Interview by Hilary Quigley

with Denah Smith, B.Sc.N., Registered Nurse

Q. What happens during an abortion?

A. The "suction abortion" is the process that uses a tube that goes into the uterus and gently sucks out the embryo. This is done in a hospital or free-standing clinic. In hospitals in Toronto, they are frequently done under a general anesthetic, so you're put to sleep to have it done. In a free standing clinic, you are given some medicine intravenously to make you kind of dopey. Then freezing is put around the cervix, the opening of the uterus. This blocks the pain. The procedure is done while you're awake but you're sedated.

There's a variation on this procedure called a "manual vacuum aspiration." This method uses something like a big syringe to provide suction. It can be done on a pregnancy up to 79 days after a woman's last menstrual period.

In Canada, abortion can be done on a pregnancy up to 20 weeks after a woman's last menstrual period. In the United States, the practice differs from area to area. Most abortion facilities will perform abortions on a pregnancy that is between 8 weeks and 12 weeks.

Q. What are the pros and cons of having an abortion? A. The pros and cons have to do with the effect of the pregnancy and the abortion on the individual woman who is making the decision. Sometimes someone has a health condition that means pregnancy is dangerous for her physical well-being. More often, a woman is facing issues like asking herself, "Am I able to support a child?", "Do I want a child at this time?", "Do I feel like

I can be responsible for a child?", "What are my circumstances?", "How do I feel about abortion?", "What are the alternatives?". It is normal for a woman to experience a range of emotions after an abortion, such as relief, sadness, happiness, and feelings of loss. Each woman is unique.

Q.Why are some people against abortions?

A. Some people object to abortion based on their moral or religious beliefs. For many people, a pregnancy represents the possibility of human life; the idea of ending that possibility is upsetting for them. Much of this issue is shaped by how you define when a life begins. Many people who are opposed to abortion believe that life begins at the moment the egg is fertilized by the sperm. Other people believe the life doesn't come into being until later in the pregnancy, when there's a more fully formed fetus that has the potential to live on its own, or even until the birth of the baby.

Q. How does it feel physically to have an abortion?

A. It depends on if you're awake or asleep. If you have a general anesthetic, you're put to sleep and so you're not aware of what's happening. Afterwards, you might have some mild cramping, like menstrual cramps, and some bleeding, like a period. Sometimes the cramping can be more severe.

If you're awake during the procedure, the experience is a little bit different and varies from woman to woman. There will be a speculum inserted in your vagina. There will be some discomfort from the local anesthetic, a numbness similar to what you'd experience at the dentist only around your vagina, not your mouth. There is some cramping, which varies from woman to woman in intensity. Most women are given some kind of painkiller. Basically, it would be like having a very painful period in terms of discomfort. The thing to remember is that it doesn't last very long. The whole procedure doesn't last more than 10 minutes.

Q. How much does it cost?

A. In Canada, the fee varies from province to province (in Ontario, the Ontario Health Insurance Plan covers the cost in hospitalsandclinics). IntheUnitedStates,theaveragecostis around $375, but it can much higher depending on the extent of the tests and examinations required.

Q. How are you protected from protestors at abortion clinics?

A. Most places have security in place to control who is allowed inside.

Q. What does abortion tissue look like?

A. It really depends on how far along the pregnancy is. In a very early pregnancy—up to 8 weeks from the woman's last period— the embryo is so small that you wouldn't be able to see it with- outamicroscope. At10or12weeks,youmayhaveanembryo that could be identified with the naked eye if it were intact. From then on, the fetus will have more and more identifiably human characteristics.

Q. Is abortion killing a baby?

A. That's a good question. Abortion in Canada can only be performed in the first 20 weeks of a pregnancy, and most places in the US restrict them to even earlier. At that point, if the fetus was born, there would be no chance of it surviving. In terms of what the tissue looks like early on, an embryo has no identifiable human characteristics; you could look at it and say it's not a baby. It has the potential to grow into a living human being but it is potential rather than a real human being. It's like the difference between a seed and a tree. After 8 to 12 weeks, when an embryo becomes a fetus with more identifiably human parts, the idea of abortion can be even more difficult for people. Counseling is an important part of abortion services. It should help and support a woman in making a decision that is best for her.

To find out where to go for abortion counseling and services nearest you, check out the resource section at the back of this book.