It's hard to ignore that we are at a pivotal moment in history in terms of women's reproductive rights. But in addition to being an issue at the forefront of this year's election, abortion is also a very real experience that people face on a deeply personal level.
That's why, earlier this month, Refinery29 teamed up with Tumblr to open the floor to any questions you might have about abortion. We set up our Tumblr ask box, you asked the tough questions, and we recruited a panel of experts to answer them.
Among those experts were: Kristine Kippins, a federal policy counsel with the Center for Reproductive Rights, Jack Qu’emi Gutierrez, a writer and educator with We Testify and the National Network of Abortion Funds, Yamani Hernandez, executive director of the National Network of Abortion Funds, Judy Waxman, a healthcare law and policy expert, and Sara Imershein, MD, MPH, a board-certified OB-GYN.
After receiving over a thousand questions, we, along with our panelists, carefully combed through them to choose the ones best suited to their expertise.
Overall, we wanted you to be able to learn more about the issues facing people who are considering getting an abortion, have had an abortion, or simply want to learn more about the option of getting one. With that in mind, we also chose to pay special attention to the practical problems facing those who are seeking an abortion (how do I pay for it? how much does it cost?).
You can take a look at all the answers on our Tumblr, but we've also chosen 10 standout questions and answers for you ahead. Click on to learn more about any concerns you might face while considering an abortion.
"I'm having an abortion tomorrow. Is there a place I can get support?"
"Before an abortion, you will undergo extensive counseling to obtain your medical history, determine gestational age, and review your options, including continuing a pregnancy to birth and parent[ing], or adopt[ion], and the pregnancy termination options. These will be reviewed without judgement to help YOU decide the right course for you. Abortion clinics have trained staff who inform you, answer your questions, and support you during the procedure, if you choose. Some facilities have dedicated ‘doulas’ trained specifically to offer support during abortion procedures." — Dr. Sara Imershein, board-certified OBGYN
"I’m glad we can be here to offer some information! A lot of people feel alone at the time of their abortion, and if information and support can help you, I’m so glad we’re able to offer it. There are definitely resources for support during and after your abortion. Check out Backline. They offer...a nonjudgmental talkline where you can call and discuss any questions or feelings you’re having. You can also check out this article on what to expect when having an abortion. They’re a really great group that can help you talk through any confusing stuff you’re feeling, any emotions you need to get out, and really help you feel less alone. They also have great resources to point you towards, like a community of people of faith who support your decision to have an abortion. You can also share your story at We Testify. A lot of people report feeling better once they’ve told someone else about their abortion, even anonymously. Often, it’s not the abortion that makes us feel bad, but feeling like you don’t have anyone to talk to about it. You’ll find there’s a whole bunch of great people who’ve had abortions, who love you and trust your reasons, and want to welcome you to this community." — Yamani Hernandez, executive director, National Network of Abortion Funds
Illustrated by: Abbie Winters
"How does abortion work? Like, the operation?"
"Abortions are completed with one of two methods: medication or a simple procedure. Medication is given to stop the pregnancy from growing, and additional medication causes the uterus to contract and expel the uterine lining normally lost during menses, along with the pregnancy tissue. The process occurs over one to two days, and oral pain medication is provided. Using medication for abortion is approximately 95-97% effective, less effective with increasing gestational age. In the few cases when medication alone doesn’t work, the alternative office procedure is performed to complete the abortion.
"Alternatively, a first trimester abortion may be accomplished by a simple two- to five-minute procedure, which is not surgery. There is no cutting or suturing, and the procedure can easily be accomplished in a medical office or dedicated facility. The opening to the uterus, or cervix, is gently stretched, sometimes aided by medication to soften the cervix. Then, usually, a thin, hollow tube is inserted, and the lining of the uterus, which a woman would lose during her normal menstrual flow, is gently removed by aspirating the tissue, along with the pregnancy. The process is quick and nearly 100% effective. Both methods are extremely safe, far less risky than childbirth." — Dr. Imershein
Illustrated by: Abbie Winters
"I recently had an abortion, and I'm struggling. Are there resources to help me?"
"First, thank you for sharing your experience with us. Abortion experiences can bring up a lot of feelings, especially because we’re often dealing with many of the situations surrounding the abortion itself. Most people, 95%, feel that abortion was the right decision for them and don’t regret it. Often, talking about your abortion with a loved one or friend can help and give you space to process your experience. You can also call Backline and talk to their counselors about your experience. They will offer a nonjudgmental listening ear. Their number is (888) 493-0092. If you want to read abortion stories to know that you aren’t alone, check out We Testify and the 1 in 3 Campaign." — Jack Qu'emu Gutierrez, We Testify, National Network Of Abortion Funds
"Even when a decision is right for you, it is not uncommon to think, what if? This is also true of many decisions we make in life. I call these 'what if' fantasies, rather than doubts. When asked, a 70-year-old woman told me about her illegal abortion before Roe. When figuring when it happened, she responded not with her age, nor the year…but told me how old the child of that never-completed pregnancy might have been. And she also never regretted her decision; at the time [of the abortion], she had three teenagers.
"Still, knowing these thoughts are common may not help you address your discomfort. Good for you for having insight to see you are not quite back to normal. You can give it time…but, here are free resources available:
EXHALE After Abortion Talkline: 1-866-4-EXHALE (1-866-439-4253)
Faith Aloud, Faith-Based Hotline: 1-888-717-5010
National Abortion Federation’s 'What Should I Expect After Abortion' Aftercare & Follow-Up page. Look under 'Emotions.'" — Dr. Imershein
Illustrated by: Abbie Winters
"Is my gynecologist required to tell my parents?"
"This is a common concern for young people, and you are entitled to respectful and medically accurate answers to your questions. You are entitled to confidentiality, but sometimes if you’re on a parent’s insurance, you do have to ask about the procedures the office follows. While Health Insurance Portability and Accountability Act, also known as HIPAA, keeps your health information safe, it may show up on the explanation of benefits, which is sent to the health insurance policyholder — often a parent, guardian, or partner. Before taking a pregnancy test, you can ask your gynecologist’s office or any place that offers pregnancy tests how it will show up on the insurance paperwork and whether they call your parents. If they do, there are places where you can get a free, confidential pregnancy test so it won’t show up on your insurance. If you’re searching for a free pregnancy test, be aware that there are places called Crisis Pregnancy Centers that will lie to you about abortion and your pregnancy options. Steer clear and instead go to a local Planned Parenthood." — Hernandez
"Each State has its own regulations regarding parental notification. You can find an overview and specific laws pertaining to where you live at Guttmacher.org. Where notifying a parent is required, there must be a ‘judicial bypass’ procedure for minors who fear for their safety if forced to obtain parental permission. In most states, mothers at any age can consent to care for themselves and their minor children. (For medical care, a 16-year-old mother is not a minor, but an adult, who can consent for her own, or her child’s, medical care). The rules may be different for contraception, abortion, and access to STI testing or treatment in each state.
"However…once you involve a third-party insurer (your parents’ insurance company), the insurance company will notify the primary insured (the parent, whose insurance is a benefit of their employment, and covers a dependent child) that a payment for health services has been made. This is true for all health services for the dependent spouse or child. The exact procedure, or contraception, or routine exam, or evaluation for infection, or an abortion, may not be listed, but the charges, the amount paid…and the healthcare provider who receives payment is reported to the 'primary insured,' your working parent. So, the report of payment won’t say you had an abortion, but it will say the doctor or office practice received payment for 'medical services.' Fortunately, federally supported Title X clinics, and many others, have a sliding scale for fees for all patients and only consider a young person’s income — not their parents' — to preserve privacy.
"Federal law prohibits funds from paying for abortion services, with few exceptions. However, 17 states use State Medicaid funds for abortions, most under court order. And Guttmacher.org explains that many States have passed laws limiting private insurance coverage for abortion services." — Dr. Imershein
"There are different answers to the questions about parents’ involvement in a minor child’s abortion.
"A medical provider cannot tell a patient’s parents about the results of an abortion test or the abortion itself. The patient’s medical records are confidential. There are some things to watch out for, however. Some insurance companies automatically send a notice to the policy-holder every time anyone in their family has any medical service that the insurance plan covers. It is possible that a parent could receive a form that says 'we paid for this person in your family to get services from this specific doctor.' Maybe your parents don’t even look at these forms when they come, but maybe they do.
"There are no federal laws controlling parental involvement in a child’s abortion, but a majority of states have some requirements. While there are no laws that require your parents to be notified of a test or test result, some states require that one (11 states) or both (one state) parents be notified if their child seeks an abortion. Other states require that one (18 states) or both parents (three states) give their consent to the abortion. Five states require both notification and consent. Almost all states that require parental notification and/or consent allow you to get permission from a judge to not tell your parents if there are significant reasons why you cannot tell them. Also, many states have exceptions in the case of an emergency or abuse. Check out Guttmacher.org for information on which states have which requirements." — Judy Waxman, healthcare law and policy expert
Illustrated by: Abbie Winters
"Are staff trained to help patients in case they're not sure?"
"YES, YES, YES. A colleague who works at a pro-choice adoption agency recently confirmed that supportive, patient-centered, non-directional options counseling is strongest at dedicated abortion facilities. Abortion providers want to help patients determine what they want, and we want each person to be sure. We want to empower individuals to know there is no right or wrong decision, but rather help you make your best decision." — Dr. Imershein
Illustrated by: Abbie Winters
"The cost of an abortion varies by many factors, including where you live, what type of abortion you need, and how far along in the pregnancy you are. The median cost of a medical abortion (taking the pills) is around $500. Surgical abortions (a doctor using aspiration) costs more, depending on the factors above.
"The most common reasons for abortions are: I can’t afford a child right now. I am not ready to be a parent. I have to take care of the children I already have.
"Most likely, your insurance will cover your abortion. Traditionally, all plans cover abortion as a medical service like any other. In general, it is up to the insurance company as to whether or not this coverage is included. In recent years, some states have begun to restrict abortion in a variety of ways, including prohibiting insurance coverage. Ten states now ban insurance coverage of abortion. You should check with your insurance plan to be sure." — Waxman
"The average abortion costs $450 to $550 for a first-trimester termination with medication or a same-day procedure. Costs go up with gestational age and pain-relief options. There are funds available for women who do not have adequate resources." — Dr. Imershein
"The cost of an abortion depends on how far a long your are in your pregnancy, if you have sedation or need additional tests, and if you need additional funds to cover travel costs to get to the clinic or a hotel when staying overnight...due to a mandatory waiting period. Abortions can start around $400. While most people pay for an abortion out of pocket, your insurance may cover the procedure, so you should check with your insurance provider. If you have trouble paying for an abortion, a local abortion fund might be able to assist you in covering your procedure. Visit the National Network of Abortion Funds’ website or the National Abortion Federation’s website for more information.
"People seek abortions for a variety of reasons, and often for several reasons. According to research from the Guttmacher Institute, three-quarters of patients say that they are unable to afford a child and feel that they would be unable to take care of children and other family members if they continued the pregnancy. Two thirds of people having an abortion are already parents, thus their decision to have an abortion is often made to ensure they are able to care for the children they already have." — Hernandez
Illustrated by: Abbie Winters
"is abortion free when you are a minor?"
"No, but funds to help pay may be available." — Dr. Imershein
"Abortion is not free when you’re a minor. If you’re having trouble coming up with the money you need to get your abortion, make sure you tell your clinic and ask if they have any discounts they can help with or resources they can point you to. Also, your local abortion fund may be able to help you. Lastly, if you feel like you can safely ask your parents, friends, or family for assistance, you should try to have that conversation. A lot of times, minors assume that their parents will be angry, embarrassed, or frustrated with them, or even stop loving them, because they got pregnant or want an abortion. But even if there’s a difficult conversation, families and friends usually come through as an important support system, both financially and emotionally. And many parents who find out after an abortion often most regret not being able to offer love and support during your difficult time, like Renee’s parents. If it’s safe to talk to them, your family might surprise you with their support. If you don’t feel like it’s safe to talk to your parents because of abuse, make sure you ask your clinic about what the local laws are for minors in your state, and what resources are available to help you through the process." — Hernandez
Illustrated by: Abbie Winters
"What can I do if I want an abortion, but it's still illegal in my country?"
"Accessing an abortion in countries where it is illegal can be a challenge, but is not impossible. Women on Waves and Women on Web might be able to help you. They help people who need abortions in countries where abortion is illegal. If they are unable to help you, they might be able to point you to someone local who can." — Hernandez
Illustrated by: Abbie Winters
"How do you use abortion pills? And does it hurt?"
"The ‘abortion pill’ mifepristone is available only by prescription, but cannot be obtained from a pharmacist. A physician must order the medication directly from the manufacturer. After thorough and complete non-directional, patient-centered options counseling, patients who qualify may opt for medication abortion.
"The pill is swallowed by the patient under the clinician’s direct supervision; 24 to 48 hours later, at a convenient time in a safe location, four tablets of misoprostol previously given to the patient is taken by dissolving the pills in the cheeks over 30 minutes. The medication is rapidly absorbed and usually causes uterine cramping to expel the pregnancy over several hours. Usually stronger than menstrual cramps, the pain is very variable, and oral pain medication is provided." — Dr. Imershein
Illustrated by: Abbie Winters
"An abortion is a medical procedure, which is part of your medical records. The confidentiality of medical records is protected by federal law. No one can see them except you and your medical providers." — Waxman
"All your medical care is always recorded at the facility where you receive care, and by each individual who contributes to your care (takes your blood pressure, or evaluates a blood test in the lab, for example). The record is maintained by the healthcare facility securely, on paper or electronically, per federal privacy laws called HIPAA. When you first go, the health care facility will ask you to sign a form stating you were offered a copy of these privacy policies.
"The only way to access your records is if you give written permission, with rare exception for YOUR health. Aggregate data for quality assurance (with your private information scrubbed) may be collected. Your employer can NEVER access your records without permission, except possibly in cases of workman’s compensation. But your employer may receive aggregate data on payments made by your insurance company for medical services for all employees. If you do not use your employer-based insurance, then your employer wouldn’t know, because the insurance company contracted for your health coverage never makes a payment.
"According to the Guttmacher Institute, 67% of women seeking abortion services have insurance, including Medicaid, although abortion may not be covered; 57% percent of patients pay cash for their abortions without using insurance or accepting aid. About 10% of insured women do not use their insurance, presumably because of stigma or concerns about confidentiality.
"And certainly, future employers have no access to your records, nor right to request any personal medical data." — Dr. Imershein
Illustrated by: Abbie WintersLike what you see? How about some more R29 goodness, right here?
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