Reproductive health studies show that approximately one-quarter to one-third of pregnant adolescents choose to undergo pregnancy termination, also known as abortion (I will use the terms interchangeably.) Abortion is a highly emotional topic in the United States, and there is a wide range of opinions on its morality. This post is not intended to address the ethics of abortion, nor to be a recommendation to keep or end a pregnancy; only a person in that situation can know what is right for them. This post aims to help parents and teens have accurate information about the types of medical procedures and resources available to them. (I should note that Seattle Children’s Hospital does not provide any prenatal or pregnancy care, and that includes pregnancy terminations.)
If your teen chooses to seek an abortion, she has different options based on the length of the pregnancy. If the decision has been made, it’s important to seek the procedure as soon as possible. The majority of teens seek abortion services in the first 15 weeks, so I will be focusing on terminations that occur in that time range. After 15-16 weeks, it is possible to have a safe and effective abortion, but finding a provider is more challenging and the procedure may be more complicated. This link gives basic medical information about termination procedures after 15-16 weeks.
Finding a Clinic: A quick Google search will familiarize you with the clinics in your area that offer abortion services. In a major metropolitan area like Seattle, there may be many options to choose from; in a rural area, the closest clinic may involve long travel times. Look for a clinic run by one or more licensed providers- a Medical Doctor, Nurse Practitioner, or Physician Assistant. Planned Parenthood, which offers pregnancy terminations as well as reproductive health, women’s health, and cancer screening services, is a long-standing and respected organization present in every U.S. state. No matter where you choose to go, you and your teen should feel comfortable and respected at the clinic you attend. If you are uncomfortable or disturbed by the actions of clinic staff, stop the appointment immediately and seek services elsewhere.
Types of Terminations: The two main types of terminations are medical and surgical. This link compares both types, and contains information you and your teen may want to consider in choosing between them. Both types will involve a discussion with a health care provider of pregnancy options and medical history. A urine or blood pregnancy test will be obtained, and possibly an ultrasound if the length of the pregnancy needs to be established.
Parental Notification and Consent: Depending on what state you live in, there may or may not be parental notification and/ or consent requirements. There may also be a mandatory waiting period- usually 24 hours from the first appointment to the procedure- or other counseling that health care providers are required to give. This chart lists the requirements in each state.
What to Expect After the Procedure: After the termination, your teen may have some bleeding and cramping for up to 4-6 weeks, starting with bleeding that is heavier than a menstrual period, and diminishing to slight spotting. It’s very important that she finish the antibiotic course, to avoid infection, and follow up with the provider as instructed. The provider will give information about when to contact the clinic, but as a general rule, fever, very heavy bleeding (completely soaking a jumbo pad or tampon in less than 2 hours), nausea and vomiting, and/ or foul-smelling vaginal discharge mean your teen needs medical help as soon as possible.
Safety: Less than 0.5% of women have complications that require intensive medical or surgical interventions. Your provider can talk to you in more detail about any safety concerns. Questions have been raised in the past about abortion being linked to an increased risk for breast cancer, or mental health complications. Studies have shown that neither of these links are statistically valid. In addition, a pregnancy termination does not statistically increase the likelihood of fertility problems in the future. We still don’t know whether multiple (3 or more) abortions might have effects on future pregnancies. However, if your teen has a pregnancy terminated, it’s time to explore effective birth control so they aren’t faced with an unwanted pregnancy again. Talk to your provider about effective birth control methods, like Implanon or an IUD.
Keep the lines of communication open after the procedure, and check in with your teen over the coming months. Some teens may continue to process their experience over time, and have questions, thoughts, or fears they want to discuss with you. Let them know you support and love them, and you are happy to talk about this (or any other subject) whenever they need you.