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Pregnancy Info
A missed period is the most common indicator that you might be pregnant. Other common symptoms may include: Frequent Urination, Nausea, Breast Tenderness, Dizziness, Change of Appetite.

If you think you are pregnant, make an appointment or come by. We provide complimentary pregnancy testing. Our pregnancy tests are up to 99% accurate and done in a clinical and private setting.

A positive pregnancy test suggests a high probability that you are pregnant. However results should be confirmed by a physician or by obtaining a limited ultrasound.

As a licensed community clinic we can provide a limited ultrasound exam for you at no charge, after you have been evaluated by one of our nurses. The limited ultrasound may confirm the pregnancy, or it may indicate likelihood of your pregnancy ending naturally by miscarriage. If this is the case there is no need for the cost and pain associated with an abortion procedure. Each year 15-20% of pregnancies end in miscarriage.

What should I expect when I come to alternatives?
Your visit will last approximately one hour. You will meet with a counselor
and a medical professional in a confidential setting. A trained medical professional will perform an hCG urine pregnancy test.

What does hCG have to do with pregnancy tests?
Human chorionic gonadotropin, or hCG, is a hormone produced by the placenta.
Urine-based pregnancy tests analyze the presence of hCG. The appearance and increased levels of hCG provide an excellent indicator of pregnancy. hCG is released into the mother's circulation almost immediately after implantation (5 - 8 days after conception). hCG is produced in minute amounts and then, rising exponentially, the concentration doubles approximately every 2.2 days.

Do all pregnancy tests have the same sensitivity to hCG?
No. There are many types of tests on the market for both professional and home use. They have different sensitivity levels for detecting hCG. Some over-the-counter home tests may not pick up the presence of hCG until well after the first missed period.

How early can a pregnancy test give positive results?
Because our urine test is so sensitive, it may show a positive result as early as 4 days before your next expected period. Although the test picks up the presence of hCG (pregnancy hormone), it does not guarantee a viable pregnancy. For a diagnosis of a viable pregnancy a limited ultrasound can be obtained at our clinic with no charge to you. It is important to have a diagnosis of a viable pregnancy before moving forward with an abortion you may not need.

What if my pregnancy test is positive?
If your pregnancy test is positive, the nurse will take your vital signs and if your last period was at least seven weeks ago, an ultrasound may be performed during the same visit.

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Ultrasounds

Why do you perform ultrasound examinations?
At alternatives, limited obstetrical ultrasounds are performed to indicate the following:

  • Confirm pregnancy
  • Detect fetal heart motion
  • Determine fetal age in weeks
  • Determine estimated date of confinement (due date)
  • Determine location of pregnancy (intrauterine/ectopic)

The ultrasound examination is not intended to diagnose any abnormalities and/or problems you or your baby may have at this early stage.

Does everyone get an ultrasound?
Ultrasounds are considered a medical procedure and thus you must be evaluated by a medical professional before the scan can be done.

Do I need to prepare for an ultrasound?
Our staff will provide you with pre-instructions for your exam. However, should you have an ultrasound on your first visit you should wear a loose-fitting two-piece outfit to your appointment. This will prevent you from having to re-adjust your clothing during the exam.

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Morning After Pill (Plan B)

Q: What about the “Morning After Pill”?
Before taking the “morning after pill”, you should understand what it is, how it works, and how it could affect your health. or make an appointment and one of our staff will be happy to give you more information.

What is it?
The “morning after pill” or Plan B is a large dose of oral contraceptive that is actually 2 tablets, one taken within 72 hours of intercourse and the second 12 hours later. It is not RU-486.

How does it work?
Plan B is believed to act as an emergency contraceptive principally by preventing ovulation or fertilization. In addition it may act as an abortifacient by inhibiting implantation. It is not effective once the process of implantation has begun.

Things to consider:

  • Emergency contraception is not effective if a woman is already pregnant.
  • Plan B does not protect against HIV infection (AIDS) and other sexually transmitted infections.
  • The most common side effects in the Plan B clinical trial were nausea, abdominal pain, fatigue, headache, and menstrual changes.
  • The manufacturer warns that Plan B is not recommended for routine use as a contraceptive.

Source: Manufacturer's Prescribing Information for Plan B (Levonorgestrel) tablets, 0.75 mg. Mfg. by Gedeon Richter, Ltd., Budapest, Hungary for Duramed Pharmaceuticals, Inc., Subsidiary of Barr Pharmaceuticals, Inc., Pomona, NY 10970. Revised Feb 2004. BR-038 / 21000382503

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What is an abortion?

Abortion is the termination of a pregnancy. It can be induced (abortion) or spontaneous (miscarriage). There two types of induced abortion: Medical and Surgical.

What are some of the possible side effects of abortion?

  • Cramping of the uterus, or pelvic pain
  • Diarrhea
  • Headache
  • Dizziness
  • Fatigue
  • Emotional or psychological distress
  • Abdominal pain and cramping
  • Nausea
  • Vomiting

What are the risks of abortion?

The risks for any anesthesia include:

  • Allergic reactions to medications
  • Problems breathing

The risks for any surgery include:

  • Hemorrhaging (bleeding)
  • Infection

Additional risks of surgical abortion include:

  • Excessive bleeding
  • Infection of the uterus
  • Infection of the fallopian tubes (which can cause scarring and cause infertility)
  • Puncture (perforation) of the uterus
  • Scarring of the uterine lining (suction tubing, curettes, and other abortion instruments may cause permanent scarring of the uterine lining)
  • Damage to the cervix (creating complications with future pregnancies)
  • Death, in rare circumstances

Other risks include:

  • Hemorrhaging requiring treatment with an operation
  • Incomplete removal of the fetus, placenta or contents of the uterus which leads to sepsis sometimes leading to death.

In cases when a medical abortion fails to terminate the pregnancy, a surgical abortion will become necessary to complete the abortion.

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Abortion procedure

If you are considering an abortion, it is important to be educated concerning all aspects of the procedure. Abortion, whether medical or surgical, comes with risks to the mother. You should also consider that miscarriage, or natural loss of the pregnancy, is very common. According to the American College of Obstetricians and Gynecologists (ACOG), an estimated 15-20% of all clinically recognized pregnancies will naturally end in a miscarriage.

If you would like to speak to someone regarding abortion and/or alternatives, please contact us to make an appointment or . We provide free and confidential services to empower you in the decision making process.

Medical Abortion
A medical abortion causes the termination of a pregnancy by using a combination of medications. The protocol approved by the Food and Drug Administration allows a medical abortion up to 49 days (7weeks) after the last menstrual period. Ultrasound is used to determine if the pregnancy is in the uterus and the gestational age obtained will ensure the 49 days is adhered to.

The current regimen approved by the FDA includes one dose (three pills) of mifepristone (RU-486). These pills block the effects of progesterone, altering the blood supply to the uterus and placenta, and cutting off the supply of blood and nourishment to the developing embryo.

After taking the mifepristone, a woman will return to the doctor two days later and be administered misoprostol, also called Cytotec™, either by mouth or by inserting it in the vagina to make the uterus contract and empty. It normally takes about 6-24 hours after taking the misoprostol for the abortion to be complete. (It is reported that some doctors give their patients these pills to take at home, but that is not what the FDA recommends.)

A third visit to the doctor confirms that the abortion is complete, but 5-8 percent of women will still be pregnant. If the medical abortion is incomplete, a surgical abortion will be necessary as well, to avoid complications like excessive bleeding or infection. Bleeding may occur for weeks after the medical abortion. Always follow your doctor’s instructions concerning the amount of bleeding that needs follow-up. Medical attention may become necessary.

Surgical Abortion Suction Aspiration
(Also called Manual Vacuum Aspiration)

This method is used early in the first trimester. The cervix is stretched open with dilators (metal rods). A hollow plastic tube is inserted into the uterus. The fetus and the remaining contents of the uterus are removed using a handheld suction device.

Dilation and Curettage (D&C) with Vacuum Aspiration
(Also called Suction Curettage)

This is the most common surgical procedure usually used between 6 and 14 weeks. Because the baby is larger, the doctor normally opens the cervix with dilators (metal rods) and then empties the uterus with a hollow plastic instrument connected by tubing to a suction machine. Local or general anesthesia is available to control physical pain. The doctor may then scrape the walls of the uterus with a curette, a loop-shaped knife, to ensure the fetus, placenta, and contents of the uterus have been completely removed.

Dilation and Evacuation (D&E)
This surgical procedure is generally performed from 13-24 weeks of pregnancy. The doctor must first insert laminaria (thin sticks of seaweed) into the cervix for 1-2 days to start the dilating process. These dried seaweed sticks absorb moisture and expand, causing the cervix to enlarge. On the day of the procedure, the physician will use dilating rods to further enlarge the cervical opening. The fetus is dismembered and removed with forceps, along with the placenta and other tissue. A curette may then be used to scrape the uterus to make sure that all tissue has been removed. It is important that all of the fetal parts are identified to help ensure a complete abortion.

Dilation and Extraction (D&X)
This procedure is used for 20 weeks to full term. This procedure takes three days. During the first two days, the cervix is dilated and medication is given for cramping. On the third day, the woman receives medication to start labor. After labor begins, the abortion doctor uses ultrasound to locate the positioning of the fetus. Using forceps the fetus is delivered up to the head. Next, scissors are inserted into the skull to create an opening. A suction catheter is placed into the opening to remove the skull contents. The skull collapses and the fetus is removed.

Anesthesia for Surgical Abortion
Three options are available for pain relief during a surgical abortion:

  1. Local anesthesia: A local anesthetic is injected into the cervix to cause a numbing effect before dilation.
  2. Local anesthesia with sedation: Along with a local anesthetic injected into the cervix, a medication usually oral) is given to help the woman relax or become “sleepy” during the procedure.
  3. General anesthesia: Anesthetic medications are given intravenously to cause the woman to be “asleep”, completely unaware of her surroundings.

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Abortion Providers

Q: What questions should I ask when consulting an abortion provider?
When considering an abortion, it is important to realize it is not a risk-free procedure and needs to be treated seriously. For your safety and future reproductive health, there are several very important questions to ask an abortion provider.

Is this facility a licensed medical clinic?
What are my legal rights?

To receive more information on patients rights, you may contact alternatives for a confidential consultation. (make an appointment, ) Remember, we are here to help.

Is the person performing the procedure a licensed OB/GYN physician?
Make sure to speak with the physician before going through with the procedure regarding anesthesia choices, how the procedure is done, and the possible complications.

References

  1. RU-486-know the facts about the “abortion pill” before you decide, FOF 2007, F00903T
  2. American College of Obstetricians and Gynecologists Induced Abortion, 2001.
  3. Warren Hern, Abortion Practice, 1990, Philadelphia: J.P. Lippincott Company
  4. Before you decide, 2007 Care Net