Options

Unwanted pregnancy isn’t uncommon. Almost half of all pregnancies in the United States are unintended, according to a 2016 study.

If you become pregnant and you’re either not ready to be a parent or you don’t want to have a baby, know that you’re not alone and you do have options.

You can choose to terminate the pregnancy with an abortion or put your baby up for adoption. It’s a big choice and one that can feel overwhelming.

Remember, the “right” decision is the one that’s healthiest for you, and only you can determine that.

If you know you don’t want to have a baby but are unsure of what to do next, it’s OK to ask for help. Your spouse, partner, friends, other supportive family members, or a therapist can help talk you through the decision.

A doctor can also help guide you through this process and recommend appropriate resources.

Abortion

Abortion is a procedure that terminates a pregnancy. Most abortions are performed during the first trimester, or first 12 weeks of a pregnancy.

This procedure is legal in the United States, but restrictions vary from state to state. In some states, parental consent is required for people under age 18.

Finding a provider

Doctors, abortion clinics, and Planned Parenthood centers all provide abortions. Although abortion is legal in every state, some states have fewer providers than others.

To find a clinic near you, ask your primary care doctor or obstetrician/gynecologist to refer you to a doctor who performs abortions. Or, look through a directory of providers offered by an organization like Planned Parenthood or the National Abortion Federation.

When you visit the clinic, make sure there are doctors on staff. Some clinics offer free pregnancy tests or ultrasounds, but they don’t actually perform abortions. These facilities may call themselves “crisis pregnancy centers.”

Here are a few questions to ask the doctor or hospital/clinic staff:

  • What type(s) of abortion can I have?
  • How much will it cost? Are all medications and follow-up visits included in the fee?
  • Will insurance cover any of the costs?
  • Do you provide counseling before and after the abortion?
  • What types of medical training do your doctors have?
  • For a medical abortion, do you provide additional medications for pain and nausea relief?
  • For a surgical abortion, what kinds of anesthesia will you use, and who administers it?
  • How long will the procedure take? Can it be done in one visit? If not, how many visits are required?
  • What will you do in case of an emergency?
  • Will the clinic provide follow-up medical care after my abortion?

Costs

Abortion costs range from $300 to $800 for a medical abortion, up to $1,000 or more for a surgical abortion.

The cost depends on where you have the procedure and how far along you are in your pregnancy. A second-trimester abortion in a hospital is more expensive than a first-trimester abortion in a clinic.

Some health insurance providers cover abortion costs. Call your provider to find out what they’ll cover. Medicaid and other government insurance plans also might pay some or all of the costs.

Abortion methods

A few different types of abortion are available.

During a surgical abortion, a doctor uses suction to remove the fetus and placenta. With a medical abortion, or the abortion pill, you’ll take a combination of drugs to end the pregnancy.

The method you choose depends on your preferences and how far along you are in your pregnancy. Surgical abortions can be performed in the first and early second trimesters of pregnancy. The abortion pill can be used until the 10th week of pregnancy.

Surgical abortion

There are two types of surgical abortion:

  • vacuum aspiration abortion
  • dilation and evacuation (D&E) abortion

Vacuum aspiration is done during the first trimester or early second trimester of pregnancy. After you’re given medication to numb your cervix and prevent pain, the doctor will insert a tube through your cervix into your uterus. Suction is then used to pull the fetus and placenta out of the uterus.

In a D&E abortion, the cervix is first numbed with a local anesthetic. Then, a dilator opens the cervix. A thin tube is inserted into the uterus through the cervix. The tube is attached to a suction machine that removes the contents of the uterus.

Surgical abortions are safe and normally take no longer than 10 to 20 minutes. You can go home on the same day the procedure is done.

You may have some cramping after an abortion. You shouldn’t have sex or insert a tampon for up to two weeks to let the uterus heal. Heavy menstrual-like bleeding and blood clots are common.

The clinic will give specific instructions about the amount of bleeding and how long it may last. They may also recommend scheduling a follow-up appointment, either at the clinic or with your gynecologist.

Abortion pill

The abortion pill is also known as a medical abortion. This method uses two pills — mifepristone (Mifeprex) and misoprostal (Cytotec) — to end a pregnancy.

A drug-induced abortion can be done up to your 10th week of pregnancy. Mifeprex works by blocking the hormone progesterone. Without this hormone, the embryo can’t implant in the uterus and grow.

You take Cytotec a few hours or up to four days after Mifeprex. It makes your uterus contract to push out the pregnancy tissue.

After an abortion

It’s normal to have side effects like bleeding and cramping after an abortion. The provider that performed your abortion should offer follow-up care for these side effects. An ultrasound is usually performed afterward to ensure the abortion is complete.

Even if the pregnancy is unwanted, the experience of having an abortion may be emotional. If you feel depressed or anxious, talk to a mental health provider or social worker.

You can also reach out to these organizations for support after an abortion:

Adoption

If you aren’t comfortable with the idea of having an abortion, you can put your baby up for adoption. A public or private adoption agency can help you find a family who’ll raise your child in the way that you’d want. Some agencies will even pay your medical and legal costs.

An independent adoption is done directly between you and the adoptive parents. The parents might be your relatives, friends, or people you’ve found through a trusted source such as an attorney or social worker.

Some states don’t allow independent adoptions. If they’re legal in your state, an attorney can help you with the paperwork.

Types of adoption

Adoptions can be closed or open.

A closed adoption means you’ll have no contact with the adoptive family in the future. Once the adoption has been finalized, the records are sealed. Your child may have access to these records when they turn 18.

An open adoption allows you to have some contact with the adoptive family. That contact can range from letters and phone calls to visits with your child.

How to find an adoption agency

Finding a reputable adoption agency will help ensure that your baby goes to the best possible family. You can start by asking an adoption lawyer or social worker for a referral. Or, do a search through an organization like the National Council for Adoption.

To make sure the agency is reputable, contact your state’s licensing specialist and Better Business Bureau to see if any complaints have been filed against them. Also contact the state’s attorney general’s office and ask if any legal action has been taken against the agency.

Finally, ask the adoption agency for at least three references from clients who’ve been through the adoption process.

The agency you choose should counsel you on your decision but never pressure you. You should never have to pay the agency for counseling or adoption services.

Questions to ask the agency

Here are a few questions to ask any adoption agencies you’re considering:

  • What state adoption laws do you have to follow? Does your state check to make sure you’re complying with those laws?
  • How many staff members do you have?
  • Is someone available 24 hours a day, 7 days a week?
  • What kind of counseling services do you offer?
  • How much input will I have in choosing an adoptive family for my child?
  • Are there any costs involved in putting my child up for adoption?
  • Will you cover any of my medical or legal costs?
  • What kinds of services will you provide after my child is placed with a family?
  • Will you help me communicate with my child in the future?

Takeaway

Deciding how to handle an unwanted pregnancy can be an emotional experience. Everyone’s circumstances are different, so do what feels right for you and your situation. The choice is ultimately yours.

Having a strong support network and good medical advice can help make the decision easier. It’s also important to feel comfortable with the abortion provider or adoptive agency you select, so don’t be afraid to ask lots of questions about a procedure, process, or facility.

No matter which option you choose, make sure you take time for self-care afterward. It can be helpful to talk with a social worker or therapist in order to process emotions that arise.