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Abortion Options

An abortion is a medical procedure performed to end a pregnancy , which is done in a hospital, clinic or at home with the abortion pill. There are two types of abortion in Canada: abortion pill up to 9 weeks gestation and in-clinic abortion up to 24 weeks gestation.

Making a decision about what type of abortion is right for you depends on many factors such as how many weeks pregnant you are, where you would like to have your abortion, and who you would like to have with you through the process.

Knowing how many weeks pregnant you are is calculated based on the first day of your last menstrual period or with a dating ultrasound. You will need to know the first day of your last menstrual period or have a dating ultrasound in order to book an abortion.

Abortions are legal, safe, medical procedures covered by OHIP, although some clinics may charge a fee for non-insured services. You do not need a doctor’s referral to have an abortion.

Have questions about abortion? Read the facts.

On this page you can learn more about:

• Emotional support before an abortion
• Emotional support after an abortion
• The differences between the abortion pill and uterine aspiration

Support Before and After Abortion

We offer a safe, non-judgemental space to ask questions, explore your options, and talk about how you are feeling with a counsellor who will support your needs and goals.

Support Before an Abortion

Decision making support, information, and referrals for pregnant people who are looking for assistance in learning about their abortion options and support before having an abortion.

Some of the things you may want to talk about at this appointment are:
• Medication abortion (“the abortion pill”)
• Surgical abortion (“in-clinic abortion”)
• The process for each option
• What to expect during appointments
• Questions you have about abortion

Want to book an abortion options session? Click here to book now.

**At this time all appointments are offered virually by secure video or phone call.

Support After an Abortion

Support for anyone who has had an abortion within the past 2 years. These sessions are tailored to address your individual needs.

Some of the things you may want to talk about at this appointment are:
• What the process of having an abortion was like for you
• How you have been feeling since your abortion and unpacking your emotions
• Making meaning of your experience
• Sharing your story in a supportive, pro-choice environment
• How to talk to family, friends, and others about your abortion

Want to book a support after abortion session? Click here to book now.

**At this time all appointments are offered virually by secure video or phone call.

What's The Difference?

Medication Abortion ("the abortion pill") and Uterine Aspiration ("in-clinic abortion")

Medication Abortion (” the abortion pill”)
After meeting with your clinician, doing blood work, and filling your prescription, 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. Click here to learn more about the abortion pill. 

Uterine Aspiration (“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. Please check with the clinic to determine all fees when you book your appointment.

When can it be done?

Abortion Pill
Under 9 weeks (63 days) of pregnancy

In-Clinic Abortion
Under 24 weeks of pregnancy.

How successful is it?

Abortion Pill
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

Abortion Pill
At SHORE Centre: Minimum 5 appointments  (ultrasound, blood test, clinic, follow-up blood test and follow-up at clinic)
At free standing abortion clinics in Greater Toronto Area: Minimum 2 appointments (ultrasound and blood tests are completed at the clinic)

In-Clinic Abortion
Minimum 1 appointment (usually 3 to 4 hours) and a follow-up appointment 2 to 6 weeks after procedure. You may require more than one clinic visit if your pregnancy is between 14 and 24 weeks.

Cost

Abortion Pill
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

Abortion Pill
In Waterloo Region: Cost is approximately $600.00
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: $575.00
Outside of Waterloo Region: $400.00 and up based on clinic and gestation
Blood work, ultrasound, and clinician appointments are included in this cost.

Limited financial assistance may be available for people who do not have any health insurance and are unable to afford the costs related to their appointment at SHORE Centre. Please contact us directly by phone at 519-743-9360 or by email at optionsteam@shorecentre.ca for more information.

Is it painful?
Abortion Pill
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?
Abortion Pill
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?
Abortion Pill
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.

Future Pregnancies

Abortion Pill & In-Clinic Abortion
Being able to become pregnant in the future is not affected by the abortion pill or in-clinic abortion, barring rare, serious complications.

Advantages
Abortion Pill
●     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
Abortion Pill
●     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
Adapted from:
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.

 

 

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