Frequently Asked Questions
How is abortion regulated today?
The Canadian Medical Association's abortion policy defines abortion as the active termination of pregnancy up to 20 weeks in gestation. Canada does not have an abortion law, so abortion is governed by the same legislation as other medical procedures.
When are abortions performed?
Abortions are performed when a pregnant woman asks a doctor to terminate her pregnancy and a doctor agrees to it. In general, an abortion is requested when a woman is not able to accept the unwanted pregnancy and the prospect of having a child.
There are usually several reasons why women decide to have an abortion. Some of these are:
- not being ready to raise a child
- lack of partner's support, absence of a partner, being in an abusive relationship
- need to complete education or keep a job
- having to raise other children
- financial situation and the lack of social support
- health problems
- pregnancies caused by incest or rape
- fetal abnormalities
Where are abortions performed?
In Canada, only a limited number of hospitals, clinics and physicians perform abortions. Since there is a fear of anti-abortion groups' reactions, or due to the religious beliefs, some hospitals and doctors do not offer to perform an abortion.
Canadian statistical data shows that 50% of all abortions are performed in hospitals with 50% being done in clinics. At the same time, abortions seems to be available only in main urban cities.
The difference in the procedure between a hospital and a clinic is that hospitals usually require referral from a woman's physician, while clinics do not. In hospitals, abortions are mostly done under general anaesthesia (where a woman is asleep) while in clinics it is done under local anaesthesia (where a woman is awake). At Women's Care Clinic, parental consent is not required for patients under the age of 18 years.
Abortions in hospitals are covered under provincial health insurance plans. Abortions performed in clinics may be fully covered, partially covered, or not covered at all, depending on the province.
How are abortions performed in a clinic?
Nowadays, an abortion is a surgical procedure in which a doctor removes the embryo (fetus) and placental tissue from the woman's uterus. This is how an abortion is performed:
- During the abortion procedure, the woman lies on an examining table with her feet in stirrups.
- Ultrasound is performed to determine the gestational stage of a fetus.
- Woman is then offered a choice of local anaesthesia by a nurse.
- Once the woman feels ready, the doctor inserts a speculum into the vagina.
- The woman's cervix is numbed with an injection of local anaesthetic.
- The physician gradually widens (dilates) the cervix by inserting and removing a series of narrow, tapered rods, each slightly wider in diameter than the last.
- The doctor inserts a small, hollow tube which is attached to an aspirator machine (similar to the one dentists use to clear the mouth of saliva). The suction is turned on and the doctor moves the tube back and forth for a short time. When the uterus is empty, the suction is stopped.
- The walls of the uterus are then gently scraped with a loop-shaped instrument (curette) to make sure no tissue from the embryo or placenta remains.
- An abortion usually takes less than five minutes. Dilation is often uncomfortable. Many women feel menstrual-like cramps both during and after the procedure.
The other technique is sometimes employed in a small percentage of second trimester abortions. The D&E (dilatation & evacuation) technique is similar to the vacuum aspiration method described above, but with the physician also using forceps to remove fetal matter.
Does an abortion hurt?
The actual procedure is completed under local anaesthesia and IV sedation. During the procedure, most women feel cramping, similar to menstrual cramps, for five minutes.
Is it dangerous to have an abortion?
As with all surgical procedures, abortions have some potential for complications. Individual circumstances and medical conditions can cause problems if they are not assessed before the abortion.
It is very important to discuss your medical history with the counselor during your pre-op examination or specific issues with the doctor inside the operative area. Statistically compared, childbirth is far more dangerous than abortion.
Most women have no complications after an abortion. If complications do arise, there are usually minor and easy to treat. More serious complications are rare but require a follow-up treatment.
Will having an abortion affect my ability to have children in the future?
There are no statistical data that show that abortions are linked to future miscarriage or sterility. However, research shows that a woman's ability to become pregnant is not affected by a single abortion.
I have had an abortion in the past. Is it dangerous to have another?
Regardless of prior abortion history, 1st trimester abortions are very low risk procedures.
Can my spouse / partner / friend / family member stay with me throughout the whole procedure?
We encourage one person to accompany each patient to the clinic. In case there are some issues and concerns or translation is needed, we will ensure that they accompany you into the counselling room. Only medical personnel are allowed in the surgical treatment areas. A comfortable waiting area or a coffee shop in the main lobby is available for your significant other until you are discharged from the recovery area.
On the day of the procedure:
- You will be required to have your Ontario Health card or other Health Insurance information ready. You will also be required to complete a medical chart outlining your past & present medical history, demographic information and consent form. All information is kept confidential.
- Expect some private time with a staff counselor to review your medical history, birth control plan and other information. This is also an opportunity for you to ask questions and raise any concerns you may have. Remember, being clear and resolved in your decision is our primary concern.
- You will have a finger prick blood test done for hemoglobin and the Rh factor.
- Your abortion will take place in a procedure room with the physician/surgeon and assistant nurse present. An ultrasound will be done to determine the gestational age of the pregnancy.
- The abortion is a safe, simple procedure that generally lasts 2-4 minutes. You will experience cramps similar to menstrual cramping. A nurse will be at your side during the procedure to ensure that you feel comfortable. You will NOT be asleep during the procedure. However, you will be given medication to distance you from the discomfort.
- IF YOUR BLOOD TYPE IS RH NEGATIVE, YOU WILL BE GIVEN A SHOT OF RHOGAM (WINRHO) TO ENSURE THE HEALTH OF FUTURE PREGNANCIES.
- After the abortion, you will be escorted to the recovery room. There you may rest and will be offered light refreshments. You will be offered Tylenol if you experience cramping. Generally, most women feel ready to leave within 20-30 minutes. A nurse will explain what is normal to experience in the next few weeks. Birth control options are discussed and birth control pills are given if you wish to choose this method. A prescription for antibiotics is given to avoid infection. You will be given an emergency contact number for after-hours attention, if necessary.
Women's Care Clinic and its staff take pride in providing a warm and friendly ambience in a comfortable environment.
On the day of procedure, to ensure your comfort at the clinic please observe the following guidelines :
- Do not eat or drink for several hours before your appointment
- Take a bath or a shower prior to your appointment
- Bring your photo OHIP card or photo ID (if you do not have OHIP)
- Medical abortions and post-operative prescriptions will require additional costs, make sure to bring a form of payment to cover out of pocket expenses with the pharmacy.
- Bring an extra pair of underwear
- A long gown/T-shirt and socks that you will change into
- Extra hygiene pads
- Have someone accompany you for translation or to take you home
- You should not be driving that day
- Do not bring children