Today’s post comes courtesy of FFC contributor Sarah Erdreich and guest contributor Sarah Cohen, who worked at the National Abortion Federation hotline for several years and currently lives in Philadelphia with her husband and their cat.
January 22, 2013 marks the 40th anniversary of the Roe v. Wade decision. All month, we’ll be running posts examining various aspects of this landmark ruling. If you’d like to contribute, let us know!
When you work in reproductive rights, people pepper you with practical questions about getting an abortion. How much does the procedure cost? How long does it take? Does it hurt? While the answers vary depending on the particular circumstances, there are a few tips you should know.
First, confirm that you actually are pregnant. This might sound obvious, but as many of us know, it’s surprisingly easy to lose track of when your last normal period occurred. If a home pregnancy test shows a positive result, you are probably pregnant; home test kits rarely give a false positive. If a home pregnancy test shows a negative result, it’s possible that you’re too early for the test to detect a pregnancy. Most test kits come with two in the package, so wait a few days and, if you still think you might be pregnant, take the second test.
If you are indeed pregnant and have decided that you want to have an abortion, the next step is to find a provider. If you have a regular OB/GYN, ask if he or she either performs abortions or can refer you to someone who does. Simply speaking from anecdotal evidence, it’s not uncommon for doctors to provide abortion care for regular patients, but not advertise that due to the negative attention it could attract. In fact, you might want to ask your doctor before you ever get pregnant, so that if you ever do need an abortion, you know if your doctor can provide one.
If this isn’t an option, then look for a clinic that provides abortion care. This sounds simple but, depending on where you live, it may be challenging. Planned Parenthood and the National Abortion Federation (NAF) can help you find the clinic closest to you.
You can also search online for your area and “abortion services,” but make sure to ask any clinic you call if they provide abortions. If they say no, or don’t give you a straight answer, move on to the next potential clinic. Some anti-choice organizations run fake “clinics” designed to give women incorrect information meant to dissuade them from having an abortion.
Calling the Clinic
Be prepared to spend about 20 minutes on the phone when you call to schedule an appointment. You’ll be asked when the first day of your last normal period (LMP) was; if it’s been between less than nine weeks since your LMP, you may be eligible for the medical abortion (abortion by pill). Talk to your clinic to find out, and keep in mind that many clinics require that patients having the medical abortion live or stay temporarily within a certain distance of the clinic in case they need to be seen urgently.
If it’s been fewer than 14 weeks since the first day of your LMP and you’re not interested in or eligible for the medical abortion, you will have a surgical abortion. Likewise, if it’s been between 14 weeks and 24 weeks since the first day of your LMP, you’ll have a surgical abortion that may require spending more than one day at the clinic. Many clinics require that patients having a multi-day procedure live or stay temporarily within a certain distance of the clinic in case they need to be seen urgently.
Depending on the type of procedure you’re having, the clinic may have other requirements that you’ll want to discuss. For example, if you need or want to have sedation or twilight anesthesia, the clinic might require that you bring a friend or family member to accompany you home. Don’t be shy about asking whatever questions occur to you—for instance, some clinics charge more if you’ve had a previous C-section. No question is too minor or embarrassing—they’ve heard it all!
If you’re under age 18, you may have to comply with parental involvement laws — either parental notice or parental consent. If you can’t tell your parents about the abortion, the clinic should be able to advise you about getting a judicial bypass. That means you’d show a judge that you’re mature enough to make the abortion decision on your own. You don’t need to hire a lawyer for this, but it will probably take a couple of days to go through the steps.
Many states have a mandatory waiting period, which require an initial visit to the clinic for an information session, informed consent counseling, and/or an ultrasound. If your state has a waiting period, you will likely have to take an extra day off work and/or arrange for an additional day of childcare.
If it’s been 24 weeks or more since the first day of your LMP, most clinics will consider you to be in the third trimester. An abortion at this point is generally not available unless your health or life is in danger, or if the pregnancy is the result of rape or incest. In some cases, you may be able to have an abortion if your fetus has a severe anomaly. Call NAF’s referral hotline to find a clinic that may consider seeing you. There are only a few clinics in the country that perform the procedure—so be prepared to travel long distances. The procedure will likely be very expensive, so if you have health insurance, talk to the company as soon as possible to find out if your plan will cover the procedure.
Paying for the Procedure
Which brings us to perhaps one of the most important considerations: cost. If you have health insurance, call the company to find out if they cover abortion procedures; about two-thirds of private insurers do, and they will probably refer you to the clinics that they work with. In about fifteen states, Medicaid will cover an abortion.
If your insurance won’t cover your abortion, or if you don’t have insurance, you will have to pay for the procedure. Be sure to find out from the clinic what the price will be, as well as any potential extra costs (such as separate ultrasound fees). The average price for a first-trimester abortion is about $350, but it can be anywhere from $250 to $650. Second-trimester abortion prices are even more variable, but they can reach $3,000 or more. Usually, the price stays the same for the first several weeks of the pregnancy (up to ten, twelve, or fourteen weeks, depending on the clinic). After the first trimester, the price usually increases every week.
It can be very difficult to raise that much money, especially if you don’t have a lot of time. Some sources to look to for assistance might include the man involved in the pregnancy; an advance from your workplace; credit cards; pawning or selling belongings; and borrowing money from friends or family members. More suggestions can be found on the National Network of Abortion Fund’s (NNAF) website; NNAF may also be able to provide funding help. NAF’s hotline may also be a source of assistance, but even if these funds can help, you will still need to contribute some or most of the money.
At the Clinic
On the day of your appointment, follow all of the clinic’s instructions regarding pre-procedure requirements (for example, depending on your anesthesia decision, you might not be allowed to eat or drink anything after a certain time). Be sure to allow plenty of time to get to the clinic; if you arrive late, you may have to reschedule. Plan to be at the clinic for several hours on the day of the procedure. Take a sweater since the procedure rooms can be chilly, as well as something to read while you wait. If a friend or family member comes with you, he or she might be required to stay at the clinic until you can leave, or he or she may be allowed to drop you off and come back.
Some clinics—though not all—have anti-choice protesters near their buildings. These protesters have a variety of ways of expressing their beliefs, from silently praying, to trying to hand people anti-choice pamphlets, to shouting and being more aggressive. This something that you can ask about when you make your appointment—if there are protesters, and if they are allowed to come up to patients (some states have laws prohibiting this). If you arrive at the clinic and see people outside, look for someone with a “Clinic Escort” vest or button. That person can walk with you to the clinic’s door. You don’t have to speak to the protesters or even be polite, and if they try to hand you something, you don’t have to take it. The best thing to do is to totally ignore them.
The clinic will give you instructions regarding aftercare. In particular, don’t have unprotected sex until you’ve had a normal menstrual period. You can’t predict when you’ll ovulate, so you may be fertile again as soon as a few days after your abortion. Make sure to go to your follow-up appointment. This can be done at the abortion clinic, at a different clinic, or at your regular gynecologist’s office. Even if you have an early abortion or local anesthesia, you might want to take an extra day off following the procedure.
The decision to have an abortion is personal, and it’s common to experience a range of emotions following the procedure—some women feel empowered by having made a choice that is right for them; others feel relieved; and other women feel sad at the circumstances that made abortion the best choice. All of these reactions are normal—there’s no one “right” way to feel. But if you’d like to talk to someone about your experience, both Exhale and Backline are good, supportive resources, and I’m Not Sorry and the 1 in 3 Campaign offer a range of personal stories about abortion. And if you’d like to help ensure that all women can access abortion care, NOW, NAF, Feminist Majority Foundation, Planned Parenthood, and NARAL all offer ways to get involved.