Abortions 101, Part 1: Procedural Abortions

JULY 2022

ABORTIONS 101 PART I: PROCEDURAL ABORTIONS A ZINE BROUGHT TO YOU BY ABORTION NURSES

TABLE OF CONTENTS intro...............................................................................3 what happens to my body during an in clinic procedural abortion?.......................................................................4 what happens to my body after a procedural abortion?........................................................................5 what are the risks of a procedural abortion?.................6 what are the benefits of a procedural abortion?.......................................................................6 some frequently asked questions and answers.........................................................................7 resources.......................................................................8 an offer for a call to action.............................................9 a personal abortion safety plan (by @liza_tistry).........10

INTRO This zine was created by abortion nurses with the intention of sharing medical knowledge with the people and further opening the conversation about abortions. We present to you the first in a series of zines on abortions and reproductive health as part of the People's Health Education Program, a collaboration between the Panther Solidarity Organization Ridgewood NYC Collective and the NYC Socialist Rifle Association.

We wrote this because as both nurses and as patients, we know that we collectively don’t know much about our own bodies. The medical industrial complex keeps us in the dark about our health and our bodies so that it can continue to profit off us, push drugs onto us, treat us as diseases and conditions to be fixed and not as human beings who need and deserve kindness, compassion, and care. To combat this and to actively render the medical industrial complex obsolete, we must equip each other with the tools and knowledge we need to better take care of ourselves and each other. We must work to build independence from the inherently racist, sexist, classist, ableist healthcare system, with the ultimate goal of building the people power necessary to overthrow this entire system and establish something entirely new, something rooted in care and love for the people. As medical professionals, we have the responsibility to de-professionalize the medical professions and share with the public medical knowledge that has been monopolized and sold to you at exorbitant prices. It must be free and accessible to all.

It is especially important to share this knowledge and destigmatize abortions as we see the fascist far right ruling class further strike down on our bodily autonomy from every angle.

True bodily autonomy cannot exist under capitalism, as our bodies, time, and labor are commodified and exploited by our bosses. Every day we see how healthcare under capitalism exploits our illnesses and ailments. Every day we see how life under capitalism strips away our bodily autonomy.

The fight for bodily autonomy and reproductive rights must therefore be a fight for a classless, stateless society, liberated from the interlocking systems of oppression.

Do what must be done in order to fight for a better world. A better world is not just possible.

A better world is inevitable, and we must dare to imagine it, dare to struggle, dare to win.

All power to the people!

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What happens to my body during a procedural abortion?

Note: in this zine, we refer to in clinic abortions as "procedural" abortions instead of "surgical" abortions because abortions are technically procedures and not surgeries.

There is no cutting or scraping.

The abortion provider uses gentle suction to remove the pregnancy tissue.

You may or may not get sedation for your abortion. If you do, you may feel more relaxed or be asleep completely. After you receive sedation, the procedure will begin with the insertion of the speculum. This is a duck bill shaped metal device that goes into the vagina and opens the walls of your vagina so that the abortion provider can see your cervix (the lower part of your uterus that opens into the uterus). If you receive no sedation or minimal/conscious sedation, you may get an injection of lidocaine (numbing medicine) at your cervix. This part can be really uncomfortable for some people. Other people can tolerate the discomfort.

Once the provider can see the cervix, they will then gently stretch it open using thin metal rods that have been sterilized. The later you are in your pregnancy, the more the provider has to dilate (expand or open) the cervix.

If you are later in the pregnancy (12 weeks and over), you may receive a medication called Misoprostol to put in your cheeks for an hour and a half before the procedure. This medication helps make the procedure safer by dilating or opening your cervix.

If you are 14 weeks and over, you may have to do a 2 day procedure, during which you get dilators (sticks that sit in your cervix and slowly expand overnight) on the first day, then the abortion procedure on the second day. You may be given another medication called Mifepristone to help soften the cervix and make the procedure safer.

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What happens to my body during a procedural abortion? (cont'd) Once your cervix has been dilated or opened enough, a small plastic tube called a cannula will be inserted. This cannula will be attached to either a hand held suction device (called a manual vacuum aspirator or MVA) or a suction machine (called an electronic vacuum aspirator or EVA). The MVA or EVA will then use gentle suction to remove the pregnancy tissue.

Once the tissue is removed, the provider will make sure you are not bleeding too much and then remove the speculum. Your procedure is now over.

The tissue will be sent back to the lab where a technician or sometimes a physician will examine the tissue to make sure that everything was removed.

What happens to my body after a procedural abortion?

After your procedural abortion, you can expect both vaginal bleeding and cramping.

This is from the uterus contracting, or squeezing in on itself. It is your body naturally doing what it was designed to do after it is no longer pregnant.

Bleeding: Most people have as much bleeding as a period (or less) for a few days after the abortion. It is common for the bleeding to stop and start for several weeks after the abortion. Some people have no bleeding for 2 or 3 days and then begin to have as much bleeding as a period. Other people have only spotting for a few days and then no more bleeding at all. You may notice increased bleeding with exercise and other activities; this is normal and you don’t need to worry. You can use tampons or pads whichever you prefer, though it can be easier to keep track of how much you are bleeding with the pads.

Cramping: Some people have cramps off and on during the week following an abortion. This is because the uterus is getting smaller, and you don’t need to worry. You can use pain medication such as acetaminophen (Tylenol®), ibuprofen (Motrin® or Advil®), or naproxen (Aleve® or Nasprosyn). You can also use a heating pad, or drink some warm tea or soup, to alleviate cramps.

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What happens to my body after an abortion? (cont'd) \Your emotions: Most people feel very relieved when the abortion is over. Some people also feel sad.

These feelings may come from changes in hormones, now that you are no longer pregnant. Feeling emotional at this time is normal.

Your next period: It is not the same for everyone. Most people get their period in 4–8 weeks.

What are the risks of a procedural abortion?

You may bleed more than normal. They will have ways to treat that while you are in the clinic. If the bleeding is extremely heavy, this may require a trip to the hospital for a blood transfusion (very rare).

You may develop blood clots that are too large to pass on their own. This may require another procedure to remove the clots.

You may have some or all parts of the pregnancy tissue that get stuck in the uterus. This may also require another procedure to remove the tissue.

You may get an infection, but this risk is very low. You may get a single dose of antibiotics to reduce that risk to as close to zero as possible.

You may get damage to the vagina, cervix, uterus, or other organs in the belly (like the bladder, bowels, or blood vessels). This would require a trip to the hospital for higher levels of care, but is incredibly rare.

What are the benefits of a procedural abortion?

The procedure is very safe - for people in the first trimester (under 12 weeks and 6 days), it is 14 times safer to have the procedure than to continue the pregnancy.

For people in their second trimester (weeks 13 to 26), it is just as safe to have the procedure than to continue the pregnancy.

The procedure is very effective - for every 100 abortions that are performed, 99 of them will be completed with no to minimal complications.

The procedure has no effect on your ability to get pregnant in the future. You can get pregnant in as soon as 3 weeks after the procedure.

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Some frequently asked questions & answers: Does an abortion make it harder to get pregnant in the future?

No. Not at all. Unless you have a very rare complication (like an infection or damage to an organ, which happens to less than 1% of people and are the same complications that could come from giving birth) your body isn't changed at all from this procedure.

How long do I have to wait before I can have sex again after having an abortion?

For people under 14 weeks, you don't need to wait unless you want to. Many of the guidelines about what you shouldn't do after an abortion were based on childbirth, and so there was a belief that you would be at risk for infection if you had sex right away because your cervix is more open. There is no evidence to support this though.

For people who are over 14 weeks, there is also no evidence that you need to wait to have sex. However, your cervix is slightly more open, so if you want to be more cautious, you can wait 3-5 days.

When can I go back to work or return to my normal activities?

We are advocates for resting as much as you need and listening to your body!!

But, there are no strict restrictions on activities. An abortion is not a surgery in that there is no cutting and no stitches, so you are not at risk of harming your body with physical activity. Activity can sometimes make you bleed and cramp more, but again, this is not dangerous.

Does the fetus feel pain during an abortion?

No. Studies have been done that show this part of the brain and nervous system is not developed.

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RESOURCES for more info and educational materials on medical and procedural abortions, visit the reproductive health access project and RHEDI (repro health edu in family medicine): https://www.reproductiveaccess.org/ https://rhedi.org/ to volunteer with or donate to organizations that help/ support getting an abortion, including financial support and help with logistics like travel, food, lodging, or childcare, visit the brigid alliance, national network of abortion funds, and haven coalition (nyc only): https://brigidalliance.org/ https://abortionfunds.org/need-abortion/ http://www.havencoalition.org for info and support on self-managing abortions with pills, including where to get pills, visit the miscarriage + abortion hotline: https://www.mahotline.org/ and for an extremely comprehensive list of ways to get involved and other organizations supporting reproductive justice, visit these google docs: bit.ly/How2ShowUp4AbAccess tinyurl.com/AbortionResourceKit bit.ly/AbortionFundsTwitter other zines: www.diydoula.org/

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AN OFFER FOR A CALL TO ACTION IF YOU HAVE HAD AN ABORTION, WOULD YOU BE INTERESTED IN SHARING YOUR THOUGHTS? We are asking: What were your expectations vs. what actually happened? --- Is there anything you wish someone had told you before you had the procedure? --- Were there things lacking in the care you got? Were there other things you needed? Were there other things that would have made the process easier or better? --- What were the things that made the experience feel ok ?

THERE IS AN OCEAN OF FAKE NEWS AROUND ABORTION, AND GAPS IN THE CARE AS IT EXISTS NOW. NOTHING IS AS VALUABLE AS FIRSTHAND EXPERIENCE IN OVERPOWERING THE FAKE NEWS AND IDENTIFYING THE GAPS. IF YOU HAVE HAD AN ABORTION, YOUR EXPERIENCE AND INSIGHT CAN PUSH CHANGE FORWARD.

If you would like to share, send an email to thepeopleshealtheduprogram@protonmail.com with your responses or requesting an anonymous survey.

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SUGGESTIONS FOR CREATING

A Personal Abortion Safety Plan If I have an unplanned pregnancy, would I want to have an abortion?

What steps am I taking to prevent an unplanned pregnancy?

Stocks Ella!

A better choice than Plan B for people who weigh 164+ lbs.

Contraception Bedsider.org

Emergency contraception Nurx.com FIGURING OUT THE LANDSCAPE What are the laws in my state?

Will I prefer:

Guttmacher .org/state-policy

Medication abortion or

Procedural abortion

What telemedication will I use and how will I access it?

What clinic will I go to?

PlanCPills.org

INeedAnA.com

How will I pay?

Savings and/or personal emergency abortion fund (What is my savings plan?)

Insurance (Does my insurance cover abortion?)

Abortion fund (Which one?) AbortionFunds.org Clinic (Have I confirmed with my clinic that they offer financial assistance?

OTHER CONSIDERATIONS Security DigitalDefenseFund.org/ddf-guides/abortion-privacy Doula Practical Support Groups PostRoeHandbook.com Gestation period Euki app Who can I reach out to for support? Have I had a conversation with them about what support might look like?

On the very rare occasion that you end have a complication: As long as you go into a hospital and safely say, ‘I’m pregnant. I think I might be having a miscarriage. I’m scared.’ and nothing else, it is impossible for a doctor to know that you tried to induce your own termination.

Telemedicine According to Abortion Care Network, 60% of all abortions are performed by non-Planned Parenthood clinics.

Planned Parenthood Often do not provide care for later gestation

Independent Clinics

Birth Control

PlanCPills.org

WombOfOnesOwn. wordpress.com

AidAccess.org

Medication Abortion AbortionPillInfo.org

SELF-MANAGED ABORTION CARE

ABORTION CLINICS

Primary Physician Non-Medication

INeedAnA.com

Menstrual Extraction WomensHealth Specialists.org /self-help

Practical Support Groups

Abortion Resource Map

DigitalDefenseFund.org /ddf-guides/abortion-privacy

JanesDueProcess.org IfWhenHow.org

Stories

Abortion Funds

WeTestify.org

AbortionFunds.org

ShoutYour Abortion.org

@trauma_informed_doula on Instagram

Security

Legal Defense

ADDITIONAL SUPPORT

Herbal Abortion

CAUTION

PostRoeHandbook.com

Clinic Escorts

Manual Vacuum Aspiration (MVA)

Crisis Pregnancy Centers ReproAction.org /FakeClinicDatabase

WE WANT TO HEAR FROM ALL OF YOU !! SEND AN EMAIL TO THEPEOPLESHEALTHEDUPROGRAM@PROTONMAIL.COM IF THERE ARE OTHER ABORTION OR REPRODUCTIVE HEALTH RELATED THINGS YOU WANT TO LEARN ABOUT/ SEE FEATURED IN A FUTURE ISSUE !!!

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