When you go in, you'll either be asked to give or bring a sample of your first morning's urine. This will allow the clinic to do a confirmatory pregnancy test. You'll also have to fill out miles of paperwork--most of it will be a medical history. It's important to list any previous C-sections or complications with previous pregnancies, as well as any drug allergies or problems like high blood pressure that you might have. The consent sheets are scary but will cover every possible complication of a suction abortion; don't sign them if you have any questions. Ask a counsellor or nurse for further information.

A basic health assessment will follow. What this entails is really pretty simple: most places do a blood test to check for Rh factor if you don't know yours; some do that as a matter of course, whether or not you know your Rh factor. You'll have your blood pressure, pulse, and temperature taken. After that, you'll be asked to empty your bladder.

At my old clinic, we'd then do an ultrasound (this step of the process varies in timing from place to place). The ultrasound's important, as it helps the clinician determine the gestational age of the embryo or fetus as well as its placement. In addition, ultrasonography can alert the clinician to any potential problems such as uterine fibroids, a molar pregnancy, or an ectopic pregnancy.

The abortion itself will be done under local anesthesia or twilight sedation or a combination of the two. The local anesthetic is injected directly into your cervix. Do not be alarmed--this sounds a *whole* lot worse than it actually is. For me, it felt like very weird, alien period cramps. The twilight sedation most often used is something called fentanyl (Sublimaze), with or without a Valium tablet beforehand. Fentanyl will act like two martinis on an empty stomach--unless you try very hard to stay awake, you'll sleep, and you almost certainly won't care much about what's going on. The fentanyl is administered intravenously and takes about this long >--< to take affect. 

After you're thoroughly loopy (my own description--not medical terminology, there), the doc will dilate your cervix with a series of metal or plastic dilators. This will involve having a speculum placed beforehand and your cervix and vagina washed with Betadine or another anti-bacterial wash. Dilation feels a lot like mild to moderate period cramps--breathing deeply and slowly helps immensely. The maximum dilation for an eight-week abortion is usually six millimeters. This takes roughly thirty to forty-five seconds.

After dilation is complete, the doc will insert a sterile suction catheter into your uterus. You know those things the dental hygenists uses to suck spit from your mouth? Same thing, pretty much the same suction. Suction curettage is the clinical name for the procedure, by the way. The evacuation of uterine contents usually takes less than seven minutes. Our machine was loud; most machines are fair-to-middling noisy. 

After that, the doc may or may not do a manual curettage to make sure that the inside of your uterus is clean. My doctor (the one I had my abortion with and worked for) did; she felt that it cut down on post-abortion bleeding, but opinions vary. You may or may not be given a drug called methergine to help your uterus contract back to its normal size. Methergine causes cramping, but it's cramping that's easily taken care of with ibuprofen.

Following your abortion, you'll be asked to stay in the clinic for anywhere between twenty minutes and an hour, until your vital signs are stable and you can walk normally without running into things. Fentanyl, luckily, wears off very quickly. About 20% of women who get IV fentanyl experience some nausea; if this happens, ask for crackers and ginger ale. You should eat something after you leave the clinic, but nothing heavy--soup and toast is about right. I made the mistake of going to IHOP and threw my whole breakfast up.

You'll also get antibiotics to prevent infection. Take all of them.

Downtime after an abortion runs like this: That day, you'll want to do nothing but sleep. For two weeks following, you should not take tub baths, have sex, or put anything in your vagina like tampons. You should monitor your temperature for the first week and call the clinic if it goes above 101. For the first two weeks post-AB, I'd recommend against running marathons or lifting heavy things, but you can usually go back to work the next day.

The only thing that changes if you're past about 11 weeks LMP is the dilation procedure and the recovery time. After 11 weeks at our clinic, the doc used something called laminaria to do a 24-hour dilation--laminaria are nothing more than sterile pieces of seaweed. They're placed in your cervix where they can absorb moisture and expand slowly. I've heard from patients who had 11.5 to 13.5 week LMP abortions that they felt groggy and tired for two days rather than one, and that pregnancy symptoms took longer to go away.

After two weeks, you'll head back to the clinic for another pregnancy test to confirm that the hormones are out of your system, for a pelvic exam to make sure there are no signs of infection, and a general check of your physical and emotional health. A regular, ordinary, over the counter pregnancy test will still turn positive up to three weeks post-AB, so don't freak yourself out by buying one and using it. The ones used at the clinic post-abortion are the old-fashioned Wampoles or Pregna-Certs, which are a whole lot less sensitive.

Hope that helps. Planned Parenthood has great information on abortion on their website, including lists of possible complications and descriptions of procedures.

MegU