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What to Expect at First Visit
Upon arrival to Legal Abortion By Pill Clinic, you will first be greeted by a warm, friendly receptionist who will give you a medical history form to complete and sign. Most women suspect that they are pregnant when their menses is late. The history includes asking the first day of the last menstrual period. There may be some women who may not have reported missing a period because of irregular bleeding, breast feeding, or other reasons. Some women may experience abnormal bleeding in early pregnancy that generally occurs a week after implantation (day 27 to 30 of menstrual cycle) which can be confused with a regular menstrual period. Other symptoms women have in early pregnancy are nausea, vomiting, fatigue, dizziness, constipation, frequent urination, urgent urination, decrease or increase appetite, breast tenderness, nipple tenderness or sensitivity.
Additional history obtained includes allergies to medications, medications the patient is taking, the use of street drugs, bleeding disorders, hypertension, diabetes, heart disease, liver disease, kidney disorder, or connective tissue disease.
You will be asked to provide a urine sample, and a small amount of blood will be taken (from your finger) to determine whether or not your pregnancy test is positive, if you have a low red blood cell count (anemic) and your Rh factor. Your vital signs (blood pressure and temperature) will also be taken.
The first step for providing abortion care is to establish that the woman is indeed pregnant and if so, to estimate the duration of the pregnancy and to confirm the pregnancy is in the uterus. The risks associated with pregnancy though small increase with the duration of pregnancy. With modern techniques of cervical preparation, new medications and surgical techniques, the complication rate at Legal Abortion By Pill Clinic is among the lowest in the U.S. and the world.
Measuring hemoglobin or hematocrit levels determines if a patient is anemic which enables treatment and preparation if heavy bleeding occurs during or following the abortion procedure.
Immunization of all Rh-negative women who are Rh-negative has been recommended since 1961 in the U.S. after abortion procedure. Rhogam is administered at the time of the surgical abortion procedure. For women using the abortion pill, Rhogam is administered on the day the RU486 (Mifeprex, mifepristone) or Methotrexate is given.
Sonograms are performed on all patients to determine length of pregnancy and confirm that the pregnancy is in the uterus. Even if you have had a previous sonogram, it is our policy to repeat all sonograms. It is a painless procedure which uses sound waves to visualize the uterus (womb) and the surrounding structures. Sonograms are the most reliable method for determining gestational age. Early pregnancy can be detected in the uterus as soon as 3 to 4 weeks from the last menstrual period. This gives patients the choice to undergo an early surgical or medical abortion. The risks associated with pregnancy although small, increase with the duration of pregnancy. Determination of the length of pregnancy is critical in selecting the safest and most appropriate method for abortion. With modern techniques of cervical preparation, new medications and surgical techniques, the complication rate at Legal Abortion By Pill Clinic is among the lowest in the U.S. and throughout the world. The sonogram fee is included in the abortion procedure. There is a nominal fee for patients who have only a sonogram performed. A sonogram is not required in the first trimester of pregnancy though it may help to diagnose ectopic pregnancies.
Abortion can be one of the most difficult decisions a woman may ever have to make in her lifetime. Each year in this country alone there are approximately 1.3 million unwanted pregnancies that end in abortion. Making it one of the most commonly performed procedures in the United States. The decision to have an abortion is very complex. Women have to consider moral, ethical, religious, age, economic, personal issues and family values. The reasons women want to terminate their pregnancies vary. The most common reasons are 1) they cannot afford to have a child at the present time, 2) they need to take care of the children and family that they have, and 3) having a child will interfere significantly with their current life path and could potentially lead to a hindrance of planning for future goals.
There are a host of other reasons which can include difficulty with significant other, recent death of the partner, severe medical problems of the mother or the fetus, and possibly rape or incest. These are only a few. No woman wants to have an abortion. She alone has her reasons.
Counseling can be very important in helping the woman consider her options and ensure that she is making the proper decision for herself and that she is not being coerced. If the patient decides to have the abortion and she is absolutely not certain, she should be rescheduled for another appointment although the greater safety and effectiveness of an earlier abortion procedure should be explained. Appropriate referral for patients who choose to keep the pregnancy or are considering adoption should be made.
For patients who suspect sexual abuse, violence or coercion, appropriate referral is necessary.
During your counseling session the alternatives to abortion will be discussed, along with describing the procedures that are available. If you ultimately decide to terminate your pregnancy you will then be able to choose the method of abortion that is best for you.
Women should be given information on the following:
Options for the different abortion procedures should be discussed after determination of length of gestation.
Long term birth control and Emergency Contraception (morning after pill, day after pill, post coital contraception, day after contraception, Plan B) should be discussed with all patients. This is the key to reducing the incidence of unwanted and unplanned pregnancies in the U.S. and throughout the world. Patients are able to become pregnant 7 to 10 days after having an abortion performed. Over 50% of women have used some form of contraception within the past 30 days of becoming pregnant. If the patient became pregnant due to contraceptive failure, this needs to be discussed in detail to determine whether or not the same method of contraception can be used or if the patient needs to be switched to a different method of contraception. It is ultimately up to the patient which method of birth control she chooses if any.
Emergency contraception should be discussed with the patient as the majority of women may have heard of it, but do not know when it is indicated or how it is used. Hormonal Emergency Contraception (combined estrogen and progesterone, or progestin only levonorgestrel [plan b, Next Choice]) are most effective in preventing an unwanted pregnancy after unprotected intercourse immediately after the event. The term morning after pill or day after pill can be confusing as each hour that goes by after the unprotected sexual event increases the chance of an unintended pregnancy. Hormonal Emergency Contraception can be used up to 5 days after unprotected intercourse. Plan B is approved by the FDA to be 89% effective if used 72 hours or less after unprotected intercourse. The Copper T Intrauterine Device (IUD) is over 99% effective if inserted within 120 hours (5days) or less after unprotected intercourse.
Prevention of Sexually Transmitted Diseases (STDs) along with HIV and the discussion of condom use should be discussed with all patients. Long term contraceptive use and condoms to protect against sexually transmitted disease and pregnancy should be discussed.
It is Legal Abortion by Pill Clinic’s opinion that the Copper-T IUD should be the number 1 choice to consider for women who need Emergency Contraception. Otherwise; all women should be offered hormonal contraception to keep at home for their immediate use if they are exposed to an unprotected sex event.
A medical staff member will take you to the exam room when it is time for you to see the Doctor. The Physician will go over the medical history, risks and benefits of the procedure, answer all questions that the patient may have and perform a physical examination. The pelvic exam is done to determine the uterine size, to see if the uterus is anteverted in mid-position or retroverted, whether there are masses in the uterus, and perform palpation of adnexal masses (ovaries or fallopian tubes)
A speculum is inserted inside the vagina which is the same instrument used to perform a Pap smear. The presence of any infection in the vagina and cervix increases the incidence of developing a post-procedural uterine or pelvic infection. If there are clinical signs of pelvic infection (frequent urination, burning with urination, vaginal discharge, lower abdominal pain and pelvic pain, low grade temperature, lower abdominal pain, pelvic pain, and uterine and or adnexal discomfort on pelvic exam) the patient should be treated immediately with antibiotics and then the abortion can be carried out.
If you are having a surgical procedure, the abortion is done by using suction to remove the contents of the uterus. If you are very early (less than 6 weeks) and have chosen not to receive IV Sedation, you will be given a medication that helps to soften and open the cervix to make the surgery more comfortable. A choice of regular IV sedation, advanced technology IV sedation where the medications used are in and out of the body in 30 minutes allowing the patient to drive herself to and from the office where she has the ultimate in privacy of having the abortion procedure performed. We also offer Deep IV sedation and General Anesthesia.
The surgical procedure for early abortion lasts 3 to 4 minute. It is safe and generally pain free for those who choose to have regular IV Sedation, Advanced Technology IV sedation, Deep IV sedation, or general anesthesia.
Please remember, the advantage of not having IV Sedation with the early surgical abortion is that you may resume normal activities the same day.
During recovery, patients will be offered the ultimate in comfort and support. Monitoring of vital signs, pain, and bleeding are observed. Patients are generally able to leave as soon as they feel comfortable, there is no evidence of complications, and their vital signs are stable. Due to the advanced medications that are used for IV sedation and analgesia, patients who are given these medications do not need a longer recovery time than patients who do not get them.
Patients who undergo the early surgical procedure without IV Sedation are able to go home in 10 to 15 minutes after the procedure is performed. It is normal to experience mild cramping for 3 to 5 minutes after the procedure is completed. During this period of time your vital signs will be checked and your bleeding monitored. If you are further along in pregnancy (greater than 7 weeks) or you had IV Sedation, you will stay in recovery for about 30 minutes. Patients in the second trimester of pregnancy remain in recovery for 45 minutes to an hour. Once we have determined that you are ready to go home, you will be given your post-op packet with instructions on how to care for yourself at home.
Abortion Aftercare Instructions
All patients receive a take home bag that contains post abortion medications, and a post abortion instruction written sheet that has clear, simple and written instructions about how to care for themselves after leaving the health care facility including how to recognize problems or complications that require patients to call the office immediately.
You will be given a 24 hour number to call if you have any concerns or questions after leaving. Our medical staff and Physicians are on call 24 hours a day, 7 days a week. After a surgical abortion women may experience light cramping and bleeding or spotting for just a few days. Bleeding can sometimes last a couple of weeks or longer but that is usually not the case. Patients that bleed more than 2 pads an hour for more than 2 hours should call the facility as a visit to the office for evaluation may be necessary. Indications for clinical evaluation may include fever greater than 100.4, pelvic pain, or heavy vaginal bleeding. Abdominal cramping usually subsides in 24 hours or less and is usually relieved with the use of acetaminophen or a non-steroidal anti-inflammatory medication such as naproxen, ibuprofen, or diclofenac.
Women who are undergoing a medical abortion (abortion pill, RU486, Mifeprex, mifepristone) are told to expect light, moderate or heavy vaginal bleeding. The patient should call the office if bleeding more than 2 pads an hour for two hours in a row. More than 50% of patients do not need any pain medications with less than 5% requiring more than acetaminophen or a non-steroidal anti-inflammatory to relieve pain and discomfort. Patients that are greater than eight weeks pregnant are more prone to heavier vaginal bleeding, or severe pelvic pain requiring stronger medications to alleviate the discomfort.
Patients who have surgical abortions are seen 3 weeks after the procedure. This appointment is to evaluate the patient for any problems and determine about her recuperation. This is the time to discuss if the patient is having problems adjusting psychologically or physically. A pregnancy test, pelvic exam, and a possible sonogram may be performed if the Physician thinks that it may be necessary. Long term contraception and Emergency Contraception are discussed as well. This follow-up appointment visit is done at no additional charge. A well woman exam that includes a Pap Smear and breast exam can be set up during your follow-up exam.
A patient may request an exclusive or private appointment with Dr. Pendergraft by contacting him by E-mail preferable: Drpendergraft@gmail.com or call him directly at 321-445-2545 or call office location nearest you by clicking locations. Same day appointments can be arranged.
For further information including family planning, please visit our premiere website.
Legal Abortion By Pill Clinic
If 6 Weeks Or Less
Second Trimester Or Late Term Abortions