Signs of early pregnancy and abortion info

Dear Worried for a friend, 

If your friend is concerned that they may be pregnant, the only way to find out with certainty is to take a pregnancy test. However, a person can sometimes tell they are pregnant in the first few weeks just by monitoring their symptoms. Some of the symptoms that a person might feel in the first few weeks of pregnancy include sore breasts, fatigue, missed periods, abdominal cramps, nausea and vomiting, headaches, among other symptoms. Since these symptoms can also be associated with other conditions, the only way to confirm a pregnancy is through a test. Once a pregnancy is confirmed, if the pregnant person knows they want to have an abortion, it's recommended to have one as soon as possible. 

To determine the next steps, it'll be good to first confirm whether or not your friend is pregnant. Some pregnancy tests can be used as soon as a few days before the next expected period and are more accurate if used after a missed period.  Home pregnancy tests are often available to purchase at a drug store or pharmacy (be sure to follow the directions exactly in order to get as accurate a result as possible). You might also choose to make an appointment with a health care provider to confirm a pregnancy. Pregnancy is measured from the first day of the last menstrual cycle. If your friend tests after their first missed period, they would be at least four weeks pregnant already. Due to the overturning of Roe v. Wade in the United States, where your friend lives and how far along they are in the pregnancy may determine if they’re still able to get an abortion. 

If your friend is indeed pregnant, they have some options and some decisions to make. You may find you can be most helpful to them during this time by helping them understand these options and listening to their feelings. They can either continue or terminate the pregnancy (that is to say, have an abortion). If they decide to continue the pregnancy, then they can either keep the baby or opt for adoption. For more information about continuing a pregnancy and adoption, check out the Pregnancy Options category in the Go Ask Alice! archives. 

If your friend decides to have an abortion, there are a number of methods that may be available to them, and these depend primarily on how far along they are (i.e., how many weeks into the pregnancy). Though abortions are generally low-risk, they’re safest when performed earlier in the pregnancy. Most abortions are performed during the first twelve weeks of pregnancy. The different types of abortions include: 

• A medication abortion, in which the patient takes two prescription pills to terminate a pregnancy. The first medicine, mifepristone, blocks the production of progesterone in the body, meaning that the pregnancy can't continue to grow. The second medicine, misoprostol, is taken up to 48 hours after the patient takes mifepristone and induces both uterine cramping and bleeding. It’s important to note that the legality of mifiprestone is currently being debated and therefore may not be available in all states. The process for a medication abortion is comparable to a heavy period and is very effective in ending a pregnancy. Medication abortions also allow the patient to be at home rather than staying in an office or clinic. 
• A suction abortion (sometimes also called vacuum aspiration) is a procedure in which a health care provider will empty the uterus using light suction. This procedure is the most common form of in-clinic abortion and is typically completed in five to ten minutes. 
• A dilation and evacuation procedure (sometimes abbreviated as D and E) uses either medication or dilators to open the cervix and then empties the uterus via gentle suction. 

The availability of these different abortion options may be dependent on the timing of pregnancy. For example: 

• The medicine required for a medication abortion is typically only available for up to 77 days (that is to say, 11 weeks) after the first day of a patient’s missed period. 
• Suction abortion is usually an option for people up to 14 to 16 weeks after the first day of their missed period. 
• A dilation and evacuation procedure is typically performed 16 weeks or more after the first day of a patient’s missed period. 

What’s also important to note is both the clinic a patient uses and the state in which the patient resides can impact accessibility. Following the overruling of Roe v. Wade, legislation regarding abortion is constantly changing. Many states are introducing increasingly strict limitations on when and how patients can seek abortions. As these changes can be both confusing and overwhelming, organizations such as Planned Parenthood remain committed to providing support even in states where abortion is illegal and can offer clarification on what resources are available to those seeking care. The Center for Reproductive Rights also maintains a map that details abortion regulations in each state—a tool that can be used to stay up to date on local abortion-related legislation and track any changes. Though some insurance plans do offer abortion-related coverage, there are often restrictions that make it difficult to cover costs—especially now as legislation is updated. Resources such as the National Network of Abortion Funds can help to connect those seeking abortion-related care with organizations that can assist with their financial needs. Each fund has a unique application process, so reading guidelines can be useful. 

If your friend’s concern over pregnancy risk was due to having unprotected sex within the last few days or because the condom broke or slipped off, they may want to consider emergency contraception (EC), sometimes called the morning after pill. Depending on the type of EC, it can be taken up to 120 hours (five days) after unprotected sex, although it's more effective when taken as soon as possible. Emergency contraception works to prevent a pregnancy from occurring (thus the reason for taking it as soon as possible). If your friend is already pregnant and takes EC, it won’t work. The copper intrauterine device (IUD), Paragard, can also be used as a form of emergency contraception and would also need to be inserted within five days of having unprotected sex. The IUD can also be kept in place as a long-acting reversible contraceptive (LARC) to prevent pregnancy in the future. 

Your friend is fortunate to have someone like you to support them. Though the state of reproductive rights is fragile, there will always be people like you to offer kind assistance.