What Is Abortion?
Abortion is the surgical or medical termination of a pregnancy. If you condense the subject of abortion down to its central issue, you find that it is really about a woman’s right to decide what to do with her own body. Should a woman be forced to give birth when she does not want to, or cannot, carry a pregnancy to full term? Current laws say no, but they are being challenged in the courts routinely. In the United States today, you have the right to decide your own destiny as a woman. If you are faced with an unexpected, unplanned, unwanted, anomalous, or medically complicated pregnancy, you should know some important facts about abortion.
Reasons For Abortion
Women choose to have abortions for many reasons. Some feel they are too young for the responsibilities of parenthood. Some are not in a stable relationship or worry about being a single parent. Some cannot afford a child, or do not want their life’s goals interrupted. Some are concerned they will not be a good mother. Some pregnancies involve an unhealthy fetus, or one with lethal anomalies. Other pregnancies are complicated by maternal medical conditions.
Many of life’s decisions can be postponed for a period of time. One decision that cannot wait for long is the difficult decision about whether or not to continue a pregnancy. This decision needs to be made as soon as possible. It is helpful to talk with someone — such as your parents, a close friend, a minister, or other professional counselor — in addition to your husband or boyfriend.
Abortion Facts
The decision to have an abortion or continue with a pregnancy is a difficult one. Knowing the facts about abortion can help you decide the best course of action for you at this point in your life. Many myths and misconceptions about abortion continue to circulate despite scientific evidence supporting its safety.
Safety Of Abortion
Abortion is one of the safest surgical procedures performed in the United States today. In fact, the National Abortion Federation reports that complications from a first-trimester abortion are less frequent and less severe than complications from live birth. But abortion has not always been so safe. Before abortion was legalized, women had serious complications — and sometimes died — after trying to induce abortions themselves, or by going to untrained practitioners who operated in unsafe conditions. Since 1973, women have benefited from advances in medical and surgical technology and greater access to safe, high-quality services — such as those performed in our office.
Abortion Statistics
Nearly half of all pregnancies that occur in the United States every year are unintended. Of these unplanned pregnancies, forty percent are terminated by abortion. According to the NAF, one in three American women will have an abortion by the age of 45.
More than half of women who have abortions were using some sort of contraceptive method (usually the pill or condoms) during the month they became pregnant, and considered themselves at a low risk of pregnancy.
Abortion Myths
Myth: Abortion increases a woman’s risk of developing breast cancer. There is no scientific evidence that abortion leads to an increased risk of breast cancer.
Myth: Making abortion illegal will end abortion once and for all. In countries all over the world where abortion is illegal, abortion remains a leading cause of death among women. Nearly 70,000 women worldwide die every year from unsafe, illegal abortions. Keeping abortion legal helps protect women from unsafe and unsanitary procedures at the hands of untrained practitioners.
Myth: Abortion causes a type of post-traumatic stress disorder. Though some argue that abortion can lead to severe negative reactions and poor mental health, the existence of “post-abortion syndrome” is not recognized by any medical or psychological organization. The American Psychological Association has stated that severe negative psychological reactions after abortion are rare, and that no scientific evidence exists to suggest that abortion leads to an increase in mental health problems.
Types Of Abortion Procedures
Drs. Nauser and Fowler perform two types of procedures in our office:
D&C Procedure (First Trimester)
A D&C procedure, also known as a vacuum aspiration procedure, is the abortion procedure typically performed during the first trimester. A woman is considered to be in the first trimester of pregnancy if fewer than 14 weeks have passed since her last menstrual period.
A D&C, which stands for dilation and curettage, is an extremely safe procedure and the most common one performed in our office. During a D&C procedure, your doctor will numb your cervix with a local anesthetic. The doctor will then gradually dilate the cervix by inserting narrow, tapered rods. A small tube called a cannula is inserted into the uterus and connected to a suction device. The contents of the uterus are suctioned through the tube. The doctor will then check the wall of the uterus to make sure no tissue remains. The abortion procedure itself takes only about a minute. Some women have discomfort similar to menstrual cramps during the procedure, and sometimes for an hour or so afterward.
D&E Procedure (Second Trimester)
The other type of abortion procedure performed in our office is a D&E procedure, or a dilation and evacuation. Less than 5 percent of abortions in the United States are performed between 15 and 21.6 weeks of pregnancy, and most of these are performed using a D&E procedure.
The D&E procedure is an extension of the D&C procedure described above; however, the cervix must be dilated wider so that the doctor can use forceps as well as suction to remove the contents of the uterus. Your doctor will insert a medical product known as a laminaria stick into your cervix. Laminaria sticks are rods made of sterile seaweed. Over the course of several hours, the rods absorb moisture and expand, dilating the cervix.
The actual D&E procedure takes approximately 3 to 5 minutes. You may be given intravenous medication in addition to local anesthetic to make you more comfortable during the procedure.
The Abortion Pill (Medical Abortion)
A medical abortion is the ingestion of medication to end an early pregnancy. Our office offers medical abortion up to 9 weeks 6 days into pregnancy.
Medical abortion consist of these steps:
- Doctor Nauser or Fowler will give you the pill, Mifeprex, at the time of your appointment. This pill works by blocking progesterone. This causes the lining of the uterus to break down, and the pregnancy to stop growing.
- 48 hours after you take the Mifeprex you will take a second medicine, Misoprostol. This medication will cause the uterus to empty itself of the dead pregnancy. You will experience cramps and bleeding, usually lasting a few hours.
- Follow-up: You must return for your follow-up appointment 14 days after you take the second medication to ensure the abortion is complete.
What To Expect During Your Abortion Procedure
We want you to be physically and emotionally comfortable during your appointment. We have structured your time with us to provide all the medical and psychological attention you will need. Your visit with us will take about an hour, and will include:
- Testing: We will do a sonogram to accurately determine the length of your pregnancy. Dr. Nauser or Fowler will then talk with you about the abortion procedure and perform a brief physical examination.
- The procedure itself: The doctor will give you a local anesthetic to minimize discomfort during the abortion procedure. The D&C aspiration procedure takes about one minute; a D&E procedure takes 3 to 5 minutes, but more time may be needed to dilate your cervix.
- Recovery: After the abortion procedure, you will rest in the procedure room. You will receive written abortion aftercare instructions and will be given take-home medications at no additional charge.
Abortion Cost
Please contact our office for more information regarding abortion cost. You will need to bring enough funds with you to pay for your procedure at the time of your appointment.
Abortion Side Effects
After your abortion procedure, you will receive written aftercare instructions to follow for the next several weeks. Please follow your doctor’s instructions carefully to prevent potential complications.
Some side effects after an abortion procedure are normal. It is important to listen to your body for the next several days and contact our office if you experience any symptoms that may be alarming.
Bleeding After Abortion
Some bleeding for a week or two after an abortion is normal. This is not a regular menstrual period, but the effects of hormonal changes occurring in your body. The bleeding may stop for a short period of time and then start up again. If you are experiencing very heavy bleeding (soaking through a regular pad every hour), call our office immediately at 913-491-6878.
Complications of Abortion
Complications after abortion are very rare. If you should develop any of the following complications, please contact our office immediately:
- Heavy, bright red bleeding
- Severe cramping
- Chills or a fever higher than 100.6⁰ F
- Passage of bright red blood clots larger than an egg
- Foul-smelling or greenish vaginal discharge
After An Abortion
Before you leave our office, we will schedule you for a follow-up appointment by one of our practitioners within 2 to 3 weeks after your procedure. There will be a nominal charge for this exam. It is important to keep this appointment to ensure there are no unexpected complications after your abortion procedure. Do not use tampons or have intercourse until you have been seen for your follow-up appointment.
We have just done a surgical procedure on you, so it is desirable that you have the exam here in our office for continuity of care and to be sure that all is back to normal. However, you may choose to have a follow-up appointment with your regular family doctor. If this is the case, you may want to determine that your regular doctor is supportive of your decision to have an abortion. Your doctor will need to be aware of your full medical history. Please inform us if you plan to see a different provider for your follow-up exam.
Sex and Birth Control After An Abortion
After an abortion, you can ovulate at any time. It is possible to get pregnant almost immediately after an abortion, so it is important to continue using a reliable contraceptive method. If you need assistance with birth control or are interested in long-term birth control or permanent birth control, please let us know. In some cases, we may be able to place an IUD at the same time as your abortion procedure. If you are using a birth control pill, we recommend you use a backup method for the first 4 weeks after your abortion. Start your contraceptive method on the date you were instructed, even if you are still bleeding. Call our office at 913-491-6878 if you have any questions.
If you would like to continue the birth control method we started you on today, we must have a current Pap smear on file. You can bring a copy of your most recent Pap smear to your post-op check up, or we can do a Pap smear at that time. You may also sign a release with our receptionist today, and we will obtain a copy of your medical records from your doctor’s office. We are using the newest type of liquid-based Pap smear that can also do a reflex test for HPV — the virus known to cause abnormal cells and cervical cancer.
Getting Your Period After An Abortion
After an abortion, you will begin a new menstrual cycle. You should expect to have a regular period in 4 to 8 weeks.
Depression After An Abortion
Some women report feeling angry, sad, or guilty immediately after an abortion. However, serious emotional problems or depression after abortion are rare. There is no scientific evidence to support the idea of “post-abortion syndrome.”
If you feel like you need someone to talk to after an abortion, you may want to talk to a supportive friend or family member or even a licensed professional. Our office can provide you with a referral for a licensed counselor or support group.
Information on Abortion Procedures – Informed Consent
According to Kansas state law, at least 24 hours prior to an abortion procedure, patients must receive information on a variety of topics related to having an abortion. This includes:
- The name of the physician who will perform the abortion (Dr. Traci Nauser or Dr. Tristan Fowler).
- A description of the proposed abortion method.
- Description of the risks related to the proposed abortion method.
- A handbook titled, If You Are Pregnant.
- Directory titled, If You Are Pregnant: Directory of Available Services.
- The probable gestational age of the fetus at the time the abortion is to be performed.
- The probable anatomical and physiological characteristics of the fetus at the time the abortion is to be performed.
- The medical risks associated with carrying a fetus to term.
- Any need for Anti-Rh immune globulin therapy.
ACCORDING TO KANSAS LAW:
- INFORMATIONAL MATERIALS are available in printed form and online at www.womansrighttoknow.org and www.kansaswomansrighttoknow.org, describing the unborn child and listing agencies which offer alternatives to abortion with a special section listing adoption services, and a list of providers of free ultrasound services.
- ALTERNATIVES to ABORTION include: parenting, foster care and adoption. Medical assistance benefits may be available for prenatal care, childbirth, and neonatal care. More detailed information on the availability of such assistance is contained in the printed informational materials you received from Center for Women’s Health, or online at the following sites: www.womansrighttoknow.org and www.kansaswomansrighttoknow.org,
- “…the father of the unborn child is liable to assist in the support of her child even in instances where he has offered to pay for the abortion…”
- “…the abortion will terminate the life of a whole, separate, unique, living human being…”
- “…the woman is free to withhold or withdraw her consent to the abortion at any time prior to the invasion of the uterus without affecting her right to future care or treatment and without the loss of any state or federally funded benefits to which she might otherwise be entitled…”
- “…No person shall perform or induce an abortion when the unborn child is viable (>22 weeks) unless such person is a physician and has a documented referral from another physician not legally or financially affiliated with the physician performing or inducing the abortion and both physicians determine that: 1) the abortion is necessary to preserve the life of the pregnant woman; or 2) a continuation of pregnancy will cause substantial and irreversible impairment of a major bodily function of the pregnant woman…” And, “…No person shall perform or induce a partial birth abortion on a viable unborn child (>22 weeks) unless such person is a physician and has documented referral from another physician not legally or financially affiliated with the physician performing or inducing the abortion and both physicians determine that: 1) the abortion is necessary to preserve the life of the pregnant woman; 2) a continuation of pregnancy will cause substantial and irreversible impairment of a major physical or mental function of the pregnant woman…” If the child is born alive, the attending physician has the legal obligation to take all reasonable steps necessary to maintain the life and health of the child…”
- Per Kansas Law Section 1. K.S.A. 2016 Supp 65-6709 amended 7/1/2017, The following will be received by a patient seeking a pregnancy termination at least 24 hours before the procedure. This shall be provided on WHITE PAPER in a printed format in BLACK INK with 12 –POINT TIMES NEW ROMAN font via the practice website: www.hodesnauser.com. Traci L Nauser, MD will be the physician who is to perform the abortion. She received her medical degree in 1994. She has been employed at the Center for Women’s Health since August 1, 1998. Dr. Nauser has had no disciplinary action by the Kansas Board of Healing Arts. Dr. Nauser carries malpractice insurance as required by the state of Kansas. She has clinical staff privileges at Menorah Medical Center (August 26, 1998), Saint Luke’s South Hospital (January 1, 1999), and Overland Park Regional Medical Center (September 4, 1998). She has not lost privileges at any hospital. Dr. Nauser is a resident of the state of Kansas.
Per Kansas Law Section 1. K.S.A. 2016 Supp 65-6709 amended 7/1/2017, The following will be received by a patient seeking a pregnancy termination at least 24 hours before the procedure. This shall be provided on WHITE PAPER in a printed format in BLACK INK with 12 –POINT TIMES NEW ROMAN font via the practice website: www.hodesnauser.com. Tristan Fowler, DO will be the physician who is to perform the abortion. He received his medical degree in 2016. He has been employed at the Center for Women’s Health since August 2020. Dr. Fowler has had no disciplinary action by the Kansas Board of Healing Arts. Dr. Fowler carries malpractice insurance as required by the state of Kansas. He has clinical staff privileges at Menorah Medical Center (September 16, 2020), Saint Luke’s South Hospital (September 23,2020). He has not lost privileges at any hospital. Dr. Fowler is a resident of the state of Missouri.
Notice
It is against the law for anyone, regardless of their relationship to you, to force you to have an abortion. By law, we cannot perform an abortion on you unless we have your freely given and voluntary consent. It is against the law to perform an abortion on you against your will. You have the right to contact any local or state law enforcement agency to receive protection from any actual or threatened physical abuse or violence. You have the right to change your mind at any time prior to the actual abortion and request that the abortion procedure cease. It is unlawful for anyone to make you have an abortion against your will, even if you are a minor. The father of your child must provide support for the child, even if he has offered to pay for an abortion. If you decide not to have an abortion, you may qualify for financial help for pregnancy, childbirth and newborn care. If you qualify, Medicaid will pay or help pay the cost of doctor, clinic, hospital and other related medical expenses, including childbirth delivery services and care for your newborn baby. Many agencies are willing to provide assistance so that you may carry your child to term, and to assist you after your child’s birth.
Abortion Aftercare Instructions
Be sure to listen to your body for the next few days. What you are experiencing could be normal. If you have questions, be sure to call our office at 913-491-6878. Failure to call us may lead to a delay in the proper treatment and could cause further complications. You may not hold us responsible for problems or other medical expenses if you obtain treatment elsewhere, without our prior instruction to do so. Patients are often given wrong information by well-meaning friends, an emergency room doctor, or other health care sources. Please call our office first if you have any questions or problems.
Keep active following the procedure. Do not go home and go to bed. Resume your normal activities immediately. If you have a long car ride home, plan to stop and walk every hour. To eliminate uterine clots, it will help if you massage or rub your uterus from time to time.
Complications after D&Cs are very rare. You can prevent infection or other problems by following the instructions we give you and by using good common sense. Do not use tampons, and change your pads frequently.
In order to prevent infection, do not use tampons, douche, take tub baths, swim or have sex (even sex with condoms) until your 2-3 week post-op check-up. In addition, take all of the antibiotics that you are given. Do not take the antibiotic with dairy products. The antibiotic can make your skin more sensitive to the sun, so use caution outdoors. If you have been given any other medication, take as directed.
It is common to have light bleeding or spotting on and off for a week or two after the procedure. This is not a menstrual period, but the effects of hormonal changes and your uterus going back to its normal size. The bleeding may be red to brown to almost black. It can occur daily, or stop for a day or two, then start up again unpredictably — all of this is normal. If you have started a birth control method, keep using it as directed. However, if the bleeding is heavy (soaking through a regular pad every hour) call the office immediately at 913-491-6878.
If you experience any of the following problems, call our office at once:
- Heavy bright red bleeding (over 1 regular pad per hour)
- Severe cramps not relieved by rubbing and massaging your uterus, and taking 800mg of ibuprofen (4 Motrin® or 2 Aleve® tablets), especially if you are not bleeding at all – Tylenol®, Midol®, or Pamprin® do not work nearly as well
- Passage of bright red blood clots larger than an egg
- A foul-smelling, or greenish vaginal discharge
- Fever of over 100.6°F (Don’t guess — use a thermometer)
When calling after regular business hours, make sure you properly enter your phone number as prompted by our answering service. Turn off your answering machine and/or call blocking. Do not go to an emergency room without calling our office first.
If we do not return your call in 10 to 15 minutes, please call back. When you call the office, be prepared with the phone number of a pharmacy that is open, in case we need to call in a prescription for you.
ABORTION APPOINTMENT REQUIREMENTS
You have scheduled a surgical procedure in our office.
The following medical and legal requirements must be met in order to proceed:
- Completely fill out, at least 24 hours in advance, the State of Kansas paperwork and consent FORMS, and bring all of them with you. The forms are available by clicking the Continue button below. Print these forms out prior to calling to schedule your appointment. You will need information from the forms when scheduling the appointment. Do not FAX to us. Failure to have the forms printed on white paper with black ink and filled out at least 24 hours prior to your appointment will require a rescheduling of your appointment.
- You should arrive 30 minutes early for pre-op processing. If you are coming from out of town, allow yourself plenty of drive time. Please use MapQuest to plan your route to our office. Patients who are late are subject to rescheduling.
- Bring proper PHOTO-ID for the patient; and, if a minor, their legal guardian’s photo ID is also required. A copy of a court-approved legal document proving the relationship is necessary if the last names are different. Clarify these details with our office in advance. A Notarized “authorization” DOES NOT meet the legal requirements necessary to prove a parental relationship.
- Bring enough funds to pay for the procedure, PLUS $150 extra to pay for a possible “RhoGam” injection for patients discovered to have RH-Negative blood type.
- Often, the sonogram shows that the patient is 3-5 weeks further along than the last menstrual period. We advise you to bring enough funds to cover a pregnancy termination up to 4 weeks further than the last period calculates. Check with our office regarding these fees BEFORE you arrive.
- All fees are due in full at the time of the appointment; and are payable by Cash, MasterCard, Visa, or Discover.
- NO personal checks or Money Orders are accepted. Patients unable to pay in full will be rescheduled.
- Often, the sonogram shows that the patient is 3-5 weeks further along than the last menstrual period. We advise you to bring enough funds to cover a pregnancy termination up to 4 weeks further than the last period calculates. Check with our office regarding these fees BEFORE you arrive.
- If you are greater than 15 weeks pregnant, you must have an early morning appointment, plus an afternoon appointment. You must have a driver.
- If you live more than a 45 minute drive from the office, our office policy requires that patients needing a 2-day procedure must stay overnight at a hotel or motel within 10 miles of the office. A printed receipt proving you have paid for the night stay is required before any portion of the appointment can begin. You must have a driver.
- To avoid rescheduling, please comply with the above requirements. If you have questions, please call the office at 913-491-6878