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?"
"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.
"I recently had an abortion, and I'm struggling. Are there resources to help me?"
"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.
"Is my gynecologist required to tell my parents?"
"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.
"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.
"Are staff trained to help patients in case they're not sure?"
"How much do abortions cost?"
"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.
"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.
"is abortion free when you are a minor?"
"What can I do if I want an abortion, but it's still illegal in my country?"
"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.
"If you have an abortion, does that go into your personal files? Who would know that I've had an abortion, assuming I choose not to tell?"
"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.