Abortion Pill and In-Clinic Abortion
Your abortion will take place at home and you can take pain relief medication as directed by your clinician (e.g. Ibuprofen). You will experience symptoms similar to a miscarriage, such as heavy bleeding and significant cramping that usually lessen within 24 hours of ending the pregnancy. Light bleeding lasts on average for 10 to 16 days, but may continue for up to 30 days. Two medications are used in combination to end the pregnancy. The medications stop the growth of the placenta and causes the uterus to contract.
In-Clinic Abortion
Your abortion will take place in the clinic and you will be given IV medication for pain relief. The abortion will take 5-7 minutes, but you can expect to be at the clinic for 3 to 4 hours. If your pregnancy is over 14 weeks, your procedure may include additional appointment days. You may experience symptoms such as bleeding, cramping, and nausea after your appointment. Most people are able to return to their day-to-day activities within 24 hours.
Note: For both the abortion pill and in-clinic abortions you may need to go to an initial consultation appointment that is scheduled on a different day before the abortion procedure. Please talk to the clinic of your choice for more information about their services.
Some clinics may charge a fee for services that are not covered by OHIP. Without an Ontario Health Card some clinics may require you to pay for your appointment and then submit the claim to your insurance company for reimbursement.
When can it be done?
Under 9 weeks (63 days) of pregnancy.
In-Clinic Abortion
Under 24 weeks of pregnancy.
How successful is it?
Up to 7 weeks, or 49 days the medications are 92% to 99% effective
8 weeks, or 56 days the medications are 91% to 98% effective
9 weeks, or 63 days the medications are 87% to 98% effective
In-Clinic Abortion
Less than 1% risk of the procedure needing to be repeated.
Number of Appointments
In Waterloo Region: Up to 7 appointments total
Outside Waterloo Region: Minimum 1 appointment and a follow-up appointment 2 to 6 weeks after procedure.
In-Clinic Abortion
Minimum 1 appointment (usually 3 to 4 hours) and a follow-up appointment 2 to 6 weeks after procedure.
Cost
Covered by:
● Ontario health card (OHIP)
● Ontario Drug Benefits (ODB)
In-Clinic Abortion
Covered by:
● Ontario health card (OHIP)
● Other province health card
● University Health Insurance Program (UHIP)
● GuardMe
● Interim Federal Health Program
● Department of National Defense
Cost Without Insurance Coverage
In Waterloo Region: Cost is $922.00
In Toronto: $530.00 and up based on clinic
Blood work, ultrasound, and clinician appointments are included in this cost.
In-Clinic Abortion
In Waterloo Region: $350.00
Outside of Waterloo Region: $400.00 and up based on clinic and gestation
Blood work, ultrasound, and clinician appointments are included in this cost.
Is it painful?
Mild to severe cramping on and off after taking misoprostol (commonly a 1 to 4 hour period). Ibuprofen used for pain relief. Some clinicians may prescribe stronger pain relief medication.
In-Clinic Abortion
Mild to severe cramping during the abortion. Given pain medication during procedure. General anesthesia is available at limited locations in Brantford, Toronto, and London.
How long will it take?
It usually takes several hours for the abortion to occur.
In-Clinic Abortion
The abortion procedure takes 5 – 10 minutes.
How much bleeding will there be?
Bleeding will usually start as soon as 30 minutes after taking misoprostol and can range from light to very heavy. Bleeding lasts on average 10 to 16 days.
In-Clinic Abortion
Light to moderate bleeding may continue for up to 14 days.
Having children after.
Being able to have children in the future is not affected, barring rare, serious complications.
Advantages
● May seem more natural
● May seem less invasive
● Takes place at home and may feel more comforting and private
● Anyone you want can be there during the abortion
In-Clinic Abortion
● More predictable and medical staff are present
● Less bleeding and cramping than with medical abortion
● It takes less time and fewer appointments
● Highly successful
● Available later in the pregnancy
Disadvantages
● It takes several days
● It is not as predictable as an in-clinic abortion
● Medications may cause side effects: nausea, vomiting and diarrhea
● Cramping and bleeding can be severe and last longer than with an in-clinic abortion
● Multiple visits to the provider are necessary
● Can be less successful than an in-clinic abortion surgical
In-Clinic Abortion
● May seem more invasive – a physician inserts medical instruments into the uterus through the vaginal canal
● Anesthetics and medication used to manage pain during the procedure may cause side effects
● There is a risk of complication
● Less control over the abortion process and who is present
● The vacuum aspirator may seem noisy
References
Canadian Institute for Health Information. (2015). Induced Abortions Reported in Canada in 2015.
Celopharma. (2016). Mifegymiso Medication Guide.
Costescu, D., Guilbert, E., Bernardin, B., Black, A., Norman, W. V., Pymar, H., Society of Obstetricians and Gynaecologists of Canada. (2016). Medical Abortion. Journal of Obstetrics and Gynaecology Canada, 38(4), 366-389. doi:10.1016/j.jogc.2016.01.002
Society of Obstetricians and Gynaecologists of Canada. (2016). Mifegymiso Online Training Modules.