Accessing Abortion in the Triangle

Edited by Carl Hintz

Republicans in North Carolina’s General Assembly are pushing through a 12-week abortion ban. North Carolina previously banned abortion after 20 weeks and six days, requiring a 72-hour waiting period, and requiring children (under 18 years) to have parent or guardian permission or a judicial bypass [abortionfinder.org]. North Carolina also requires doctors to read a script about abortion (The Guilfordian).

While there are many reasons a person may seek an abortion, one reason is because of sexual violence. According to the National Conference on State Legislatures, there are between 17,000 and 32,000 pregnancies in the US each year that resulted from sexual violence. Many cases of sexual violence are unreported and few of the cases that are reported result in convictions [rainn.org]. The court can only terminate parental rights in the small number of cases that result in a conviction [ncsl.org]. North Carolina Statute uses the term “forcible rape” which the National Alliance to End Sexual Vi olence says only acts to unnecessarily narrow protections for survivors. This is especially dangerous because perpetrators of sexual violence have a financial incentive to make custody claims, can use the child as a means of coercion over the survivor and as a means to maintain an abusive relationship.

The failure of the legal system to provide justice for survivors of sexual violence and the weaponization of custody law by perpetrators of sexual violence would be further compounded by a 12-week abortion ban, even one that claims to make exemptions for sexual violence. One way to help people who are seeking an abortion is to donate to an abortion fund such as carolinaabortionfund.org.

The following information is from abortionfinder.org and is for educational purposes, but should not be taken as medical advice.

Abortion providers in the Triangle

A Woman’s Choice of Raleigh
3305 Drake Circle, Raleigh

A Prefered Women’s Health Center
604 Jones Franklin Rd, Raleigh

Duke Family Planning Clinic
40 Duke Medicine Circle, Durham

North Durham Women’s Health
400-B Crutchfield St., Durham

Planned Parenthood Chapel Hill Health Center
1765 Dobbins Drive, Chapel Hill

Methods

There are two main ways abortion can be done: the abortion pill (also called medication abortion) and an abortion procedure (also called in-clinic abortion). Whether you have a medication abortion or an abortion procedure will depend on how far along you are in pregnancy, what the provider you choose offers, and also your own preference.

The abortion pill is generally available earlier in pregnancy. Each provider will have their own rules about how far along in pregnancy they’ll offer it—some will offer it through 13 weeks of pregnancy and others will stop offering it much earlier in pregnancy. Later on in pregnancy, your only option will be the abortion procedure.

Taking the Pill

Medication abortion is often called the abortion pill, but in reality, it’s not just one pill. And there are multiple ways to use abortion pills to have an abortion. Depending on availability and other factors, it’s possible to use only one type of medication for a medication abortion, but the most effective and common kind of medication abortion in the U.S. involves taking two different medications.

Your health care provider will give you the first of two medications and explain when and how you’ll take the second medication.

The first medication is called mifepristone. Mifepristone blocks the hormone progesterone. Because progesterone is necessary for pregnancy to continue, blocking it starts the process of ending the pregnancy. Mifepristone doesn’t usually cause any symptoms, so you probably won’t feel anything after you take it. Your provider will give you the second medication to take up to 48 hours later. Make sure to follow the instructions the provider gives you because they may differ from one provider to the next.

Up to 48 hours after taking mifepristone, you’ll take a dose (which is usually four tablets) of the second medication, called misoprostol. For this step, you need to be somewhere you can relax and where you’ll have easy access to a bathroom. Misoprostol empties your uterus, expelling the pregnancy. It causes cramping and bleeding.

You may take one or more doses of misoprostol depending on how far along you are and how your body responds to the first dose—your provider will let you know. Misoprostol starts working about 30 minutes to a few hours after you take it. When it kicks in, it’s normal to experience bleeding. The bleeding could range from medium to very heavy. You will likely pass some blood clots. You’ll also likely have cramps, which can be severe. You may also experience diarrhea or vomiting.

You can take over-the-counter pain medication, or your health care provider may prescribe a prescription-strength pain medication. But after a few hours, the symptoms will usually pass. Bleeding will decrease over the next few days. You can go back to work, school, taking care of your kids, or your other normal activities the next day. You can have sex again as soon as you’re ready.

You should get your next period within 6 weeks of having a medication abortion. If it’s been 8 weeks or more since your abortion, and you haven’t had a period, contact a health care provider.

Some health care providers will recommend a follow-up appointment a few weeks after your medication abortion to make sure the pregnancy is over. This appointment could take place via telehealth, a phone call, or in person, depending on the provider.

Just like with the abortion procedure, how much an abortion with the abortion pill hurts varies from person to person. The pain may last for several hours, as the abortion itself takes longer to be completed with the abortion pill than with the abortion procedure, which usually takes just a few minutes. You can take over-the-counter pain medications or your provider may prescribe pain medication for you to take at home. In addition to pain medicine, you may find that using a heating pad reduces pain. Other techniques like breathing exercises and meditation can also help with pain.

Your abortion provider should give you information about when and how to contact them after an abortion, but if they don’t, ask them for emergency contact information and for a list of things to watch out for.
Always reach out to your provider if something doesn’t feel right to you after an abortion or if you have questions or concerns.

Within 24 hours after you take the second medication (misoprostol), it’s normal to experience the following side effects: cramping, bleeding, fever, chills, nausea, vomiting or diarrhea.

What to look out for: If it’s been more than 24 hours since you took the second medication (misoprostol) and you are experiencing any of the following, contact your abortion provider: no bleeding yet, excessive bleeding (this means soaking two pads per hour for two hours. Keep in mind though that it is normal for bleeding to be heavy and for you to pass blood clots.), fever higher than 100.4 F, chills, nausea, vomiting, or diarrhea, pain that is getting worse or that isn’t going away with over-the-counter painkillers.

Sources: fayobserver.com, abortionfinder.org, guilfordian.com, ncsl.org, rainn.org