Before You Make Any Pregnancy Decision
The Right to Accurate Information About Abortion Procedures and Providers
Before making a decision about abortion, it is important to understand how the abortion pill works, what a surgical abortion may include, who will provide the care, and where the procedure or medication will be offered.
Medication Abortion
Medication abortion, commonly called the abortion pill, generally involves two drugs during early pregnancy.
Mifepristone is taken first. It blocks progesterone, a hormone needed for the pregnancy to continue developing. Misoprostol is then taken, typically 24 to 48 hours later. It causes the uterus to contract, leading to cramping, bleeding, and the expulsion of the developing embryo or fetus and pregnancy tissue.
Bleeding and cramping are expected and may be heavier than a menstrual period. Other possible effects include nausea, vomiting, diarrhea, chills, weakness, headache, and a temporary fever. Bleeding or spotting may continue after the embryo or fetus and pregnancy tissue have passed.
Follow-up may include contact with a healthcare provider, a pregnancy test, bloodwork, or an ultrasound to confirm that the abortion is complete. Additional treatment may be needed if the pregnancy continues, tissue remains in the uterus, or heavy bleeding or infection develops.
Surgical Abortion
Surgical abortion is performed in a medical setting. The technique used varies according to how far along the pregnancy is.
Vacuum aspiration is commonly used earlier in pregnancy. The cervix is opened, and a narrow tube attached to suction is passed into the uterus to remove the developing embryo or fetus and pregnancy tissue.
Later in pregnancy, dilation and evacuation (D&E) may be used. The cervix is opened more gradually, sometimes beginning several hours or a day before the abortion. Suction and surgical instruments are then used to remove the fetus and pregnancy tissue from the uterus.
Pain management may include local anesthesia, oral medication, intravenous sedation, or general anesthesia, depending on the procedure, gestational age, provider, and medical setting.
Possible complications may include:
- Heavy or prolonged bleeding
- Incomplete abortion or retained tissue
- Infection
- Ongoing pregnancy after medication abortion
- Injury to the cervix or uterus
- A reaction to medication, sedation, or anesthesia
- The need for additional medication, another procedure, or emergency treatment
Seek immediate medical attention for very heavy bleeding, severe or worsening pain, fainting, difficulty breathing, persistent fever, foul-smelling discharge, or feeling seriously unwell. Follow the emergency instructions provided by the healthcare professional prescribing the medication or performing the procedure.
Abortion ends a pregnancy and results in the death of the developing embryo or fetus. Knowing what each type involves—including the physical process, possible risks, warning signs, and follow-up needs—can give you a fuller picture of what will occur.
Questions to Ask Before an Abortion
Before moving forward, it is important to know exactly what will happen, who will provide the abortion, what risks may be involved, and what support will be available if complications occur.
The questions below can help you identify what you still need to know.
As you consider your options, it is important to have clear answers to these questions:
Ultrasound & Pregnancy Information
- Is an ultrasound performed before the abortion?
- Will I have the choice to see the ultrasound images?
- Is the ultrasound reviewed by a physician or radiologist?
- Can I receive a copy of my ultrasound images or report?
- How was my gestational age determined?
- Am I at risk for an ectopic pregnancy?
Medication & Surgical Abortion
- How do abortion medications work?
- What symptoms may be expected after taking abortion medication?
- What does a surgical abortion involve?
- Why is a surgical abortion being recommended instead of medication?
- What possible risks, side effects, and complications can occur with a medication or surgical abortion?
Safety, Follow-Up & Emergency Care
- How will I know if I am experiencing a complication?
- What symptoms require immediate medical attention?
- What follow-up care is provided after the abortion?
- Who do I contact after hours if I have questions or concerns?
- If complications occur, who will be responsible for my follow-up care?
Provider & Facility Information
- Who will be performing the procedure or prescribing the medication?
- Is the provider a licensed physician?
- What training and experience does the provider have?
- Have emergency medical services or an ambulance ever been called to the facility?
- Have any lawsuits, malpractice claims, disciplinary actions, license restrictions, formal complaints, or safety concerns been filed against the provider or facility?
While serious or life-threatening complications are uncommon, some women experience symptoms such as heavy bleeding, severe cramping, fever, dizziness, fainting, severe abdominal pain, or ongoing pain that require medical attention.
Understanding these details ahead of time can help you feel more prepared, know what to expect, and know where to turn if questions or concerns arise.
The Right to Understand What STI Testing Includes
Not all STI screenings check for the same things. Some organizations test for only a few infections, while others, like Circle of Hope, offer broader screening. Before you rely on your results, make sure you know:
- What specific tests were performed
- What conditions were not tested
- If blood tests are available
- If laboratory-confirmed tests were used
- If you can receive a copy of your results
- The availability of treatment if you test positive
Your Rights as a Student
If you are pregnant or parenting and attending school, you likely have protections under federal law. This may include the right to stay in school, continue your education, participate in classes and activities, receive medically necessary leave, make up missed work, and be free from pregnancy-related discrimination.
Your school should not tell you that you must drop out, switch programs, stop participating in activities, or change your educational plans because you are pregnant or parenting.
Depending on your situation, you may have the right to:
- Have pregnancy-related absences excused when medically necessary
- Return to the same academic status after medical leave
- Make up missed assignments, tests, participation points, or attendance credits
- Continue participating in school activities, clubs, sports, or programs when medically safe
- Request reasonable adjustments related to pregnancy, childbirth, recovery, or parenting needs
- Speak with the school’s Title IX Coordinator about your rights and available support
- Be treated the same as other students with temporary medical conditions
If you are unsure what your school is required to provide, ask to speak with the Title IX Coordinator, school counselor, academic advisor, or student services office.
Your Rights in the Workplace
If you are employed during your pregnancy, you may have important protections under federal and state law. These likely include the right to be free from pregnancy discrimination, request reasonable workplace accommodations, and continue working as long as you are able to perform your job.
Depending on your situation, you may have the right to:
- Request reasonable accommodations related to pregnancy, childbirth, or recovery
- Take additional restroom, water, or rest breaks when needed
- Receive temporary adjustments to lifting requirements or other physical job duties
- Have a place to sit if your job normally requires standing for long periods
- Attend prenatal medical appointments
- Take medically necessary leave related to pregnancy or childbirth
- Express breast milk in a private location as required by law
- Be free from harassment, retaliation, or unfair treatment because of pregnancy
In many situations, an employer may not refuse to hire you, fire you, reduce your hours, force you to take leave, or treat you differently simply because you are pregnant.
If you believe your rights are being violated, consider speaking with your employer’s human resources department, a supervisor, or an employment attorney to better understand the protections that may apply to your situation.
Receiving Abortion Pills Through the Mail or Online
Abortion pills may be obtained without an in-person exam, blood tests, or ultrasound. This can leave important medical questions unanswered, including how far along the pregnancy is, where it is located, whether symptoms may point to miscarriage or ectopic pregnancy, and whether health conditions or current medications could increase the risk of complications.
The Source of the Pills Matters
Pills from an unknown or unverified online source may not meet U.S. safety and quality standards. The FDA warns that counterfeit medicines may contain:
- The wrong ingredient
- Too much or too little of the active ingredient
- No active ingredient
- Harmful ingredients
Packaging that looks professional does not prove that the pills are authentic, correctly dosed, or safe.
Serious Medical Conditions May Be Missed
A remote visit may not include an exam, bloodwork, or ultrasound. Without these checks, it may be harder to know:
- How far along the pregnancy is
- Whether it is developing inside the uterus
- Whether pain or bleeding may be caused by miscarriage or ectopic pregnancy
- Whether an allergy, health condition, or current medication could increase the risk of complications
- Whether the pregnancy is within the approved time frame for mifepristone
FDA-approved mifepristone is used with misoprostol to end an intrauterine pregnancy through 10 weeks of gestation. It is not effective for an ectopic pregnancy.
An Ectopic Pregnancy Can Become Life-Threatening
An ectopic pregnancy develops outside the uterus. It can rupture and cause dangerous internal bleeding.
Warning signs may include:
- Pain on one side of the abdomen or pelvis
- Shoulder pain
- Vaginal bleeding
- Dizziness or weakness
- Fainting
- Sudden or severe abdominal pain
Because abortion pills commonly cause cramping and bleeding, symptoms of an ectopic pregnancy may be mistaken for expected effects of the medication. This could delay emergency treatment.
If you have severe pain, shoulder pain, dizziness, weakness, or fainting, seek immediate medical care. Do not wait for symptoms to improve or rely only on online guidance.
Emotional Health After an Abortion
The term “post-abortion syndrome” is sometimes used to describe emotional distress after an abortion, but it is not a recognized medical or mental health diagnosis. Even so, difficult emotions after an abortion can be very real and should never be dismissed.
Every woman’s experience is different. Some women feel relief, while others may experience sadness, grief, regret, guilt, anger, anxiety, numbness, or a mixture of emotions.
Some women are caught off guard by these feelings. They may not expect sadness, anger, grief, or regret to surface—especially if they initially felt relieved or believed they would be able to move forward without difficulty. These emotions may begin right away or appear weeks, months, or even years later.
Emotional responses may be shaped by:
- Personal beliefs or values
- Feeling pressured, isolated, or uncertain about the decision
- The circumstances surrounding the pregnancy
- A previous history of depression, anxiety, loss, or trauma
- Conflict with a partner or family member
- Limited emotional or practical help
When It May Help to Reach Out
Consider speaking with a licensed counselor, healthcare professional, or trusted person if you experience:
- Sadness, guilt, regret, or hopelessness that does not improve
- Ongoing anxiety, panic, anger, or emotional numbness
- Trouble sleeping or frequent distressing memories
- Difficulty concentrating or managing daily responsibilities
- Avoiding reminders of the pregnancy or abortion
- Strain in your relationships
- Increased use of alcohol or drugs to cope
- Thoughts of harming yourself or feeling that life is not worth living
There is no single “right” way to feel afterward. What matters is that your experience is taken seriously and that you have a place to speak honestly about what you are carrying.
Abortion Recovery and Healing at Circle of Hope
Circle of Hope offers confidential mental health services, abortion recovery, and healing programs for women who are struggling after an abortion. Our team provides a compassionate setting where you can process difficult emotions, talk through what happened, and begin healing at your own pace.
You do not have to carry these feelings alone. Whether the abortion happened recently or many years ago, confidential care and a compassionate place to begin healing are available at Circle of Hope.