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For lots of reasons, teens may have an unplanned pregnancy. The choice for these young women are to carry to term, adoption, and abortion (before 20 weeks). Terminating a pregnancy is often an emotional and complex decision for a woman at any age. If a young woman has an unplanned pregnancy, in the US (and many other countries) she has a legal right to decide to have a safe termination of the pregnancy, an abortion. Since 1973 abortion has been an option in the US for women of all ages (though some states require parent permission if a young woman is under 18).

There are different reasons why someone might think about having an abortion:

What are the options for a woman who has an unwanted or unplanned pregnancy?

There are many things to think about before having an abortion. If a young woman decides that an abortion is the right decision for her, the next thing she'll need to think about are her options; whether she wants to have a:

What is a medical abortion?

A medical abortion involves taking a prescription medicine called “Mifepristone” which is also called the “abortion pill”. The pill is used to end an early pregnancy. It works by blocking progesterone, the hormone that builds up the lining of a women's uterus (womb) during pregnancy. Without progesterone, the lining of the uterus is unable to hold a pregnancy. As the lining of the uterus breaks down, bleeding occurs. The abortion pill can only be used up to 49 days after the first day of the last period (or 9 weeks). It's about 97% effective.

Other facts about taking the abortion pill:

Is the medical abortion safe?

A medical abortion is considered safe; however, when taking any medication there's always the possibility of having a reaction. In just a small percent of the time, the abortion pill is not effective. If it doesn't work, the pregnancy will need to be terminated by a surgical abortion. Rarely, someone may have: an allergic reaction to the pills, heavy bleeding, or infection. It's also possible but rare to have an incomplete abortion (this is when some of the pregnancy is left behind in the womb) or an undetected pregnancy outside of the womb (ectopic pregnancy). Very very rarely, a complication can be fatal.

There are some reasons why the abortion pill may not be the right choice for you.

You should not take the abortion pill if:

A medical abortion is a termination method that is a safe option for some women but not for others. Talk with your health care provider to see what method is best for you.

What is a surgical abortion?

A surgical abortion is a procedure that terminates a pregnancy, which is typically performed up to 16 weeks after the pregnant woman's last period. A doctor or advanced practice nurse usually performs the procedure in an out-patient office or clinic, or hospital.

What is the surgical abortion like?

First, relaxation and pain medicine is given. Next, the cervix is numbed. Once numb, a thin tube is inserted into the vagina, through the cervix and into the uterus. The tube is attached to a special vacuum. When the suction is turned on, the pregnancy is removed. Sometimes tissue is also removed with another medical instrument called a “curette”. Afterwards, the doctor will usually prescribe an antibiotic, and tell the patient to rest. The patient will then be given instructions to call her doctor or nurse if she has heavy vaginal bleeding, pain or tenderness in the abdomen, vaginal discharge that has an odor or looks like pus, or a temperature of 101° or more.

Is it safe to have a surgical abortion?

An abortion performed by a medical doctor or clinical nurse specialist today is a typically safe and a routine procedure. Before abortion became legalized in the US, there was no regulation or standard-of-care. Illegal abortions were expensive, painful and there was a high risk of infection because of unclean conditions and lack of follow-up care. Now abortions are performed in safe, clean offices with a staff of medical professionals who also provide counseling and after-care.

Although complications with a routine abortion are rare, it's important to be aware of the possible risks involved:

Sometimes young women are concerned about going to a clinic or office due to reports of picketers or threats of violence by people who don't believe in abortion. Most clinics have a strong security presence and patients coming to the clinic can ask for an escort if necessary.

Where can I get an abortion?

Once your pregnancy is confirmed by a home pregnancy test and an exam by a health care provider, and you have decided that an abortion is the right choice for you, ask for the name of a local clinic, hospital or doctor's office where abortions are an option. If for some reason you are uncomfortable doing this, or your provider is unable to help, go online to the Planned Parenthood website to access local services. Check on your state's rules about consent and parental involvement or ask your local Planned Parenthood. Three visits with a clinic or doctor may be required: the first to confirm the pregnancy and discuss options in detail; the second to perform the actual procedure, and the third for medical follow-up.

How much does an abortion cost?

The price of an abortion can vary among clinics and hospitals. It's possible that the procedure may be covered by your health insurance.

How can I make this decision?

Many young women find it useful to talk with a trusted adult about the decision to terminate a pregnancy. For teens, this is usually a parent or other relative; sometimes a counselor, nurse or your primary care provider is the first person you talk to when you find out about the pregnancy. Many clinics offer free counseling if you have a positive pregnancy test. This can be a good time to talk about your feelings and your options.

It's important to consider your:

Does my partner in the pregnancy have any say in this decision?

Some young women choose to tell the person with whom they became pregnant that they are considering an abortion and some do not. Some take the guy's feelings into consideration and some choose to make the decision on their own. Sometimes the partner helps with the cost of the abortion and goes along for the appointment and other times they are not involved. There is no right or wrong way to do this. Ultimately, it is your body and your decision.

Do my parents have any say in my decision to have an abortion?

Parents can be very helpful in your decision about what's best for you. Some young women feel comfortable talking with one or both parents/guardian(s), others are not comfortable. Don't assume that your parent(s) or guardian(s) won't be understanding and supportive about this important decision!

If you are under 18 years old, some states require your parent(s) or guardian(s) to be notified (your parent/legal guardian being told that you are seeking an abortion) or to give permission for the abortion unless a court is involved. No one can force you to have an abortion. Abortion laws vary greatly from state to state. For up-to-date information about your legal rights you can go to the Planned Parenthood website and search for your state's laws.

Will I be able to get pregnant and have children in the future if I have an abortion?

Since abortion became legal and regulated, there is very little risk involved with this procedure, so your future fertility should not be affected. Other factors such as a history of sexually transmitted infections can damage your fallopian tubes, making it difficult to become pregnant in the future.

How can I deal with people who tell me they do not believe in abortions and are angry with me for thinking about having one?

A woman's right to choose abortion can be very complicated. It is also an emotional topic for just about everyone. Both those who support abortion rights and those who don't believe in abortion often feel strongly about their beliefs, and some conversations may feel very uncomfortable. You can say that they have the right to their opinion; however, you also have the right to your opinion. If the conversation feels at all uncomfortable, or awkward, you should excuse yourself and walk away. This is your decision to make and does not belong to anyone else.

The decision to end a pregnancy can be complicated; therefore it is best to talk with someone with whom you trust. You should understand ALL of your options and know the risks and benefits involved before making a decision.

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Written and reviewed by the CYWH Staff at Boston Children's Hospital

Updated: 6/20/2013

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