Summary For The Hard Of Seeing
Preface: ("...and now a word from our Sponsor...) (faustian opinions)
Preface: ("...and now a word from our Sponsor...) (faustian opinions)
A. Medi-Cal
(3) Volunteers
B. Atypical
"Butchers..."
"...we're open"
No, really.
Just in case you were kept from getting all the facts, we did some research and made this document. Just in case you thought there were no other options.
These are real options.
This document includes links to hotlines and websites and all sorts of detailed awesome shit if you want to check any info anybody thinks we got wrong. Because we didn't. We made sure of that.
If you don't have another child now you always can later (and don't take yourself to Dr. LostVet23 to get fixed), but if you do...you've surely thought about the flip side of that coin.
If you don't want to have another child right now, we're willing to help. Specifically, we are willing to
- share our house with you,
- share our money with you, and
- share our time with you,
if it will make the difference for you. Now, granted, we won't take you in permanently, but would you want that? Sheesh. And yes, you may have to pay some of it back, but we don't want to control you either, and you know that already.
What you may not know: You can stop the cycle.
That's what this presentation is about.
We can figure shit out, really, if you don't want to give in (and your mother will get over it).
If you'd like to have another child, bully for you, but the following is info if you don't, or don't know.
1. Ethical aspects – Countering Misinformation
There's a lot of bullshit out there. Here are peer-reviewed scientific facts.
A. Fetal pain?
The following is from http://www.ansirh.org/research/late-abortion/countering-misinformation.php
Based on the best available scientific evidence, a human fetus probably does not have the functional capacity to experience pain until the 29th week of pregnancy at the earliest. The “Putting Women First” initiative was developed to meet the need for clear information and to disseminate existing scientific evidence to counter the misinformation that exists on fetal pain issues. Materials developed by this project include:
Additional resources:
Can fetuses feel pain?
Derbyshire SW. BMJ. 2006 Apr 29;332(7548):1036.
Derbyshire SW. BMJ. 2006 Apr 29;332(7548):1036.
Fetal Pain, A Systematic Multidisciplinary Review of the Evidence
Lee SJ, Ralston HJ, Drey EA, Partridge JC, Rosen MA. JAMA. 2005 Aug 24;294(8):947-54.
Lee SJ, Ralston HJ, Drey EA, Partridge JC, Rosen MA. JAMA. 2005 Aug 24;294(8):947-54.
Fetal Pain: Do We Know Enough to Do the Right Thing?
Derbyshire SWG. Reproductive Health Matters. May 2008 (Vol. 16, Issue 31, Supplement, Pages 117-126, DOI: 10.1016/S0968-8080(08)31370-6)
Derbyshire SWG. Reproductive Health Matters. May 2008 (Vol. 16, Issue 31, Supplement, Pages 117-126, DOI: 10.1016/S0968-8080(08)31370-6)
Fetal Awareness -
Review of Research and Recommendations for Practice
Royal College of Obstetricians and Gynaecologists, March 2010.
Review of Research and Recommendations for Practice
Royal College of Obstetricians and Gynaecologists, March 2010.
Summary of Scientific Evidence on Fetal Painsubmitted to Nebraska legislature
A Shift in Sensory Processing that Enables the Developing Human Brain to Discriminate Touch from Pain
Fabrizi L, Slater R, Worley A, Meek J, Boyd S, Olhede S, Fitzgerald M.Curr Biol. September 27, 2011 (Vol. 21, Issue 18, pp. 1552-1558).
See also summaries and discussions of this study:
Fabrizi L, Slater R, Worley A, Meek J, Boyd S, Olhede S, Fitzgerald M.Curr Biol. September 27, 2011 (Vol. 21, Issue 18, pp. 1552-1558).
See also summaries and discussions of this study:
A Sensitive Time in Development
Talkington, Megan. Pain Research Forum. September 19, 2011.
Talkington, Megan. Pain Research Forum. September 19, 2011.
Fetuses Cannot Feel Pain Until 35 Weeks, According To Study
Marty, Robin. RH Reality Check. September 9, 2011.
Marty, Robin. RH Reality Check. September 9, 2011.
B. Post-abortion syndrome?
The following is from http://www.ansirh.org/research/late-abortion/countering-misinformation.php
Mental health issues and abortion
The myth of “post-abortion syndrome”
The concept of “post-abortion syndrome” as a traumatic response to abortion is a myth, developed by those who seek to discourage women from choosing abortion as an option when faced with an unwanted pregnancy. See a summary of expert research on “post-abortion syndrome.”
According to the American Psychological Association, various factors, such as emotional attachment to the pregnancy, lack of support, and conservative views on abortion, may increase the likelihood of experiencing negative reactions. Studies have either failed to establish a causal relationship between abortion and negative psychological symptoms experienced by women, or been inconclusive.
The myth that abortion causes depression
In 2008, a team at Johns Hopkins University in Baltimore reviewed 21 studies involving more than 150,000 women, and determined: “The best quality studies indicate no significant differences in long-term mental health between women in the United States who choose to terminate a pregnancy and those who do not.” Dr. Robert Blum, the senior author on the study, stated: “The best research does not support the existence of a ‘post-abortion syndrome’ similar to post-traumatic stress disorder.” Read the report.
Additional resources
· Psychological factors in abortion: a review
Adler NE, et al (1992). American Psychologist 47(10): 1194-1204.
Adler NE, et al (1992). American Psychologist 47(10): 1194-1204.
· Abortion and long-term mental health outcomes:
a systematic review of the evidence
Charles VE; Polis CB; Sridhara SK; Blum RW (2008). Contraception78: 436-450.
a systematic review of the evidence
Charles VE; Polis CB; Sridhara SK; Blum RW (2008). Contraception78: 436-450.
· Comment: post-abortion trauma
David HP (Spring, 1996). Abortion Review Incorporating Abortion Research Notes 59: 1-3.
David HP (Spring, 1996). Abortion Review Incorporating Abortion Research Notes 59: 1-3.
· Unwanted pregnancy, mental health and abortion:
untangling the evidence
Dwyer JM, Jackson T (2008). Aust New Zealand Health Policy 5: 2.
untangling the evidence
Dwyer JM, Jackson T (2008). Aust New Zealand Health Policy 5: 2.
· Abortion Study Finds No Long-Term Ill Effects
On Emotional Well-Being
Edwards S (1997). Fam Plann Perspect 29 (4): 193-194. doi:10.2307/2953388.
On Emotional Well-Being
Edwards S (1997). Fam Plann Perspect 29 (4): 193-194. doi:10.2307/2953388.
· Is there an “abortion trauma syndrome”? Critiquing the evidence
Robinson GE, Stotland NL, Russo NF, Lang JA, Occhiogrosso M (2009).Harv Rev Psychiatry 17(4):268-90. Review.
Robinson GE, Stotland NL, Russo NF, Lang JA, Occhiogrosso M (2009).Harv Rev Psychiatry 17(4):268-90. Review.
· Psychological aspects of unwanted pregnancy and its resolution
Russo NF. In Abortion, Medicine, and the Law (4th Ed., pp. 593-626), J.D. Butler and D.F. Walbert (eds.). New York: Facts on File, 1992.
Russo NF. In Abortion, Medicine, and the Law (4th Ed., pp. 593-626), J.D. Butler and D.F. Walbert (eds.). New York: Facts on File, 1992.
· Do Depression and Low Self-Esteem Follow Abortion Among Adolescents? Evidence from a National Study
Warren JT, Harvey SM, Henderson JT (2010). Perspectives on Sexual and Reproductive Health 42(4):230–235, doi: 10.1363/4223010
Warren JT, Harvey SM, Henderson JT (2010). Perspectives on Sexual and Reproductive Health 42(4):230–235, doi: 10.1363/4223010
C. Viability?
The following is from http://www.ansirh.org/research/late-abortion/countering-misinformation.php
A discussion of “viability”
In the 1973 Supreme Court decision that legalized abortion in the United States, the Roe v. Wade decision determined “viability” as a critical marker for finding a balance between the right of a woman to end an unwanted pregnancy and the interests of the state:
“With respect to the State’s important and legitimate interest in potential life, the ‘compelling’ point is at viability. This is so because the fetus then presumably has the capability of meaningful life outside the mother’s womb. State regulation protective of fetal life after viability thus has both logical and biological justifications. If the State is interested in protecting fetal life after viability, it may go so far as to proscribe abortion during that period, except when it is necessary to preserve the life or health of the mother.”
While the Court identified “the end of the second trimester” as the point of “viability,” they provided no guidance as to the method of determining the gestational age of the pregnancy. Some states have enacted laws defining this point as 24 or 26 weeks; in April 2010 the Nebraska State Legislature identified 20 weeks as the point at which women could no longer choose an abortion.
However, there is no clear legal or medical definition of “viability.” During debates in Great Britain about whether to lower the gestational age of legal abortion from the existing limit of 24 weeks, the issue of viability was considered by the Commons Science and Technology Committee. The Committee found that “while survival rates at 24 weeks (the current upper limit for abortion) and over have improved since 1990, survival rates (viability) have not done so below that gestational point.” The Committee concluded that there was no scientific basis—on the grounds of viability—to reduce the upper time limit from 24 weeks.
The British Medical Association also weighed in during this debate. “It is the BMA’s view, based on the peer-reviewed published UK data, that there is no evidence of significant improvements in the survival of extremely preterm infants to support reducing the 24-week limit for legal abortion.”
Additional resources
2. Late-term abortion
Epner JE, Jonas HS, Seckinger DL. Journal of the American Medical Association 1998;280:724-9.
Epner JE, Jonas HS, Seckinger DL. Journal of the American Medical Association 1998;280:724-9.
3. The EPICure study: outcomes to discharge from hospital for infants born at the threshold of viability
Costeloe K, Hennessy E, Gibson AT, Marlow N, Wilkinson AR.Pediatrics 2000;106:659-71.
Costeloe K, Hennessy E, Gibson AT, Marlow N, Wilkinson AR.Pediatrics 2000;106:659-71.
4. Neurologic and developmental disability after extremely preterm birth
Wood NS, Marlow N, Costeloe K, Gibson AT, Wilkinson AR. EPICure Study Group. New England Journal of Medicine 2000;343:378-84.
Wood NS, Marlow N, Costeloe K, Gibson AT, Wilkinson AR. EPICure Study Group. New England Journal of Medicine 2000;343:378-84.
5. The EPICure study: associations and antecedents of neurological and developmental disability at 30 months of age following extremely preterm birth
Wood NS, Costeloe K, Gibson AT, Hennessy EM, Marlow N, Wilkinson AR. Archives of Disease in Childhood Fetal & Neonatal Edition2005;90:F134-40.
Wood NS, Costeloe K, Gibson AT, Hennessy EM, Marlow N, Wilkinson AR. Archives of Disease in Childhood Fetal & Neonatal Edition2005;90:F134-40.
6. Neurologic and developmental disability at six years of age after extremely preterm birth
Marlow N, Wolke D, Bracewell MA, Samara M. New England Journal of Medicine 2005;352:9-19.
Marlow N, Wolke D, Bracewell MA, Samara M. New England Journal of Medicine 2005;352:9-19.
7. Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies)
Costeloe KL, Hennessy EM, Haider S, Stacey F, Marlow N, Draper ES.BMJ 2012;345:e7976.
Costeloe KL, Hennessy EM, Haider S, Stacey F, Marlow N, Draper ES.BMJ 2012;345:e7976.
8. Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies
Moore T, Hennessy EM, Myles J, Johnson SJ, Draper ES, Costeloe KL, Marlow N. BMJ 2012;345:e7961.
Moore T, Hennessy EM, Myles J, Johnson SJ, Draper ES, Costeloe KL, Marlow N. BMJ 2012;345:e7961.
2. Providers
There are quite a few clinics that take Medi-cal for abortions up to 24 weeks.
The following info is from:
*ACCESS: Women's Health Justice </> *
1.800.376.4636
Www.Accesswhj.org
The providers below are sorted by length of pregnancy. All take Medi-cal except the very last one on the list.
Up to 22 weeks
Family Planning Specialists Medical Group <#>
200 Webster Street
Oakland, CA 94607
510-268-3720
M-F 8:30am-5pm/ Sat varies
about 89 miles from the location you entered
Surgical Abortion: yes from 4 to 22 weeks
Medical Abortion: yes until 9 weeks
Accepted Payment Methods: credit cards
Accepted Types of Medi-Cal: Emergency, Managed Care
Languages: English, Spanish
Up to 23 weeks
Stanford Gynecology Clinic <#>
900 Blake Wilbur Drive
Palo Alto, CA 94304
650-725-6079 opt 1
Monday - Friday 8 am - 430 pm
about 107 miles from the location you entered
Surgical Abortion: yes from 4 to 23 weeks
Medical Abortion: yes from 4 to 6 weeks
Accepted Payment Methods: checks, credit cards
Accepted Types of Medi-Cal: Emergency, Managed Care
Languages: English
Santa Clara Valley Medical Center <#>
751 South Bascom Avenue
San Jose, CA 95128
1-888-334-1000, 408-885-5550
M-W 8:30am-9pm, Th, Fri 8:30am-5pm
about 109 miles from the location you entered
Surgical Abortion: yes from 8 to 23 weeks
Medical Abortion: no
Accepted Payment Methods: checks, credit cards
Accepted Types of Medi-Cal: Emergency, Managed Care
Languages: English
Up to 24 weeks
Choice Medical Group Sacramento <#>
2322 Butano Dr.
Sacramento, CA 95825
1-800-338-1361, Kaiser patients: 916-483-2885
M-F 9am-4pm
Surgical Abortion: yes from 3 to 24 weeks
Medical Abortion: yes until 8 weeks
Accepted Payment Methods: credit cards
Accepted Types of Medi-Cal: Emergency, Managed Care
Languages: English,Spanish
Pregnancy Consultation Center <#>
5301 F Street #10
Sacramento, CA 95819
916-446-0222, 1-800-954-2464
M-F 8:30am-4:30pm
Surgical Abortion: yes from 5 to 24 weeks
Medical Abortion: yes from 5 to 8 weeks
Accepted Payment Methods: credit cards
Accepted Types of Medi-Cal: Emergency, Managed Care
Languages: English,Spanish,Hmong
Choice Medical Group Fremont <#>
1895 Mowry Ave
Fremont, CA 94538
510-792-3398, 800-338-1361
Surgical Abortion: yes from 4 to 24 weeks
Medical Abortion: yes until 8 weeks
Accepted Payment Methods: credit cards
Accepted Types of Medi-Cal: Emergency, Managed Care
Languages: English,Spanish
Women's Options Center, San Francisco General Hospital <#>
1001 Potrero Avenue, Ward 6G
San Francisco, CA 94110
415-206-8476
M-F 8am-5pm
Surgical Abortion: yes from 5 to 24 weeks
Medical Abortion: yes until 9 weeks
Accepted Payment Methods: credit cards
Accepted Types of Medi-Cal: Emergency, Managed Care
Languages: English,Spanish
Choice Medical Group San Jose <#>
2365 Montpelier Drive
San Jose, CA 95116
1-800-338-1361, 408-272-9244
M-Fri 8:30am-5pm;
about 104 miles from the location you entered
Surgical Abortion: yes from 5 to 24 weeks
Medical Abortion: yes from 5 to 9 weeks
Accepted Payment Methods: credit cards
Accepted Types of Medi-Cal: Emergency, Managed Care
Languages: English,Vietnamese,Chinese, Mandarin, Spanish
Up to 26 weeks
Boulder Abortion Clinic, P.C. [This is the ONLY NON-MEDI-CAL ON THIS LIST]
Warren M. Hern, M.D., M.P.H., Ph.D.
1130 Alpine Avenue
Boulder, Colorado 80304
1-800-535-1287, 1-303-447-1361
M-F 9am-5pm MDT
Warren M. Hern, M.D., M.P.H., Ph.D.
1130 Alpine Avenue
Boulder, Colorado 80304
1-800-535-1287, 1-303-447-1361
M-F 9am-5pm MDT
Surgical Abortion: yes from 5 to 26 weeks
Accepted Payment Methods: credit cards
Accepted Types of Medi-Cal:NO [but alternate funding options may be available.]
Languages: English,Spanish
3.Funding
A. Medi-Cal
Expedited medi-cal signup and funding is available for pregnant women, even if you have other insurance, here's how.
California’s state Medicaid program is called Medi-Cal. The requirements and enrollment process will vary depending on the county where you live. Medi-Cal covers abortion.
If you are receiving Social Security Income or CalWORKS, you automatically receive Medi-Cal and do not need to apply separately.
There is a separate Medi-Cal program just for pregnant women and it is often much faster and easier to get onto this program than regular Medi-Cal. This program covers abortion. The program is sometimes called Medi-Cal for Pregnancy, the 200% program, Restricted Medi-Cal for Pregnancy, or the Pregnant Women’s Program.
YOU ARE ELIGIBLE IF:
· your income is within 200% of the Federal Poverty Guidelines, AND
· you are pregnant (you do not need to provide proof of pregnancy; you can simply say that you are pregnant)
PROOF OF CITIZENSHIP: You do NOT need to provide proof of citizenship if you are applying for Medi-Cal for Pregnancy. Sometimes Medi-Cal eligibility workers get this wrong, though. If you run into a problem with someone asking you for proof of citizenship, you can call your local abortion fund, ACCESS, for help: 1-800-376-4636 (English) or 1-888-442-2237 (español).
REQUIRED DOCUMENTS:
· Proof of identity AND
· Proof of income
HOW TO APPLY: Go in person to your nearest county office. A list of offices where you may apply for Medi-Cal is available here.
You may also go to a hospital or clinic where county eligibility workers are located.
When applying for Restricted Pregnancy Medi-Cal, you do not need to say that you plan to have an abortion.
You also may download an application online.
CONTACT INFORMATION:
Find out the phone number of your local county office here.
If you would like advice or counseling on how to apply for Medi-Cal, you may call ACCESS, a non-profit reproductive justice organization, at 1-800-376-4636 (English) or 1-888-442-2237 (Spanish)
B. Alternate Funding
Even if you can't get Medi-cal, which you can right now here's other funding.
The three organizations below offer private, donation-based funding to help women who otherwise could not afford safe and legal abortion.
National Abortion Federation
For unbiased information about abortion and about other resources, including financial assistance through their Rachel Falls fund and other options, call toll-free 1-800-772-9100
Weekdays: 7:00 A.M.-11:00 P.M. Eastern time
Saturdays and Sundays: 9:00 A.M.-9:00 P.M.
Weekdays: 7:00 A.M.-11:00 P.M. Eastern time
Saturdays and Sundays: 9:00 A.M.-9:00 P.M.
Women's Reproductive Rights Assistance Project (WRRAP)
No matter where you live in the US, the Women's Reproductive Rights Assistance Project (WRRAP) may be able to help you pay for your abortion if you need assistance. You must be at least 10 weeks pregnant to use this Fund. Ask your clinic to contact the fund for you. WRRAP does not work directly with patients.
If you need help finding a clinic, click here.
Our Story
The Women's Reproductive Rights Assistance Project (WRRAP) is an all-volunteer organization created in 1994 by the Los Angeles section of the National Council of Jewish Women to raise money for low-income women of all ages, ethnicities and cultural backgrounds who are unable to pay for either emergency contraception or a safe and legal abortion.
Our Community
Every year, WRRAP helps over 1000 women who otherwise could not have paid for their abortions.
Make a Difference Fund
858-210-5798 | http://www.makeadifferencefund.org/
No matter where you live in the U.S., the Make a Difference Fund may be able to help cover some of the cost of your abortion.
First, schedule your appointment with a clinic. Next, ask the clinic to contact the fund directly at 858-210-5798 or by email at makeadifferencefund@yahoo.com to see whether there is money available. They can help with anywhere from $50 to $200.
Click here if you need help finding a clinic.
Our Story
The Make A Difference Fund is an all-volunteer organization that helps women all across the United States cover the cost of an abortion. The volunteers and individuals who generously donate their time and money to the MADF support reproductive healthcare for all and believe access to safe abortion care is an important part of reproductive healthcare.
Our Community
Last year, the Make A Difference Fund helped over 200 women afford abortions that they needed.
4. Transportation
A. Local
45 minutes (walk, bus,walk) every ½ hour from about 6 to 6 to Roseville Amtrak. Sucks to Sac Amtrak, like 2 1/2 hours. Amtrak goes twice in the a.m. from Roseville Station to Sac Station for $11.
B. Distance
(1). Amtrak
From Roseville Station to Oakland 9 times/day for $29. Once in the Bay Area you can get anywhere in the Bay Area easily.
(2). Bus
(a). Greyhound
Departs Roseville at 9:25 am and 5:40 pm to Sacramento for $11, 35 minutes, and to Oakland, $17, 3 hrs.
(b). Other
Magabus.com 4 times/day to SF for $7 to $12 from Sac. Once in the Bay Area you can get anywhere in the Bay Area easily.
C. Volunteers
Since transpo is semi-sucky there, volunteer rides might be possible, at least to get to the train or what-have-you. See next section.
5.Other Practical Issues
ACCESS Women's Health Justice
1-800-376-4636 | http://accesswhj.org/
ACCESS provides free, confidential and nonjudgmental information, referrals, peer counseling and advocacy to women seeking abortion, and can help with paying for abortion care, lodging, meals, transportation and ultrasounds for women living in California. ACCESS volunteers also may be able to help provide rides, overnight housing, childcare, translation or other assistance.
Call or e-mail info@accesswhj.org if you need help. You may contact the fund even if you have not made an appointment yet.
6.The procedure – what to expect
A. Typical Later 2nd Trimester
This information is a general overview of what a woman can expect when having a later abortion. Most clinics that offer the procedure have detailed information on their websites about the specific protocols at that clinic.
Later abortions are done by a process called “Dilation and Evacuation” (D & E) or “Dilation and Extraction” (D & X).
At the first appointment, the woman is given an ultrasound, counseling and a medical examination. Cervical dilation is begun with the use of osmotic dilators. Osmotic dilators that are used most commonly may be either sterile sticks of compressed seaweed (called laminaria) and/or a synthetic get (Dilapan) that upon insertion will gradually swell in size. This process gently opens (dilates) the cervix. The number of osmotic dilators used and the time required for dilatation will depend upon the duration of the pregnancy and the individual woman’s body. Usually it takes 24-48 hours for the cervix to sufficiently open. During this time, some clinics offer counseling and/or support groups.
For the procedure itself, medicines are used for pain control and sedation. Most commonly, anesthesia medicines are administered intravenously in the arm, and local anesthesia is done by an injection into the cervix. The physician then removes the pregnancy through the cervix with a combination of suction aspiration and grasping instruments. The abortion itself generally takes about 10-30 minutes.
In other cases, clinics or hospitals may offer labor induction as the way to end a pregnancy. In most cases, after an ultrasound, counseling and a medical assessment, an injection is used to stop the fetal heart. After that, the woman receives medicines to get her to go into labor and deliver a dead fetus vaginally. This process may take anywhere from less than a day to several days. Sometimes, the labor process is made more rapid by taking mifepristone (the “abortion” pill) and then waiting a couple of days to get the body more ready to go into labor.
For labor induction terminations, the woman may be offered any type of pain control that would be used for a vaginal delivery. This may include intravenous or intramuscular pain and anti-anxiety medicines, or epidural anesthesia.
Compared to carrying a pregnancy to term and having a delivery, most later abortions present fewer risks of complications.
B. Atypical
This what one provider who performs abortions very late 2nd trimester (up to 26 weeks) does
Second trimester abortion (up to 26 weeks) patients also receive an ultrasound-screening exam at the very beginning of their appointment at Boulder Abortion Clinic. In this case, a more extensive examination is necessary. Among those features of the pregnancy evaluated at this time include the diagnosis of fetal age, which is made by measuring various parts of the fetus, such as head size and femur length, that give a precise knowledge of fetal age. Other evaluations include position of the placenta, the presence of, absence of, or unusual quantity of amniotic fluid, the presence of visible fetal anomalies, pathology such as fibroids in the uterine wall, and whether the fetus is alive or not.
Aside from variations in the content of educational and informed consent materials appropriate for the length of gestation, the second trimester patient experiences the same preoperative procedures as the first trimester patient. The main difference is that the second trimester patient experiences an extra day of laminaria dilation of the cervix. The second trimester abortion patient returns on the second or third day (depending on her exact length of gestation) for replacement of the original laminaria with several new laminaria in order to continue and enhance the process of cervical dilation. This procedure, done under local anesthesia, usually takes only a few minutes, but it is an essential step in the process to assure maximum safety. |
15 To 19 Weeks - Three Day Outpatient Procedure
|
From 15 through 19 menstrual weeks, the patient comes in at her appointed time for her abortion and is given a preoperative analgesic and sedative medication. In the operating room, the laminaria are removed and the cervix checked for adequate dilation. The amniotic sac is then ruptured with instruments under direct ultrasound vision. The purpose of this maneuver is to release all the amniotic fluid to the extent possible. This prevents the patient from experiencing an amniotic fluid embolism, in which the amniotic fluid can enter the bloodstream and cause death or serious complications. Because amniotic fluid embolism (AFE) is one of the most dangerous possible complications of pregnancy and abortion, Dr. Hern developed the technique of preventing this complication from happening.
After that, the uterine contents are evacuated surgically by using forceps and other instruments placed into the uterus through the vagina and cervix. An intravenous infusion (IV) is in place at this time so that the physician can give medication quickly for pain and to give medication that causes the uterus to contract as the abortion is completed Late second trimester abortion patients receive all of their preoperative evaluation and consultation on the first day of their appointment, and return on the second day for the initial steps of the abortion procedure. At 20 menstrual weeks and later, the first step in the abortion procedure on the second day of her appointment is an injection of medication into the fetus that will stop the fetal heart instantly. The patient is awake during this procedure, which is done under local anesthesia and with the use of direct ultrasound vision. The woman does not observe the fetus on the ultrasound screen in this process. The injection, done with strict attention to sterile technique, usually takes about ten minutes, although the appointment may take longer because of preparations that must be made. Following the injection into the fetus, the first laminaria is placed in the cervix. The patient may leave at that time and must stay in Boulder unless arrangements are made for the patient to stay in a neighboring town. On the third day, the late second trimester abortion patient returns for a brief appointment, at which time the first laminaria is removed and more are placed under local anesthesia. This process permits maximum gentle dilation of the cervix over a two-day period. On the fourth day, the patient returns for her abortion. Following observation of vital signs (blood pressure, temperature, and pulse), the laminaria are removed and a long-acting local anesthesia is again placed in the cervix. Under direct ultrasound vision, the amniotic membrane is ruptured so as to permit free flow of the amniotic fluid from the uterus. The amniotic fluid is drained as completely as possible.
Dr. Hern developed this technique for the following reasons:
· Removal of the amniotic fluid reduces if not eliminates the risk of amniotic fluid embolism (AFE), probably the most dangerous possible complication of late abortion.
· Release of the amniotic fluid allows the uterus to contract and become firm, reducing the risk of perforation of the uterus with instruments.
· Contraction of the uterus reduces blood loss.
· Release of the amniotic fluid and contraction of the uterus enhances movement of the fetus and placenta into the cervix, the opening of the uterus, thereby adding safety and reducing discomfort of the procedure.
This maneuver permits the accurate measurement of blood loss, which is usually minimal. However, heavy bleeding may occur in late abortion, and it is absolutely necessary to know accurately the volume of this bleeding in order to guide fluid or blood replacement if this should become necessary.* As with the earlier second trimester procedures (15-19 weeks), the later second trimester procedure (20-26 weeks) may require that the physician perform a surgical evacuation of the uterus ("dilation and evacuation" or "D & C") using instruments such as forceps to remove the fetus and placenta. All the other steps taken up to that point, such as use of laminaria, induced fetal demise, and medical induction, serve to enhance the safety of the late second trimester abortion procedure. The choice of procedures is dictated by the woman's safety needs at the time. |
7. Hotlines
A. ACCESS
ACCESS Women's Health Justice
1-800-376-4636 | http://accesswhj.org/
ACCESS provides free, confidential and nonjudgmental information, referrals, peer counseling and advocacy to women seeking abortion, and can help with paying for abortion care, lodging, meals, transportation and ultrasounds for women living in California. ACCESS volunteers also may be able to help provide rides, overnight housing, childcare, translation or other assistance.
Call or e-mail info@accesswhj.org if you need help. You may contact the fund even if you have not made an appointment yet.
Other services: Spanish speakers, Helps advise about Medical process, meals, childcare, ultrasound
Our Story
The vision for ACCESS, founded in 1993, was not only to provide information and practical support on all aspects of reproductive health, but to build a community actively working to meet the real needs of women. ACCESS removes barriers to sexual and reproductive health care and strengthens the power of California women and girls to demand equity and dignity.
Our Community
Last year, ACCESS helped over 1300 women with referrals, transportation, lodging, or abortion funding. Their bilingual Healthline connects women and girls throughout California to information, referrals and advocacy on sexual and reproductive health issues. ACCESS helps women navigate programs that pay for health care and are experts in offering resources for abortion, adoption, and parenting. When women are in need of housing, food or transportation to ensure timely access to abortion care, they connect them to a network of volunteers who can provide this support or to fund. ACCESS uses women’s stories to educate and train volunteers, the next generation of reproductive justice leaders.
How ACCESS can help
ACCESS Healthline – What we do and love
Are You...
Considering abortion or want to talk about your options?
Wondering how to pay for a pap smear or prenatal care?
Looking for a clinic that provides abortion or birth control?
Seeking an abortion doula?
Call Us! We can Help.
English 1.800.376.4636
Español 1.888.442.2237
The heart of our work is our bilingual ACCESS Healthline, and it is a crucial link to resources for women in need of reproductive healthcare. We provide free and confidential information, referrals, advocacy and peer counseling on the full range of reproductive and sexual health issues, with a special expertise in pregnancy options and abortion services.
Call us if you have questions regarding:
Abortion
Birth control
Abortion Doula Support
Pregnancy
Prenatal care
Emergency Contraception
Pap smears
Infertility
STIs & HIV
Adoption
Midwifery
Teen Health
Safer Sex and Relationships
Health Insurance
Where to find a reproductive healthcare provider
We connect women with free and low-cost programs that pay for this care, such as FamilyPACT, Medi-Cal or AIM (Access for Infants and Mothers). We also refer to organizations that can help with other issues such as domestic violence, sexual assault, drug addiction, homelessness and child care. We offer a dedicated full-time Spanish healthline and additional languages may be provided.
We may also be able to help with transportation, housing or funding if you have to travel a long way to get to an abortion provider. Our services are open to all women and men living in California -- your age, income, insurance or immigration status does not matter!
B. National Abortion Federation Hotline
The NAF Hotline is available to answer any questions you may have about abortion, unintended pregnancy, or related issues. The Hotline is free, completely anonymous, and offers services to everyone, regardless of their individual situation.
For unbiased information about abortion and about other resources, including financial assistance, call toll-free 1-800-772-9100
Weekdays: 7:00 A.M.-11:00 P.M. Eastern time
Saturdays and Sundays: 9:00 A.M.-9:00 P.M.
For referrals to quality abortion providers call 1-877-257-0012 (no funding assistance provided on this line).
Weekdays: 9:00 A.M. - 9:00 P.M.
Saturday: 9:00 A.M. - 5:00 P.M.
Weekdays: 7:00 A.M.-11:00 P.M. Eastern time
Saturdays and Sundays: 9:00 A.M.-9:00 P.M.
For referrals to quality abortion providers call 1-877-257-0012 (no funding assistance provided on this line).
Weekdays: 9:00 A.M. - 9:00 P.M.
Saturday: 9:00 A.M. - 5:00 P.M.
Services
The NAF Hotline is the only toll-free source of information about abortion and referrals to providers of quality care in the U.S. and Canada. We provide callers with unbiased, factual information about abortion in English, Spanish, and French. We receive thousands of calls a week from women, their partners, families and friends. The Hotline offers:
· Factual information about pregnancy and abortion
· Confidential, non-judgmental support
· Referrals to quality abortion providers in the caller's area (1-877-257-0012)
· Referrals to funding sources
· Help in understanding state abortion restrictions
· Case management and limited financial assistance for women in difficult situations
People who call the Hotline come from various backgrounds and situations. We are here to offer our assistance and resources because we believe all women should be treated with dignity and given the respect their individual situations deserve.
A lot of the info in this document came from visiting the links at the Backline website
1.888.493.0092 M-Th 5-10pm, F-Su 10am-3pm
Finding an Abortion Provider:
· Abortion Care Network: network of independent abortion providers
· National Abortion Federation: the NAF website offers maps that allow you to highlight clinics in your area while the NAF Hotline referral line 1-877-257-0012 provides referrals to member clinics in the U.S. and Canada (no funding assistance on this line).
· Planned Parenthood (look for clinics that list ‘abortion services’ among the services they offer)
· Abortion Clinics Online: lists abortion clinics in your area.
· Abortion Funding:
· National Network of Abortion Funds: The Network can help people who need financial assistance to obtain an abortion by connecting you to abortion funds in your area, and providing information about using Medicaid or insurance.
· National Abortion Federation offers unbiased information about abortion and financial assistance. Call toll-free 1-800-772-9100 (this is a different number than the one for referrals).
· Abortion Information:
· Abortion: Which Method Is Right For Me?: Provides information for people choosing between medication and aspiration abortion.
Abortion Stories & Experiences:
Project Voice hopes to establish a resource of sharing and support, and convey that abortion is a choice many women have made, and continue to make, for a variety of reasons.
The 1 in 3 campaign is a grassroots movement to start a new conversation about abortion — telling our stories, on our own terms.
45 Million Voices is a nonprofit organization dedicated to eliminating the stigma, shame, and silence surrounding abortion through education, empowerment, and sisterhood.
I’mNotSorry.net is a site where women can share their positive experiences with abortion. The stories posted on this site may contain graphic descriptions of medical procedures, as well as attitudes that may not be in current vogue.
After-Abortion Support:
· Peace After Abortion: If you are having distress after an abortion, you can begin the healing process by exploring these pages.
· Taking Care of Yourself After An Abortion: Northland Family Planning in Michigan has great information about taking care of yourself after an abortion, both physically and emotionally.
· Faith Aloud: is an organization of people of diverse religious faiths who support reproductive justice. Faith Aloud offers online resources and free telephone counseling with supportive religious clergy.
8. Social/Societal
Nothing can replace family and friends' support, but if they crap out remember:
Over 45 million have had abortions in the U.S. since 1973. About 1 out of 3 women has at least one in her lifetime.
The following websites are there to tell other women's stories with abortion, and to stare down society's attempt to stigmatize it.
9. After-abortion support
· Peace After Abortion: If you are having distress after an abortion, you can begin the healing process by exploring these pages.
· Taking Care of Yourself After An Abortion: Northland Family Planning in Michigan has great information about taking care of yourself after an abortion, both physically and emotionally.
· Faith Aloud: is an organization of people of diverse religious faiths who support reproductive justice. Faith Aloud offers online resources and free telephone counseling with supportive religious clergy.
10. Other questions
Maybe there are some things that weren't covered, or some personal or psychological things you're afraid to look silly asking. It's okay. Here are some thoughts.
· The hotlines (above) have probably answered any question that has been asked of them.
· Some friends are willing to do research and get answers, and will do their best to point you in the direction of answers to any question, even if they don't have them themselves. This is so important and we'll take it on as a sacred trust not to make fun of you or anything like that.
11. "but the Baby money" ....really?
The USA is a land full of right-wing motherfuckers (people who have sex with their own mothers), who could give a shit about children between birth and military draft age. Their hero, Ronald Reagan, partially got elected by making up the myth of the Welfare Queen getting rich from having babies. [This was a man even John Wayne took to task for lying.] So it's very doubtful the right wing motherfuckers (people who have sex with their own mothers), left a single stone unturned making damned sure there is zero actual advantage in benefits, after counting costs, to any additional child whatsoever.
Really.
Really.
However if you want to be sure, we will research the question and get back to you.
