then!

Now that you know exactly what an abortion is and isn’t, the best way to avoid needing to make this decision is to not have sex. Or if you’re choosing to have sex, make sure you’re using condoms or other latex barriers to protect you and your partner against sexually transmitted diseases and a hormonal birth control method like the Pill to prevent pregnancy. Roe v. Wade guarantees that women have the right to an abortion if they need one, but wouldn’t it be great if you didn’t have to make that difficult choice?

In many states, there are laws that require girls under 18 to get a parent’s permission before having an abortion. Find out about the laws in your state.
 

If you’re struggling with a difficult decision about a pregnancy, talk to a parent, trusted adult or counselor. If you need more factual information about abortion and non-judgmental support, call the National Abortion Federation Hotline at 1-800-772-9100.
 

Get more answers to your questions about abortion.