This page describes the medical process involved with an abortion so that people can make fully-informed decisions. Local clinics that provide abortion services are also listed.
What is a surgical abortion?
Legal abortion, carried out by trained medical practitioners, is one of the most common and safest surgical procedures. About 600,000 million Americans have induced abortions each year. Fewer than a quarter of a percent of all abortion patients experience a major complication associated with the procedure.
Abortion refers to the extraction of the contents of the uterus (uterine lining and implanted fertilized egg), which ends the pregnancy. In Rhode Island, surgical abortion procedures are performed in medical clinics rather than in a physician's office. Each clinic is inspected and regulated by the Rhode Island Department of Health in the same manner as hospitals and individual medical providers. In other states, abortion procedures may be performed by an individual physician in their office.
In early pregnancy, the procedure used most commonly in the US is vacuum aspiration (suction). The procedure itself takes about 10 minutes and is usually done with a local anesthetic, although sedation or general anesthetic may be requested. The cervix (opening to the uterus) has to be opened (dilated) enough for a small tube to fit in. The plastic tube is attached to a machine that creates a mild suction. With this suction, the doctor removes the endometrial lining of the uterus, the embryo, and the placenta. Vacuum aspiration abortions may be done from 5 to 16 weeks after the last menstrual period. For pregnancies beyond that point, which represent about 1/10 of the total abortions performed, other methods are used. Abortion is not performed before 5 weeks because the embryo is too small to ensure that all fetal material has been removed. Lab examination of the removed uterine contents helps to prevent incomplete abortions.
After any surgical abortion procedure, patients remain at the clinic for several hours so that their vaginal bleeding and health status can be monitored. An injection of antibiotics is often given after the abortion to guard against infection. Also routine is a discussion about contraceptive methods and giving the patient contraceptive supplies before the end of the visit. We encourage involvement of a friend, partner or family member throughout the abortion process, from the diagnosis of pregnancy through follow up after the procedure.
What is a medical abortion?
A medical abortion, often referred to as the "abortion pill," is an alternative to surgical abortion that was approved in the US by the FDA in September 2000. These medications are not the same thing as emergency contraception, also known as the "morning after pill." After a pregnancy is confirmed, a medical abortion is performed by administering prescription medications (either an injection or pills) that will induce an expulsion of the uterine lining and the implanted fertilized egg.
These medications (a combination of mifepristone and misoprostol or methotrexate and misoprostol) are collectively called RU-486. Mifepristone is more commonly used than methotrexate because it is more effective, more predictable and less toxic. It is the standard of practice to use the combination of mifepristone and misoprostol because of these differences. Given a choice mifepristone should almost always be used instead of methotrexate. As an abortion method, RU-486 can be used up to 10 weeks after the first day of your last menstrual period.
A medical abortion can take anywhere from 4-5 hours to a few days after after taking the medication, and requires a minimum of 2 visits to the clinic or medical office. These return visits are very important since there is no other way to be sure that the abortion has been completed. In the vast majority of cases, the expulsion will complete within a few days and most patients return to normal activities the day after a medical abortion. In the small percentage of cases (3-4%) where the medications do not result in a full abortion, a surgical abortion is needed to complete the process.
Is abortion legal in Rhode Island?
Yes. Abortion is legal, but there are restrictions if you are under 18. In Rhode Island, people under 18 are required to have the consent of one parent or legal guardian to have an abortion. If this is not possible, the state provides an alternative called "judicial bypass" which means you go to court to have a judge determine that you are mature enough to make this decision without a parent's consent. Local abortion clinics can link you to counselors trained to help with this process and to accompany you to court.
Does my health insurance cover the abortion procedure?
Call the clinic ahead of time to discuss insurance and payment. If you have the University-sponsored health insurance plan, you do not have to get a referral from Health Services in order to have the insurance cover your abortion services. Voluntary pregnancy termination is covered the same way as any other medical condition. Specific questions about the University-sponsored plan should be directed to the Office of Insurance and Risk at 401.863-1703.
If you have another health insurance plan, you should check to determine if it will pay for part or all of your abortion services and to determine how to maximize your coverage. You might also want to ask what the insurance company's procedures are regarding notification of the plan subscriber (the person who pays for the insurance plan, whether it's you or your parents) about services covered. If you don't know the name of your health insurance company, call Health Services at 401.863-3953 to find out.
What happens after a surgical abortion?
Physical complications are rare. The most common complications are heavy blood flow and infection. Danger signs include excessive bleeding, fever, nausea, severe cramps or foul-smelling vaginal discharge. The clinic will give you instructions about what to do if any complications occur.
Recovery time varies after an abortion. An antibiotic to prevent infection and a medication to help the uterus contract to its normal size are sometimes prescribed. Avoid strenuous activities for a few days and then resume normal activities when you feel well.
There is often a bloody discharge like a menstrual period for several days after an abortion. Some individuals do not bleed at all. Both of these situations are considered normal.
Normal periods should start within 4 to 8 weeks following an abortion. You can begin birth control again immediately, as it is possible to get pregnant right after an abortion.
To prevent infection, avoid douching, baths, tampons, and sexual intercourse for about 2 weeks after an abortion.
A post-abortion checkup is important and can be done by the provider who performed the abortion or by a medical provider at Health Services. This checkup is a time to make sure your body is healing properly and to discuss contraceptive options. It is possible to become pregnant in the time after an abortion and before your next menstrual period, so it's important to use a contraceptive method or abstain from sex.
What happens after a medical abortion?
For medical abortions, physical complications are also rare. If you experience any chills, fever, or nausea, these symptoms should subside quickly. However, if you experience any of these symptoms for more than 24 hours following taking the second set of pills, call a doctor or local health line. While uncommon, these symptoms may indicate an infection.
How patients feel following a medical abortion varies with each individual. When the second set of medication is taken, prepare to have a day of rest in a comfortable setting. It typically takes 1 to 2 days for patients to return to their baseline of health.
You can return to normal activities the day following the medical abortion if you feel capable. However, do not do any strenuous activities for several days!
It may take hours to days before bleeding and cramping is totally complete for medical abortions. For medical abortions, it is okay to use tampons or menstrual cups to help with this bleeding. Often it is recommended to use pads in order to track bleeding for the few days following an abortion.
Expect a period 4 to 6 weeks following the medical abortion. Birth control can be used immediately following a medical abortion, as it is possible to get pregnant very soon after. After a medical abortion, you can have sex whenever you feel ready.
Are there any long term side effects?
There are many myths regarding the long-term consequences of abortion, such as abortion is linked to breast cancer, however, there is no scientific evidence to support claims like these.
Only in the rare cases of serious complications that go untreated are there long-term effects of an abortion.
In the vast majority of cases, abortions do not affect future pregnancies, fertility, or your overall health.
Additionally, long-term emotional problems following an abortion are very uncommon. They are about as uncommon as they are after giving birth.
Where can I go to have an abortion?
This list is intended solely to provide information on the various agencies in and around Rhode Island that offer abortion services. It is not intended as a recommendation of specific agencies.
Planned Parenthood of Southern New England 401.421-9620
175 Broad Street, Providence
Surgical abortion procedures are provided Tuesday and Friday. Medical abortion (the pill form) are provided Monday thru Saturday. Call or schedule an appointment online.
Surgical abortion procedures are done up to 20 weeks of pregnancy. Medical abortion procedures are done up to 10 weeks.
Medical abortion: up to 10 weeks, $600
Up to 12 weeks: $600 for local anesthesia, $623 for sedative (Ativan), $710 for general anesthesia
12 to 13.6 weeks: $715 local anesthesia, $738 for sedative (Ativan), $825 general anesthesia
14 to 15.6 weeks: $715 local anesthesia, $738 for sedative (Ativan), $825 general anesthesia
16-19.6 weeks: $885 local anesthesia, $908 for sedative (Ativan), $995 general anesthesia
20 weeks: $885 local anesthesia, $908 for sedative (Ativan), $995 general anesthesia
Cash and card are accepted. Personal checks and money orders are not accepted. If you have the University-sponsored insurance plan, you may call the Office of Insurance and Risk at 401.863-1703 to discuss your coverage anonymously. If you have other insurance coverage, call the insurance company ahead of time to determine the amount of coverage and procedures for payment. Most major insurances are accepted.
A partner, friend, or family member may accompany the patient through counseling, but they are not allowed in the room during the procedure. Group counseling is also offered for partners, friends, and family members. Anti-abortion protesters may be outside the facility. Escorts are always available through Planned Parenthood to accompany patients into the clinic.
There is an opportunity to receive funding from Planned Parenthood if you cannot afford the procedure or pill, but you must ask for this financial assistance during your appointment and consultation.
Women's Medical Center 401.467-9111
1725 Broad Street, Cranston
This clinic only provides medical abortions (termination by pill). Appointments are available Monday, Tuesday, Wednesday, and Thursday during the day. The counseling, examination, and prescription all occur on the same day. Medical abortions are provided from the time of a positive pregnancy test to 10 weeks.
Medical abortion: up to 10 weeks, $600.
Money orders, cash, MasterCard, Discover, and VISA are accepted. Personal checks are not accepted. If you have the University-sponsored insurance plan, you may call the Office of Insurance and Risk at 401.863-1703 to discuss your coverage anonymously. If you have other insurance coverage, call the insurance company ahead of time to determine the amount of coverage and procedures for payment.
Antiabortion protesters may be outside the facility. Escorts are available through Women's Medical Center to accompany patients into the clinic.
Early Options Clinic, Obstetrics and Gynecology Care Center, 401.274-1122 x42797
2 Dudley Street, 5th Floor, Providence
Call for an appointment. Procedures are done from 5 weeks up to 22 weeks, 6 days gestation.
Surgical abortion: Depends on whether abortion done in outpatient clinic (<10 weeks gestation only) or operating room. Call for more information.
Medical abortion: $750
Most insurance plans are accepted and on-site individual financial counseling is provided. Cash, money orders, MasterCard and VISA are accepted. Personal checks are not accepted. If you have the University-sponsored insurance plan, you may call the Office of Insurance and Risk at 401.863-1703 to discuss your coverage anonymously. If you have other insurance coverage, call your insurance company ahead of time to determine the amount of coverage and procedures for payment.
Pregnancy options counseling available for people seeking termination of pregnancy. In the Early Options Clinic Friday afternoons, staff provide medication abortion ("the abortion pill") and surgical abortion under local anesthesia up to 10 weeks gestation. They can also make arrangements for surgical abortion up to 22 weeks 6 days gestation in the operating room with full anesthesia if desired. A full range of contraceptive options is available including IUDs and implants.
Four Women, Inc. 508-222-7555
152 Emory Street Unit 2, Attleboro Massachusetts
Abortion procedures are scheduled Thursdays and Saturdays. Procedures are done up to 20 weeks, according to doctor’s discretion. Medical abortions (the abortion pill) appointments are scheduled on Wednesdays, and can be used as an abortion method up to 10 weeks.
Updated fee information not currently available. Call for more information.
Money orders, cash, Mastercard and VISA are accepted. Personal checks are not accepted. If you have the University-sponsored insurance plan, you may call the Office of Insurance and Risk at 401.863-1703 to discuss your coverage anonymously. If you have other insurance coverage, call the insurance company ahead of time to determine the amount of coverage and procedures for payment.
Partners, friends, and family members are not allowed in the procedure room. Antiabortion protesters may be outside facility. Call ahead if you need an escort to accompany you into the clinic. There is also a security guard outside the building that can serve as an escort. It is important to note that Four Women does not have any employees at the end of the driveway.
In addition to information about abortion, pregnancy, and contraception, you can link to reproductive health advocacy sites and you can enter your local zip code to find the Planned Parenthood health center nearest you.
National Abortion Federation
This site has information about all pregnancy options, the legal issues around abortion, advocacy links, and an electronic database to assist you in finding a provider in your area who is a member of the National Abortion Federation and upholds their standards for quality care.
A Talk Line that offers a safe and confidential space for women and their loved ones to talk openly about pregnancy, abortion, adoption and parenting. Call toll free from anywhere in the U.S.
Abortion Conversation Project
This site helps prepare teens for talking to parents about their pregnancy. It offers conversational tips, pregnancy resources, and real stories from both parents and teens.