In Canada, 50% of women faced with an unintended pregnancy choose to have an abortion. These women include religious women, mothers, grandmothers, young women, older women, single women, married women, unemployed women, employed women and women who were against abortion before they knew that they were pregnant. Choosing to terminate a pregnancy does not change the person that you are. Abortion is legal in Canada and is regulated

 for women who are up to twenty weeks pregnant. Provinces have different gestational limits that have to be respected by hospitals and clinics that offer abortion services. In Canada, there are a few select hospitals and clinics that will perform abortions on women who are over twenty weeks pregnant, depending on circumstances, but the procedure is safer and simpler done early.

When performed in birth control clinics, hospitals or free standing abortion clinics, abortion is a very safe procedure with an estimated complication rate of less than 1%.

There are two types of abortions - medical abortions and surgical abortions. Medical abortions use drugs to empty the uterus, surgical abortions use instruments to remove the contents of the uterus.

The type of procedure used to terminate a pregnancy may vary depending on the city you live in, on the abortion provider and on how far along you are in your pregnancy. You might also have personal preferences that can influence your decision. For example:  Do you want to be awake or asleep for the procedure? Where are you most comfortable having the procedure done (a clinic or hospital)? Do you want to have surgery or would you prefer a medical (drug) option?

Methods:

The most common abortion methods for early abortion are Manual vacuum aspiration and Suction and Curettage.

In both cases, it is a simple procedure, taking no more than 10 minutes.

Manual vacuum aspiration is performed in the first 7 to 8 weeks after the last menstrual period. It uses the gentle suction of a syringe to remove the pregnancy tissue from the uterus.

The procedure can be performed under local or general anaesthetic, depending on where you go for the procedure. For a local anaesthetic, the cervix is numbed with an injection. In some clinics, local anaesthetics may be combined with sedatives to make a person relax and sleepy but not unconscious.

After washing the vagina with an antiseptic, the physician gradually widens (dilates) the cervix by inserting and removing a series of narrow, tapered rods, each slightly wider in diameter than the last. Then, a thin tube is guided through the cervical opening into the uterus. A syringe is attached to the tube and used to gently remove the contents of the uterus.

You should have a follow-up exam two or three weeks later to make sure the procedure was a success.

Many women feel menstrual-like cramps both during and after the procedure.

Suction and curettage is a surgical procedure that uses a mechanical suction machine to gently empty the uterus. It is performed between the 6^th and 14^th week after the last menstrual period. It can be done with a general anaesthetic, where you will be asleep, or with a local anaesthetic to freeze the cervix. In some clinics, local anaesthetics may be combined with sedatives to make a person relax and sleepy but not unconscious.

After washing the vagina with antiseptic, the physician gradually widens (dilates) the cervix by inserting and removing a series of narrow, tapered rods, each slightly wider in diameter than the last.

The doctor inserts a small, hollow tube, which is attached to an aspirator machine (similar to the one dentists use to clear the mouth of saliva). The suction is turned on and the doctor moves the tube back and forth for a short time. When the uterus is empty, the suction is stopped.

The walls of the uterus are then gently felt with a loop-shaped instrument to make sure no tissue remains.

A follow-up exam is done a week or two later to make sure the procedure is complete.

Dilation is often uncomfortable. Many women feel menstrual-like cramps both during and after the procedure.

Other methods that are used are Dilation and Evacuation and medical abortion.

Other techniques are sometimes employed in a small percentage of second trimester abortions. The D&E (dilatation & evacuation) technique is similar to the vacuum aspiration method described above, but with the physician also using forceps to remove foetal matter. It usually requires a visit to the clinic on the day prior to the surgery to begin to dilate (widen) the cervical opening. The procedure takes between 10 and 20 minutes.

In Canada, a medical abortion is done by combining the drugs of Methotrexate and Misoprostol. Methotrexate is usually given by injection. Misoprostol tablets are placed in the vagina five to seven days after the Methotrexate injection is given. In most cases the uterus will be emptied within 24 hours, but in about 35 percent of cases, it can take several days or weeks. Pain medication is used to ease the pain of the cramps, which occur when the pregnancy tissue comes out of the uterus.

Medical abortion is available from a few abortion clinics and is usually done in the first 7 weeks of pregnancy. A medical abortion requires at least three or four visits to the doctors’ office. A follow-up exam is done one or two weeks after the methotrexate injection to make sure that the abortion has happened. A woman who takes these drugs must be prepared to have a surgical abortion if the medical abortion is unsuccessful because the drugs that induce medical abortions cause birth defects.

While most women will experience a sense of relief after their abortion, others may experience mixed emotions. Some women may have more difficulty coping with their abortion than others. Difficulties in coping seem to be triggered by a number of factors, including factors that are not directly involved with having the abortion procedure. In other words, the experience of abortion depends on more than just the woman's feelings, thoughts and personality. Some things that may affect how a woman feels about her abortion are:
- her ability to access resources when needed
- her life history and current life situation
- her relationship with the significant others of her life (partner, family, friends etc.)
- her treatment from doctors, teachers, colleagues, employers and health workers
- society's expectations and beliefs.
- laws, policies and practices

If you are unsure about your decision, you may want to call a counseling center to talk to someone about your options. Or, if you have had an abortion and are experiencing mixed emotions, talking to someone about your feelings may help. Click here to see find a counseling centre near you.

If you have questions about the procedure, or if you want to talk with a compassionate and non-judgemental woman, please call Canadians for Choice toll-free at 1-888-642-2725. If you would like someone to accompany you to the hospital or the clinic, please call us at 1-888-642-2725 and we will arrange for someone to be there for you.