Making Abortion Decisions
By Ayanna

Each year, 750,000 to 850,000 teenage women become pregnant. Seventy-four to ninety-five percent of these pregnancies are unintended. In 1999, the most recent year for which data are available, over 148,000 teenage pregnancies ended in abortion, and women under the age of twenty accounted for 19 percent of abortions in the U.S. Teenage women choose to have abortions for various reasons. They may not be ready to become a parent because they:

• cannot afford a baby
• are too young
• don't want anyone to know they're pregnant
• don't want to be single parents
• think a baby would interfere with school or work
• already have children and do not want any more
• are influenced by partners or parents who want them to have an abortion
• believe the fetus has health problems
• were victims of incest or rape.

Women can take steps before and after sexual intercourse to prevent pregnancy and the possibility of an abortion. However, if an unwanted pregnancy does occur, each woman has the right to decide what is right for her. The right to make childbearing decisions has allowed many women to pursue education or jobs that they otherwise might not have been able to.

Legal abortion is one of the safest surgical procedures. While abortion in the U.S. has only been legal since 1973, that did not stop women in earlier years from terminating pregnancies when they felt they had no other options. Many women had serious complications or died from attempting to have “back alley” (illegal, unsafe) abortions.

Abortion is legal in every state, though some states make it hard for women, especially teens and low-income women, to get them. Some states let teens make their own abortion decisions, but others require permission from parents. Teens must have an option, such as judicial and medical bypass, whenever parental consent is required.

Whether to have an abortion may be a difficult decision, and the conditions that led up to the pregnancy may be upsetting. A woman may want to consult with a parent, counselor, teacher, clergyperson, partner, or friend about her decision or just to be there to talk with.

What is abortion?
Abortion is a medical procedure that terminates a pregnancy. The embryo or fetus is removed from the uterus, usually in the first trimester (or three months) of the pregnancy. This is an induced abortion because it is a voluntary action, decided by a woman, as opposed to spontaneous abortion when the body simply expels the fetus without medical intervention.

Who has abortions?
About 1.5 million American women choose to have abortions each year. Fifty two percent of them are younger than 25 years old: 32 percent are ages 20 to 24, and 20 percent are teenagers. White women have the highest percentage, 58 percent, of all abortions because there is a greater population of them than women of color living in the U.S. However, the rate for white women is below that of women of color. Black women are three times as likely as white women to have an abortion and Latina women are two times as likely.

How is an abortion performed?
A few different methods can be used to induce abortion. One method is the use of mifepristone, a drug to end the pregnancy. No surgery is required. Mifepristone is generally used up to 49 days since the first day of the last menstrual period. Mifepristone is from 90 to 95 percent effective and is not available in all clinics.

The most common surgical method is dilatation and curettage (D and C), when the cervix (the entrance to the uterus) is slightly opened and the embryo or fetus, placenta, and other contents of the uterus are removed. The entire procedure takes about five to 10 minutes. Some women experience menstrual-type cramping and bleeding afterwards. D and C is nearly 100 percent effective.

When to have an abortion?
The safest time to have an abortion is between six and 10 weeks after the last menstrual period. Eighty-eight percent of abortions are performed during the first trimester (first three months of pregnancy). Abortion is seldom performed before six weeks after the last menstrual period or later than 24 weeks after.

After an abortion
The most frequent response of women after an abortion is a feeling of relief and satisfaction with their decision. Some women experience feelings of loss or disappointment, but usually those feelings come from the events leading up to the abortion and not the abortion itself. Other women feel guilty or sad, but most say that the feelings are manageable. Also, there is usually cramping and bleeding (like that of a menstrual period) for a couple of days afterwards, and most women can go home within an hour after the procedure.

What are the risks?
Legal abortion is considered to be among the safest of all medical procedures. Less than one percent of women experience major complications from abortion. In fact, abortion is much safer than giving birth. But in an abortion, as in any surgery, there are a few risks such as:

• Incomplete abortion
• Heavy bleeding
• Infection
• Cut or torn cervix
• Organ injury
• Death in one of 100,000 abortions

Myths
Over the years a few myths have been spread about abortion, particularly from people that do not agree with it. Some of them are that: abortion increases the risk of breast cancer and endangers future childbearing; a woman will have difficulty conceiving or carrying future pregnancies; subsequent births will result in the delivery of stillborn babies; a woman will become sterile; or that the fetus feels pain during an abortion. All of these myths are untrue. Legal abortion is safe, usually will not cause future complications, and the fetus, at the time of abortion, has not yet developed the nerves to feel pain.

Costs
The cost of an abortion varies and depends on the local provider, but abortions usually range from $225 to $575 in the first trimester. In 1997, the average amount paid for a non-hospital abortion with local anesthesia was $316.

Where to go
Clinics, surgical centers, private offices, and hospitals provide abortion services, but you may have to search your area to find the best place for you. The National Abortion Federation hotline, (800) 772-9100, can give you more information, support, and can tell you where to find qualified abortion providers near you.