What to Expect After a Surgical Abortion

Take the steps to heal after an abortion.

After your abortion is completed, you may resume most normal activity. However, there are some restrictions that need to be followed to lessen your risk of post-operative complications. This information is to advise you of what to expect and do after an abortion and what to do should the unexpected happen.

Physical Changes

Bleeding after an abortion is normal and the amount and duration of bleeding time varies with each patient. Your experience may vary from no bleeding at all to spotting or bleeding off and on for several weeks.

Since bleeding may be sporadic, wearing a full-size sanitary pad is recommended. The amount is the most important thing to look for. If you are bleeding heavily try to measure the number of pads you use in a certain amount of time, If there are clots that go beyond the pad, try to estimate how many there are and size, i.e. nickel, quarter, silver dollar size.

If your bleeding is heavy (saturating 1 pad in less than an hour for a few hours back to back) call our office immediately. When calling, please have your pharmacy’s phone number ready. If you call at night, we will need the phone number of a 24-hour pharmacy.

A fever of over 100.4 degrees could be an indication of early infection and should be reported to our office immediately. For the first seven days following your termination, take your temperature every morning and every evening. If it goes over 100.4 degrees, please call us immediately. An infection discovered early is easily treated by our doctor.

Call our office immediately if you experience the following:

  • If you are soaking more than 2 maxi pads per hour for 2 hours or more.
  • If you are passing clots larger than a half dollar.
  • If you have cramping which interferes with the activity and is unrelieved by pain medication.
  • If you have a temperature over 100.4 for two readings in a row.
  • If you have an allergic reaction to one of the medications you have been given.

If your breasts become swollen or tender, wear a tight bra (sports bra) and wear the bra while sleeping. You may also use ice packs applied to your breasts for a few minutes twice a day. While this condition may be uncomfortable, it will pass and doesn’t require special medical attention.

Your period should begin in approximately 3 to 6 weeks. It may take your body some time to regulate after the abortion. Your next period may be heavier than usual with more cramping and possible clotting. If you do not get a period within 6 weeks, return to Whole Woman’s Health as soon as possible.

General Information

You must limit your physical activity for two weeks after your procedure. You should avoid any of the following activities as they could cause heavy bleeding or hemorrhaging:

  • Heavy lifting (nothing more than 15 lbs)
  • Running
  • Gym classes or other strenuous activities

In order to reduce your risk of infection you must have NOTHING in your vagina until your follow-up appointment. This means:

  • No tampons (you must use pads for any bleeding)
  • No sexual intercourse
  • No douching
  • No tub baths (showers only)
  • No swimming

At your follow-up appointment, the nurse will let you know when you may resume normal activities.

Pregnancy and Contraception

There is no way to know when you will ovulate after your abortion, so it is possible to become pregnant at any time. A reliable method of contraception is recommended when you resume intercourse to prevent another unwanted pregnancy. Unwanted pregnancies occur for many reasons. The most common are:

  • Failure of contraceptive method
  • Failure of a couple to use contraceptives
  • Lack of knowledge about birth control.

If sexual intercourse is practiced without the use of contraception, there is an 80% probability that pregnancy will occur within a year. We are happy to help you with making a choice of method and giving you samples if possible.

It is very important that you take your medications as prescribed. We will send you home with prescriptions for antibiotics (to prevent infection) and pain medication. Please note that it is normal to experience cramping after the procedure. Cramping should be light to moderate and you can use ibuprofen (Advil, Motrin), Tylenol, or the prescribed pain medication to relieve the pain.

Do not take aspirin or any products that contain aspirin, as aspirin is a blood thinner and could increase your bleeding. Increased cramps, accompanied by bleeding, may occur 3 to 6 days after your procedure as your hormone level drops. If rash or itching occurs while taking antibiotics, discontinue medication and take Benadryl, over-the-counter, according to the directions. Call our office on the next business day.

If swelling of the throat or tongue occurs or you have difficulty breathing while taking medications, discontinue taking them and go to the emergency room immediately. If vomiting occurs, discontinue medication and call the office on the next business day.

Feelings

After an abortion, some women feel elated and relieved while others feel sad. It is best not to ignore your feelings, but to talk about them with someone you trust. If your feelings become overwhelming for you, you may need professional help. We are happy to provide post-abortion discussion and/or referrals. Please call our office anytime.

We also recommend the following books, which have proven to help many women in your same situation:

  • “The Healing Choice: Your Guide to Emotional Recovery After an Abortion” by Candace De Puy and Dana Dovitch
  • “Peace After Abortion” by Ava Torre-Bueno
  • “Unspeakable Losses: Healing from Miscarriage, Abortion, and Other Pregnancy Loss” by Kim Kluger-Bell

If you need to talk with someone after the abortion, there are several places we recommend:

Post-Operative Exam

It is important that you have a post-operative exam two to three weeks after the procedure. This is the time when we can check to make sure that everything is back to normal, that you don’t have any infections and that the abortion was successful. This is also a good time to discuss contraception and your ongoing GYN care. We recommend that you have this examination with us so that we can be sure to follow through on the care that was started here with your abortion. There is no fee for the post operative exam.

It is our sincerest concern that your experience at Whole Woman’s Health was positive and that you were taken care of in a pleasant and professional manner. Please let a staff person know if there is anything we can do to further assist you.

 

How Does a Pregnancy Test Work?

At-home pregnancy tests have 99% accuracy.

Determining if you are pregnant can be a stressful experience. What type of pregnancy test is the best? Can you trust the results? How does the test determine if you are pregnant?

At Whole Woman’s Health, we offer free pregnancy testing to help you answer some of these questions. There are urine tests and blood tests, which can be completed 4-5 days after conception.

Both urine and blood pregnancy tests are looking for Human Chorionic Gonadotropin (hCG), which appears in the body immediately after a fertilized egg attaches to the uterine wall.

Urine Tests

Urine tests can be completed at home or in a doctor’s office. It is common to take an at-home pregnancy test after a missed period, and before consulting a physician.

Many women worry about the accuracy of at-home urine tests, however they are 99 percent accurate (blood tests are even more accurate).

When taking an at-home test, wait at least one week after a missed period to take it for the most-accurate results. Be sure to follow the instructions included with the test, and take it in the morning, when urine is most-concentrated.

If the pregnancy test shows “positive”, you are pregnant. If you have questions about the test or the results, contact a trusted physician, or feel free to contact our Empower Line at 877-835-1090.

Blood Tests

Blood tests are completed in a doctor’s office, and may be able to detect a pregnancy sooner than a urine test. However, getting the results of the test may take longer than those from a urine test.

There are two types of blood tests to determine a pregnancy: a qualitative hCG test or a quantitative hCG test.

A qualitative hCG test looks to see if hCG is present. It gives a simple yes or no on whether hCG is in the blood. A quantitative hCG test (sometimes called a beta hCG) measures the exact amount of hCG in your blood. It can find even very low levels of hCG.

Because these pregnancy tests can measure the amount of hCG, they may be helpful in tracking problems during pregnancy. They may also (in combination with other tests) be used to rule out a tubal (ectopic) pregnancy or to monitor a woman after a miscarriage when hCG levels fall rapidly.

False-Positive Result

It’s rare, but there are times a pregnancy test will show “positive” as pregnant, when there is no pregnancy. This can be caused by a “chemical pregnancy”, which is a very early misscarriage; medications that put hCG into the body; or an expired pregnancy test.

If you think you are pregnant, need a pregnancy test, or have additional questions, please call our Empower Line at 877-835-1090.

Medical vs. Surgical Abortion

Figuring out which abortion method is right for you.

We believe that compassionate, personal, safe abortion care is a vital part of healthcare for women. We specialize in this unique area of medicine and possess a remarkable level of expertise. Our Whole Woman’s Health clinics lead the nation in abortion care for your body, your mind, and your heart.

While you may have heard of medical abortions and/or surgical abortions, knowing which one is right for you can be a difficult decision. Let’s take a look at these two, very common abortion methods.

Both medical (the “abortion pill”) and surgical procedures are excellent, safe methods. Some patients prefer the convenience of the surgical procedure because in 1-day they know their abortion is complete and can return to regular activities. Some women prefer completing the abortion in the comfort of their own home and setting the timing of their abortion around their work, childcare or life-demands schedule. The fees for both are comparable and insurance and funding sources can help cover either choice.

Some women prefer completing the medical abortion in the comfort of their own home and setting the timing of their abortion around their work, childcare or life-demands schedule. The fees for both are comparable and insurance and funding sources can help cover either choice.

Medical Abortion

Medical abortion (sometimes called the abortion pill) is available to women up to 10 weeks of pregnancy (this varies from clinic to clinic, so please call our Empower Line at 877-835-1090 for specific information).

A medical abortion consists of taking two different medications to end a pregnancy. The first pill, mifepristone, will be given to you at a clinic by a doctor. This pill will block a necessary hormone needed for pregnancy and detaches the pregnancy from the uterine wall.

The second medication, misoprostol, will be taken at home, 24-48 hours after you’ve taken the first medication. You will put the tablets into your mouth between your cheek and gums and let them dissolve; if they have not dissolved after 30 minutes you may swallow what remains of the pills with water.

Misoprostol will cause your uterus to contract and your cervix to open slightly, allowing your body to expel the pregnancy, and can be accompanied by mild to intense cramping and heavy bleeding. This pill it what empties the uterus, and the process is often described as a heavy period with cramps.

When completing a medication abortion, you will be required to:

  • Be at home or in the home of someone who knows what is happening
  • Have a phone
  • Be within one hour of an emergency room
  • Have no other obligations including small children to care for
  • Have with you, or “on call,” a support person who knows what is happening and who has a car.

Surgical Abortion

While every surgical procedure involves some risk, the truth is that abortion is one of the safest and most common out-patient surgeries in the U.S. – 10 times safer than carrying a pregnancy to term and delivering vaginally.

  • Early Surgical Abortion: Specialized surgical abortion care for 3 – 5 weeks of pregnancy.
  • First Trimester Abortion Care: 1-2 Day abortion procedures with optional IV Sedation (same day surgical consult in our Twin Cities location).

After the anesthesia of your choice is administered, the physician will perform a pelvic exam to determine the exact position of your uterus. This is done by inserting two fingers in the vagina and putting one hand on the lower abdomen and gently pressing on the abdomen so the size and position of the uterus can be determined.

Then the physician places a speculum inside the vagina to keep the vaginal walls apart. S/he will hold the cervix, the opening to the uterus, with an instrument called a tenaculum. The physician will then insert several narrow rods, called dilators, into the cervix to further open it. The physician uses suction canula and other specialized instruments to remove the pregnancy from the uterus.

The entire process can take 5 minutes. A staff person will be in the room along with you and the doctor to help you through the procedure. Please ask about including your support person in the process as well.

  • Second Trimester Abortion Care: 1-2 Day surgical abortion procedures (appointment time and accepted length of pregnancy vary from clinic to clinic due to state laws. Please contact our Empower Line at 877- 835-1090 for specific information).

To perform an abortion in the second trimester, the cervix must be dilated more than in the first trimester. This process takes time and is safest for you when done slowly. There are two ways to achieve cervical dilation: dilating your cervix overnight with laminaria or using a medication called misoprostol (Cytotec) to soften and dilate your cervix. Our physician will review your ultrasound and medical history and will recommend the method that s/he believes will be safest and most comfortable for you. Many times the physician will recommend both methods of dilation. Our primary concern is your safety and comfort.

Laminaria are made from sterile natural materials that absorb moisture from your body and slowly expand over several hours. The physician will use a speculum (a clean metal instrument used to open the vagina) to help see inside your vagina. When the speculum is inserted and opened, you will likely feel a lot of pressure in your pelvis which may feel uncomfortable but should not hurt.

The doctor will look for your cervix, which is the end of your uterus, much like during a pap smear. S/he will then insert the laminaria into your cervix and allow it to expand overnight so the abortion can be done safely the next day. The number of laminaria depends on the length of pregnancy and the discretion of the physician performing the abortion, usually only 2 or 3 are necessary. After the laminaria insertion you may go home and relax for the evening.

Although it is not our intention that you pass the pregnancy as a result of dilation alone, there is a small chance this may happen, in which case you should call the nurse. This method requires two visits on two consecutive days; you can expect to be here about 3-4 hours on the first day and 1-2 hours on the second day. The physician will do a pelvic exam to ensure that your cervix is sufficiently dilated and then will complete the abortion procedure.

While both methods – medical abortion and surgical abortion – are safe and trusted, it’s important you choose the procedure that’s right for you. Please call our Empower Line at 877-835-1090 for specific questions, additional information, and to make an appointment at any of our clinic locations.

Amy’s Full Testimony Against Neil Gorsuch

Thursday, March 23, Amy Hagstrom Miller of Whole Woman’s Health, Lead Plaintiff in the historic Whole Woman’s Health v Hellerstedt Supreme Court case, testified before a Senate committee on why we must stop Judge Gorsuch. Amy represents abortion providers, women’s health advocates & people across the country who need access to abortion. Below is her testimony:

“I’m speaking on behalf of abortion providers, women’s health, rights and justice advocates, and the people we serve all across the country who deserve access to quality healthcare, delivered with dignity and respect.

I am the founder and CEO of Whole Woman’s Health. As a company, we were the lead plaintiff in last year’s landmark Supreme Court case Whole Woman’s Health vs. Hellerstedt. I have personally witnessed how decisions made at the high court directly impact the lives of women. I know what happens when politicians find devious ways to deny women’s constitutional rights, and why it is so important to have independent jurists who respect precedent and the rule of law.

I am gravely concerned about the nomination of Judge Gorsuch to the U.S. Supreme Court. In fact, Whole Woman’s Health joined with 54 other reproductive health, rights and justice organizations in a letter to the Senate opposing Judge Gorsuch’s nomination.

The Supreme Court has reaffirmed Roe v. Wade, the 1973 decision that made abortion legal in the United States for four decades. This hasn’t stopped legislators across the country from establishing roadblocks for women seeking abortion care. According to the Guttmacher Institute, more than 330 restrictive laws have been passed since 2010.

The laws’ impact hit the state of Texas especially hard. Anti-abortion legislators passed HB2 in 2013, shuttering over half the state’s clinics. The law resulted in women being forced to drive hundreds of miles, even across state lines, to access their right to safe and legal abortion.  In some cases, the hurdles were so high women simply took matters into their own hands.

I will never forget the woman who called us from South Texas right after the law went into effect. We told her our clinic had been forced to close, and she now had to drive 250 miles each way to San Antonio. She told us there was no way she could take two days off work, find childcare and the money to drive that far.  She said, ‘I will tell you what is in my medicine cabinet and can you tell me how I can do my own abortion?’

In our country, where abortion has been legal for more than 40 years, no woman should be forced to take matters into her own hands.  Nor should she fear criminalization or jail time if she does.

Would Neil Gorsuch support unnecessary obstacles to our constitutional rights? We need to know.

I also remember the woman who called from West Texas—where every single clinic had been shut down. She too was a single, working mother with three children. We helped her find a clinic, raised money for her abortion, childcare, transportation and her lost wages.  By the time she made it to a Dallas clinic eight weeks later, it was too late to have an abortion in the state of Texas.

Would Neil Gorsuch support laws that limit our constitutional rights to our zip codes? We need to to know.

Last year we took Texas to the Supreme Court and we won; in the final ruling the court called out these and other clinic closure laws for what they are—sham laws that create  obstacles to care with no medical basis behind them.

Sadly, even with our victory, this fight has not ended. Women need to know that if their rights are once again on trial. We need to assure that they will be served by justices who are not beholden to an ideological agenda.

We know President Trump’s litmus test was a justice who would overturn Roe V. Wade. Judge Gorsuch has refused to answer basic questions about his stance on Roe, Whole Woman’s Health, or the right to privacy.

Yet we know in the Planned Parenthood Association of Utah vs. Gary Herbert case, Gorsuch sided with politicians using misinformation and false claims to defund women’s health services. And in the Hobby Lobby Vs. Sebelius contraception case, he supported the notion that corporations are people.

If he would allow politicians to play games with our reproductive rights, how will he treat other rights that come before him?”

A Message From Our Founder: Why I’m Reopening My Clinic in Austin Amidst Continued Attacks on Texan Women

 

austinreopen2.pngNearly nine months after U.S. Supreme Court’s historic Whole Woman’s Health v. Hellerstedt decision in June, which overturned restrictions on abortion clinics in Texas and nationwide,  we’ve decided to reopen our flagship Whole Woman’s Health clinic in Austin. By mid-April, we will be serving Central Texas again.

In July 2014, Whole Woman’s Health of Austin was forced to close due to Texas’s Omnibus Abortion Bill (HB2). The admitting privileges and ASC building requirements, which legislate everything from the size of hallways to the size of the janitor’s closet, had a direct impact on Texas abortion providers, causing over half of the state’s clinics to close. Since then, women in need of abortion care have had to wait longer for appointments, drive outside of their communities for a simple procedure, and had to delay their care.

I’m making this decision as part of a bigger commitment to defend women’s access to abortion nationwide. Since I founded Whole Woman’s Health in Austin in 2003, I’ve testified and been a plaintiff in at least four different cases taking on Texas’ onerous laws, as well as fighting for access for women in states all across the USA.  After our Supreme Court victory, the Whole Woman’s Health decision has been used to reverse similar anti-abortion laws in over 8 states, restoring women’s health and access to quality care.

When we made the devastating decision to close in Austin in 2014 in the wake of HB2, I made the commitment to reopen in Austin as soon as I could. We got our start here, and I’m thrilled to announce that we’ll be restoring the fabric of care that Texans have come to count on from Whole Woman’s Health.

As we have seen, anti-abortion restrictions like HB2 are designed to shut clinics down, they shame women and they make accessing abortion difficult. But, every woman deserves support, respect, and dignity in making her own health decisions, including being able to safely and legally end a pregnancy if she needs to – and the majority of Americans support this opinion.

Polls have shown that the vast majority of Americans believe women should have access to safe, high-quality abortion care in their local communities.  In our clinics, we provide every woman the compassionate, professional and safe abortion care that she deserves and it is time this care returned to Austin.

At Whole Woman’s Health, we’ve been inspired by dozens of allies: supporters, partner organizations, staff, physicians and members of the community.  Despite opposition, our community has rallied with us to restore quality care and serve Central Texas. However, even with this re-opening, there will still only be 19 abortion facilities providing care in Texas, still a stark decline from the 41 clinics that were open prior to HB2’s implementation in 2013.

All abortion care providers –  in Texas, and throughout the country – are still subject to continued legislative attacks and targeted regulation. At least 46 anti-abortion bills have been introduced this season at the state level. They range from outright abortion bans, to more restrictions on methods and facilities, to the institution of funeral requirements for fetuses.

It would appear that Texas politicians are undeterred by the Supreme Court’s rulings and will continue to allocate precious Texas’ resources to restricting abortion access, no matter how costly or unconstitutional the fight may be. The state spent $4.5 million in the Hellerstedt battle, and lost again recently in  Whole Woman’s Health V. Hellerstedt II: A federal judge blocked state regulations forcing Texas health care providers to bury or cremate embryonic or fetal tissue from abortions, miscarriage or treatment for ectopic pregnancy–regardless of their patients’ personal wishes or beliefs. Like many other clinics and activists throughout the nation, we will persist in fighting these battles on the streets, in the courts, and in the national conversation. Despite what political rhetoric might have you believe, the people of Texas are on our side.

We can, and will, restore services and the care that women need— even in Texas. Hopefully, this opening will also serve as a beacon of hope for the rest of the nation.

In leading the long fight against HB2, we know our work is not done.

As we use our Hellerstedt victory to return to the Austin and Central Texas community, we feel more determined than ever to help restore care in the communities that need us the most throughout the country. Our Austin reopening in April is simply our first giant step forward.

Beginning April 2017, schedule an appointment at our Austin location by calling (877) 835-1090.

 

Black History Month – 3 Black Women Who Fought for Abortion Access

bhm_blog

Although it may seem like the fight for abortion rights is bigger than ever under the new administration, it has always been an uphill battle. As Black History Month comes to a close, we want to honor three African American women who’ve served as abortion activists – whether in the spotlight or behind-the-scenes – their work is still felt today.

Florynce Kennedy

Known to many as “Flo”, Florynce Kennedy was the author of “Abortion Rap”, and called the biggest, loudest, and the rudest activist by People magazine in 1974. She was an American lawyer, feminist, civil rights advocate, lecturer and activist from Kansas City, Missouri.

She moved to New York City so she could attend the Columbia University School of General Studies and majored in pre-law. In her autobiography, she wrote about being refused admission to the law school, not because she was black, but because she was a woman. When she threatened to sue the university, she was admitted and later became one of the first black women to graduate from Columbia Law School.

Less than 20 years after graduating, she sued the Roman Catholic Church for interference with abortion. A year later, she organized a group of feminist lawyers to challenge the constitutionality of New York State’s abortion law, which was credited with helping influence the Legislature to liberalize abortion in 1970.

Read more about Florynce Kennedy.

Byllye Avery

Byllye Avery served as a lifelong activist, and was the founder of several organizations for women’s health, including the National Black Women’s Health Project in 1983 (today, it’s the Black Women’s Health Imperative), the Gainesville Women’s Health Center in 1974, and she cofounded Birthplace, an alternative birthing center. She was also a leader in the underground abortion referral network in Florida.

In 2002, she founded The Avery Institute for Social Change – a non-profit organization based in Harlem, NY that is committed to quality health care for all. Currently she is a clinical professor at Mailman School of Public Health, Columbia University and an advisor to the National Institutes of Health.

Read more about Byllye Avery.

Dorothy Roberts

Dorothy Roberts is a University of Pennsylvania Professor, and has been a pioneer in the reproductive justice movement.

Although birth control, the morning-after pill, and abortions were available while Roberts was in college, she recognized the struggle women faced in other communities in order to access abortion.

For her, abortion has never been controversial, and she has always been surprised to see backlash from the decision in Roe v. Wade. She believed so much that women should have the right to reproductive healthcare that she became a lawyer.

Roberts has talked to the press about her belief that access to reproductive health means that all women are given the same access – and laws such as the Hyde Amendment, which denies federal funding for women who cannot afford an abortion – do not allow for all women to have equal access.

Read more about Dorothy Roberts.

Whole Woman’s Health Celebrates 14 Years

 

Whole Woman's Health turns 14!

Statement from Amy Hagstrom Miller, Founder and CEO of Whole Woman’s Health:

“I’m feeling so proud to have taken a risk to form my own company based solidly in my mission and vision. Being an abortion care provider in the South comes with challenges. I’m proud to have had women working with me by my side since day one who are passionate, dedicated, whip-smart and reflect and care for the communities we live and work in.

I’m proud to have grown so much over these past 14 years – adding clinics where we are needed most, fighting bad laws and bad guys, adding non-profit work in advocacy and education and emerging as national thought leaders and innovators in our field.
I couldn’t be prouder of my family and my team at Whole Woman’s Health! On this 14th anniversary, I pause to thank the doctors, nurses, counselors, medical assistants, advocates and leadership at Whole Woman’s Health. And I toast our allies all across the nation. We are all bright lights and we will shine on.”

We are more resilient than ever and are continuing our commitment to grow, advocate, educate, teach, learn, listen, and fight!