Abortion Clinic Procedures

If you book an in-person appointment for a medication abortion, you should plan to be at the clinic for 1 ½ hours to 2 hours.

• First, you will have an appointment with a counsellor who will provide support around your decision and discuss any questions or concerns. You will be given information about the procedure and aftercare. If you are interested, you will be offered information about contraceptive options.
• After seeing a counsellor, you will meet with a nurse and doctor to ensure you are a candidate for the medical abortion. At this time you will have an ultrasound to confirm the dates of the pregnancy. You will be given a prescription for Mifegymiso, Tylenol #3, and mifepristone.
• The Mifegymiso package that you will collect from the pharmacy next door to our clinic is comprised of two boxes: one box contains 1 tablet of mifepristone (200mg), the second box contains 4 tablets of misoprostol (200mcg).
• The clinic will ensure that you have detailed instructions provided to you so you understand how to take the medication.

Day 1:

• Take the mifepristone tablet. This medication destabilizes the uterine lining ending the growth and development of the pregnancy. Once you take this medication the effects are not reversible.

Day 2-3:

• 24-48 hours after you take the mifepristone, you will place the other medication (misoprostol) inside either the cheeks of your mouth or your vagina.

Expected side effects:

2 to 3 weeks following the procedure, you must ensure the medication was successful and the pregnancy has ended. You can choose one of the following: do a pregnancy test at home, attend at our clinic for an ultrasound, or get a blood test to confirm the pregnancy has ended.

You will receive a phone call from the clinic to confirm that your pregnancy has ended.

If there is a continuing pregnancy, you will need to have an aspiration abortion.

Complications are rare but can include infection and heavy bleeding. An aspiration procedure may be necessary to stop the bleeding.

If you book a telehealth appointment for a medication abortion, you will follow the following steps:

• You will receive information from our administrative team about the process along with a series of important documents to review in advance of your appointment.
• Your first phone or videoconference appointment will be with one of our physicians. The physician will review your medical history, discuss the process, review the consent forms with you, and confirm that medication abortion is a suitable option for you.
• Within the next 24 hours, you will have your second phone or videoconference appointment. This appointment will be with a member of our counselling team who will provide support around your decision and discuss any questions or concerns you may have. The counsellor can answer any further questions you have about the process. If you are interested, you will be provided information about contraceptive options.
• After that, the clinic will send a prescription for Mifegymiso, Tylenol #3, and mifepristone to a pharmacy that is convenient for you.
• The Mifegymiso package that you will collect from the pharmacy next door to our clinic is comprised of two boxes: one box contains 1 tablet of mifepristone (200mg), the second box contains 4 tablets of misoprostol (200mcg).
• The clinic will ensure that you have detailed instructions provided to you so you understand how to take the medication.

Day 1:

• Take the mifepristone tablet. This medication destabilizes the uterine lining ending the growth and development of the pregnancy. Once you take this medication the effects are not reversible.

Day 2-3:

• 24-48 hours after you take the mifepristone, you will place the other medication (misoprostol) inside either the cheeks of your mouth or your vagina.

Expected side effects:

You will have two follow up appointments after you take the Mifegymiso.

You will be scheduled for a phone or video conference appointment with the physician 8-10 days after your first physician appointment to check in and see how you are doing.

Then, 2 to 3 weeks after you take the Mifegymiso, you must ensure the medication was successful and the pregnancy has ended. You can choose one of the following: do a pregnancy test at home, attend at our clinic for an ultrasound, or get a blood test to confirm the pregnancy has ended.

You will be scheduled for a second follow up appointment with the physician 4 weeks after your medication abortion to review result of your pregnancy test.

If there is a continuing pregnancy, you will need to have an aspiration abortion.

Complications are rare but can include infection and heavy bleeding. An aspiration procedure may be necessary to stop the bleeding.

Call the clinic if you are experiencing any of the following:

• Filling and soaking through two large menstrual pad every hour for 2 hours in a row and are still bleeding. Normal bleeding is initially heavier that a period. This bleeding will usually decreases after the pregnancy tissue is passed (usually 2-24 hours after taking misoprostol). You may have bleeding for several weeks, but it should be lighter than a period after the first few days.
• Severe pain not helped by the medications. The pain usually improves after the tissue has passed.
• Shaking chills, or a temperature of more than 38ºC (100.4ºF). Usually any mild fever, nausea, vomiting, and diarrhea caused the misoprostol should go away quickly without treatment. If they don’t, you should call the clinic.
• Foul smell or pus-like vaginal discharge.
• No bleeding 24-48 hours after taking Misoprostol. This does not mean the abortion isn’t working, but you need to call to make another appointment to come back. This is not an emergency.

Where to call:

Monday – Friday from 9 a.m. – 4 p.m: 604-736-0995.

Evenings and weekends: After you have had your appointment, you will be given a phone number for medical emergencies that will connect you with one of our physicians.

** As we know your medical history, please call us first. If you are unable to reach us, please call your doctor or go to your nearest hospital emergency.**

Please let us know if you receive any hospital treatment within 30 days after your procedure at the clinic. This information is important to us so that we can follow-up on your care.

• If you are less than 14 weeks pregnant, you should expect to be at the clinic for 2 – 4 hours. The abortion procedure itself is very brief (10-15 minutes) but you will need time to see the counsellor and nurse, and then recover after your abortion.
• If you are between 14 and 17 weeks pregnant, you will be scheduled for two appointments on consecutive days.  You can expect to be at the clinic for 2 – 4 hours on each day.

• Bring your BC CareCard, UHIP card (University Health Insurance Plan) or IFH card (Interim Federal Health Program) as well as a piece of photo identification. Let us know at the time of booking your appointment if your photo identification does not accurately reflect your name, gender marker, or current gender presentation. We recognize that for some trans and non-binary people, your photo identification might not accurately reflect who you are.
• You cannot eat for 4 hours before your appointment time.
• You can drink clear fluids until you arrive at the clinic for your appointment.
• Bring a small snack with you to eat after the procedure and something to drink.
• Wear loose, comfortable clothing including a short-sleeved t- shirt and flat, comfortable shoes.
• Do not wear colored contact lenses (clear contacts are fine) or lipstick.
• Please bring the following with you to your appointment:
  • an extra pair of full back underwear,
  • an extra pair of socks,
  • two maxi pads,
  • a small snack and something to drink after the procedure,
  • any prescription medication(s) you are currently taking.

Bringing a support person?

Friends and family are no longer allowed to accompany patients inside the clinic to protect the health and safety of other patients and staff. Professional translation services are covered for those who indicate a language barrier on the patient intake form. Requests for extenuating circumstances may be accommodated. Please contact the clinic at least two business days before your appointment to submit a request for additional accommodation. Emailed requests can be sent to ​[email protected]

• When you first arrive at the clinic you will see a counsellor who will discuss the procedure and provide emotional support. The counsellor will also review contraceptive options if you wish. After counselling, you are prepped for the procedure by a nurse.
• For the procedure, we offer intravenous medications to manage pain and anxiety, which most individuals prefer. The combination of these medications is called ‘moderate sedation’ or ‘conscious sedation’. You will be awake for the procedure.
• The doctor will assess the pregnancy by pelvic exam followed by an ultrasound. Swabs for Chlamydia and Gonorrhea will be taken. The doctor then gently opens the cervical canal and passes a thin suction tube into the uterus to remove the pregnancy.

Post-Aspiration Procedure Instructions

• Following the procedure
  • You will be monitored in the recovery room for 15-30 minutes.
  • We suggest you bring a light snack and a drink to have at this time.
• Transportation from the clinic
  • You are not permitted to drive for 24 hours after the procedure. If possible, arrange for someone to drive you home. Your ride needs to be at the clinic no later than 4:30 pm.
  • If that is not possible, we recommend you take a taxi.
  • If you are going home by transit, you will need to have someone accompanying you.
  • If you have no other option other than to ride transit on your own, please speak to our staff and we will do our best to make arrangements for your transportation
• Normal bleeding can range from NO bleeding to bleeding like a heavy menstrual period.
• It can be light for the first 3 days after an abortion. It may become heavier on the 4^th or 5^th day, sometime with clots and cramping. Or you may have NO bleeding after the first day.
• Light bleeding or spotting may last for several weeks, or you may have NO bleeding.
• You should expect your next menstrual period in 4 to 6 weeks
• Some patient pass small clots after an abortion
• Cramping normally occurs during the passing of a clot
• Zero to mild cramping is normal
• If you have cramps, a heating pad, hot water bottle, rest and/or Tylenol, Advil, Motrin, Midol can help you feel more comfortable

Normal body changes (1-2 weeks)

• Nausea & vomiting, breast tenderness, fatigue and bloating will decrease
• Emotional ups and downs may occur
• Appetite and bathroom habits will return to normal
• Your breasts may leak small amounts of fluid
• Please do not do a pregnancy test. The pregnancy hormones take a while to leave the body, so it may appear positive for 4-6 weeks after you abortion

It is important to call us if you:

• Soak 3 or more maxi-pads in three hours;
• Have a fever of 38.0 C or 100.4 F or higher;
• Experience chills or shaking;
• Pass a clot that is as large as a lemon;
• Have an unusual vaginal discharge or bad odour; or
• Still feel pregnant two weeks after your procedure.

Where to call:

Monday – Friday from 9 a.m. – 4 p.m: 604-736-0995.

Evenings and weekends: After you have had your appointment, you will be given a phone number for medical emergencies that will connect you with one of our physicians.

** As we know your medical history, please call us first. If you are unable to reach us, please call your doctor or go to your nearest hospital emergency department.**

Please let us know if you receive any hospital treatment within 30 days after your procedure at the clinic. This information is important to us so that we can follow-up on your care.