What is an abortion?

An abortion is a safe, effective, and common way to end a pregnancy. About one in four people who can get pregnant will have one or more abortions in their lifetime. 

Women aren’t the only ones who have abortions; nonbinary and transgender people also receive abortion care. However, research is limited on how many people have had an abortion and whether their care was trans-inclusive. At Hey Jane, we provide medication abortion care to all people who can get pregnant, regardless of their gender identity.  

While some people may consider it a sensitive topic, abortion is a normal, common, and important part of health care. At one time in American history, abortion was not nearly as taboo as it is today. In fact, medications used to end pregnancies were available at many pharmacies and often even advertised in newspapers. 

In the mid to late 1800s, however, stricter sexual and social norms, as well as racist paternalism, led to increased stigma surrounding abortion. Still, the abortion rate remained the same and pregnant people often struggled to find safe abortion care. Today, unfortunately, access to abortion varies from state to state because of the June 2022 reversal of Roe v. Wade. But the need for abortions remains in all US states, regardless of legislation.

Despite abortion’s importance and prevalence, abortion stigma still impacts many people today. Whatever feelings someone has about their abortion are totally okay. If you’re looking for resources to help navigate abortion stigma and cope with difficult feelings surrounding your abortion decisions, you can find support here.

How abortions work and the different types of abortion

People can get abortions at clinics or at home with medications. How far along you are in your pregnancy, your medical history, and your personal preferences can help you determine what type of abortion care is the best fit for you.

In some states, laws require people to get ultrasounds to confirm how far along they are in pregnancy before getting an abortion by pills or procedure. However, abortion pills can be prescribed via telemedicine (through a clinic like Hey Jane) and taken safely and effectively without an ultrasound. If you have regular periods and can remember the date of your last one, you can use a pregnancy calculator to figure out how far along the pregnancy is. (Pregnancies are dated based on the first day of your last menstrual period.)

No matter what type of abortion you’re having, it’s good to have a few items on hand at home to use during and/or after treatment. The over-the-counter pain medication ibuprofen (Advil) is most effective for uterine cramping, although some studies show that adding Tylenol as directed can also help with pain. Heavy flow menstrual pads, comfortable clothes, and a heating pad are also great items to have around. If you’ve got the time before your treatment, consider buying or making yourself a few meals you can throw in the oven or microwave, so that the only thing you’ll need to focus on is self care.

What is a medication abortion?

A medication abortion, often referred to as “the abortion pill,” is a safe and effective way to end a pregnancy. It’s up to 98% effective through 11 weeks gestation and approved in the US through 10 weeks (although many clinics prescribe abortion pills after 10 weeks). Medication abortion is very common—63% of all abortions in the US are done with medication. 

When taking abortion medications, you may do it partially at a clinic or completely at home/wherever you feel comfortable. Medication abortions are sometimes more affordable than procedural abortions and they don’t require a trip to a clinic, which some people may find less anxiety-inducing.

How does a medication abortion work?

• The first medication, mifepristone, blocks the pregnancy hormone (progesterone), which stops a pregnancy from growing. Some people may feel nausea or have bleeding after taking mifepristone, but most don’t have any side effects.
• Then, 24-48 hours later, the second medication, misoprostol, is taken. Misoprostol causes cramping and bleeding to empty the uterus (womb).

Some online pharmacies or other access points for abortion pills may only provide misoprostol, which is also safe and effective on its own and an important option for the very small number of people who cannot take mifepristone (either because they are allergic to the medication or have certain medical conditions that would make taking mifepristone unsafe).

What are common symptoms of a medication abortion?

Everyone’s experience with medication abortion is different, but cramping and bleeding are the most common symptoms and suggest the process was successful. Cramping and bleeding may range from feeling like a bad period to much more painful than that.  

What is a telemedicine abortion?

Telemedicine abortion, also known as telehealth abortion or telabortion, is one way to access medication abortion. It involves virtual prescription of abortion pills by a medical provider through a virtual clinic rather than getting the prescription in-person at a clinic or obtaining them without medical oversight.

Telemedicine abortion uses the same medication and process as any medication abortion accessed through an in-person clinic, and it’s just as safe and effective.

While this type of care is legal in many states, including all of the states that Hey Jane serves, state laws continue to change rapidly. Keep your eyes on the Guttmacher Institute’s tracker for the latest legislation—and check out Plan C Pills’ guide for information on accessing abortion pills if you live in a state with restrictions in place.

Hey Jane is a telemedicine clinic that offers a safe and accessible way to get abortion pills for people up to 10 weeks pregnant. Learn more about telemedicine abortion with Hey Jane.

What is a self-managed abortion with pills?

A self-managed abortion is any abortion that happens outside the medical and legal system, sometimes on someone’s own or with community support. Self-managed abortion with pills is the same process as a medication abortion, only the pills (either mifepristone and misoprostol or just misoprostol) aren’t prescribed by a health care provider and follow-up care is not usually included. People may self-manage for a variety of reasons, from difficulty accessing in-clinic care to the preference for privacy.

Self-managed abortion with pills is safe and effective—especially when the person has community support (e.g., a friend, trusted family member, abortion doula, or abortion hotline/textline).

Depending on where a person lives, self-managing abortion can be risky legally. While self-managed abortion in particular is only explicitly against the law in Nevada, other laws have been used to criminalize suspected self-managed abortions. Read more about the legal landscape surrounding self-managed abortion with pills here.

To dive deeper into self-managed abortion with pills, check out Plan C Pills’ guide.

What is a procedural abortion?

Procedural abortions only happen in clinics. (Resources like Abortion Finder or I Need An A can help you find the nearest clinic.) Some people may call them “surgical abortions,” but abortion procedures don’t typically involve cutting, scraping, or suturing.

What is a vacuum aspiration or suction abortion?

Vacuum aspiration, or suction abortion, is a safe procedural abortion typically performed up to 14-16 weeks (depending on state law) by a trained abortion provider in a clinic. 

How does a vacuum aspiration or suction abortion work?

1. Before the procedure, people may be given IV sedation (when available) to help them stay comfortable, or may take an oral medication to help with pain or anxiety,
2. The abortion provider uses a speculum to open and view the cervix.
3. The provider injects local anesthesia around the cervix to reduce pain.
4. The provider inserts a plastic tube into the uterus, attaches it to a suction or vacuum pump, and gently removes the pregnancy tissue.

What are common side effects after a vacuum aspiration or suction abortion?

Common side effects after vacuum aspiration include on-and-off cramping and bleeding for up to 4-6 weeks. Patients may receive pain and anxiety medications, as well as antibiotics, for comfort and to reduce the already very low risk of infection. Over-the-counter pain meds and a heating pad can also help.

What is a dilation and evacuation (D&E) abortion?

Dilation and evacuation (D&E) is a safe procedural abortion commonly performed after around 16 weeks by a trained abortion provider in a clinic. D&E is not to be confused with dilation and curettage, or a D&C abortion, which used to be common in the first trimester but has now been replaced by the safer and gentler vacuum aspiration.

How does a dilation and evacuation (D&E) abortion work?

1. Before (possibly the day before) the D&E, the abortion provider uses medication or tiny dilators (laminaria) to dilate the cervix.
2. When it's time for the procedure, any dilators will be removed.
3. Using a suction device and other medical instruments (none that cut), the abortion provider will remove the pregnancy and leftover tissue.

Patients having a D&E might receive IV sedation, when available, and/or be prescribed pain medications and antibiotics. 

What are common side effects after a dilation and evacuation (D&E) abortion?

Common side effects include on-and-off cramping and bleeding for up to 4-6 weeks. Over-the-counter pain meds and a heating pad can help.

What is an induction abortion?

An induction abortion is an in-clinic procedure performed in both the second (after 16 weeks) and third trimesters by a trained abortion provider (depending on state laws). 

How does an induction abortion work?

1. The abortion provider gives the patient medication (orally, intravaginally, or via injection into the uterus) to induce dilation and contractions. The medications could be mifepristone, misoprostol, and/or other induction medications (e.g., oxytocin or prostaglandin analogues).
2. The patient is monitored in the clinic or hospital throughout the whole procedure, which may take 12-24 hours.

Because this type of procedural abortion induces labor and delivery, the patient may receive an epidural or other forms of pain management. 

What are common side effects after an induction abortion?

The induction medications used can cause side effects like nausea, vomiting, diarrhea, and fever, but other medications can help relieve them when necessary.

How safe is an abortion? What are the risks?

Abortion is very safe. In fact, having an abortion is less risky than carrying a pregnancy to term. One 2015 study observed extremely low rates of “major” complications (think hospitalization, surgery, blood transfusion) across all types of abortion: 0.31% for medication, 0.16% for vacuum aspiration, and 0.41% for later procedures. A telemedicine abortion through Hey Jane is incredibly safe—with a serious adverse event rate of only .16% 

The American College of Obstetricians and Gynecologists recommends seeking medical help after abortions if you have severe abdominal/back pain, soak two pads in an hour for at least two hours, or experience foul-smelling discharge or a fever.

The science is also clear: Abortion won’t cause any harm to future pregnancies or decrease your chances of becoming pregnant in the future. Abortion does not increase your risk of getting breast cancer or cause depression. Abortion is safer than childbirth and having your wisdom teeth removed. Medication abortion in particular is safer than taking penicillin or Tylenol! Importantly, there are actually many negative consequences associated with denying an abortion to someone who is seeking one out. 

What to expect after an abortion

After an abortion, you can resume physical activity (such as working or exercising) as soon as you feel ready! Some people find that they are able to resume normal life immediately, while others may need a few days at home to rest.

You can also resume sexual activity as soon as you feel ready. Some providers suggest waiting for vaginal bleeding to subside before engaging in sexual activity in order to reduce the risk of infection, but check in with yourself and your own comfort level to make this decision.

You are able to become pregnant any time after your abortion, as abortions have no impact on future fertility. Because of this, using some form of birth control immediately after your abortion is recommended if you want to avoid pregnancy. (Hey Jane’s clinical care team can help you find the best birth control option for you, your body, and your preferences, if you’re looking to get on birth control or switch a new one.)

When possible, it’s helpful to follow up with your abortion provider to confirm your abortion was successful. This may mean checking in via client survey, a secure chat or, in some cases, following up with a provider by phone or in person.

After an abortion, it’s common to experience all sorts of feelings, even if you felt sure about your decision. From relief to guilt or sadness, all of your feelings are valid. Pregnancy and abortion are both life stressors, so be patient with yourself as you process your experiences. If you’d like to speak with a caring support person, you can find links to talk and text lines on our Resource page. If you feel that you need urgent help, contact your health care provider or call 911. 

How to get abortion pills delivered

If you’re interested in having a medication abortion without having to get to an in-person clinic, Hey Jane can help. First, check if you’re eligible. In order to receive medication abortion treatment with Hey Jane, you’ll need to be in a state Hey Jane serves (both for the consult and treatment), be up to 10 weeks pregnant, and meet our medical eligibility requirements. You can determine how many weeks pregnant you are by the first day of your last period. 

Hey Jane provides care, regardless of immigration status. You can provide any form of ID that has your name, photo, and date of birth. If you have questions, you can chat with one of our licensed providers, who will help answer your questions. 

Once you’ve spoken with a Hey Jane provider and are approved for treatment, you’ll receive FDA-approved abortion pills within 1-5 days, depending on your shipping method. They’ll arrive in an unmarked box to protect your privacy, and include instructions you’ll need to complete the process. 

For our patients, we offer text support Monday-Saturday, from 10am to 8pm EST—before, during, and after you’ve taken your abortion medications. If you’re a patient with urgent medical concerns, we are available 24 hours a day. 

We are the first virtual-only abortion provider to accept insurance, and for those paying out-of-pocket we offer a variety of options to ensure that cost isn’t a barrier to receiving care. We also offer financial assistance to those who can’t afford our abortion services, through our abortion fund partner program. Plus, all Hey Jane patients have an automatic support network through The Lounge, our private peer-to-peer community forum available to patients past and present.

Have more questions? Be sure to check out our FAQ page.

Why Hey Jane cares

Hey Jane supports those seeking virtual abortion care from the comfort and convenience of their phone. We aim to make patients feel informed about their choices through sharing resources and accurate information about abortion.

By offering telehealth abortion services and abortion pills online, we eliminate the need for many people in early pregnancy to find an in-person clinic—which can be difficult, especially as the number of abortion clinics declines and wait times increase. People can also travel to the states that Hey Jane serves if telehealth abortion isn’t available where they live.