101: Abortion

Abortion 101

At Jems, we believe access to abortion and reproductive care is a human right and should be responsive, caring, non-judgmental and trauma-informed. 

Being a Canadian company, we recognize the disparities between Canadian and U.S. laws surrounding abortion, especially now that Roe v. Wade has been overturned. We understand the privilege we currently have living in Canada, where abortions are safe, legal and fully-funded medical procedures. 

However, we recognize that even within Canada, it can be challenging to access abortions and reproductive care, depending on your geographical location and whether you have the financial means to travel. This applies especially to those who live in rural or remote locations and to those in historically underserved communities.

Jems stands in solidarity with womxn and people with uteruses* and believes everybody deserves the right to bodily autonomy and access to proper reproductive care. 

*We recognize that these aren’t the words everyone uses for their bodies and support you using the language that feels best for you.

Jems is currently matching donations to @abortionfunds; please email or DM us your receipts!

What is Roe v. Wade, and what does it mean now that it has been overturned?

Roe v. Wade was a landmark legal decision issued on January 22, 1973. The U.S. Supreme Court struck down a Texas statute banning abortion, effectively legalizing the procedure across the United States. The court held that a womxn's right to an abortion was implicit in the Constitution's right to privacy protected by the 14th Amendment. Before Roe v. Wade, abortion was illegal in the U.S., and had been since the late 19th century. Since the 1973 ruling, many states have imposed restrictions on abortion rights, and the topic of abortion has remained a politically contentious issue. 

The Supreme Court overturned Roe v. Wade on June 24, 2022, holding that there was no longer a federal constitutional right to an abortion. What that means is that in the United States, currently and for the foreseeable future, access to abortions is limited. In a post Roe v. Wade U.S., abortion will not automatically become illegal – but individual states will now be allowed to decide if and how to allow abortions.

Thirteen states have passed "trigger laws" which automatically ban abortion, coming into effect upon Roe v. Wade's overturning. Others have left old laws on the books that banned abortion before 1973, which can now be enforced again.

According to the Guttmacher Institute, a research organization supporting abortion rights, more than 20 states are now taking steps to limit abortion access. Some states intend to ban abortion from conception, others at six or more weeks.

Here's a link to a map of abortion policies according to state

How many people does this affect? According to that same source, Guttmacher Institute, now that the 1973 ruling has been overturned, some 40 million womxn of childbearing age will live in states where abortions will become more challenging to access. This leaves many womxn and families in vulnerable positions – and down one constitutional right. 

How does the overturning of Roe v. Wade impact Canadians?

Twenty-six states will likely ban or nearly ban abortion in the wake of the Supreme Court's decision. This immediately makes it more dangerous for pregnant Canadian womxn – or even those within childbearing age, post-secondary students in their late teens and early twenties (the age group most likely to seek an abortion) are in particular danger – to visit more than half of America and perhaps all of it, in the case of a need for an immediate/emergency abortion. 

Pregnant Canadians regularly cross the border for work, visit family and friends, and attend major life events like weddings and funerals. Their freedom of movement is now restricted as is, in some cases, their freedom to earn a living unless they're willing to risk their lives. 

Womxn who work for U.S.-headquartered companies may see other impacts as well; benefits related to reproductive health care, including in vitro fertilization (IVF) and other fertility treatments, may disappear. 

And although abortions are legal during all stages of pregnancy in Canada, no providers in Canada offer care beyond 23 weeks and six days. Those requiring abortions past 24 weeks gestational age have previously travelled to the U.S. The decision to overturn Roe v. Wade also significantly impacts those needing to abort a pregnancy past 24 weeks. The National Abortion Federation (1-877-257-0012, www.prochoice.org) can help with referrals and sometimes costs for procedures past 24 weeks.

Here is a comprehensive list of where you can get an abortion in Canada, put together by the Abortion Rights Coalition of Canada.

If I live in the U.S. can I get an abortion in Canada? 

According to Karina Gould, Canada’s Minister of Families, Children and Social Development, American womxn can obtain abortions in Canada. However, for many, there are financial barriers to travel, and access may still be tricky.

If you or someone you know is seeking an abortion, it is essential to get the facts. Jems only recommends safe, medically supervised abortions. We’ve compiled resources and a brief FAQ to help you along your journey. 

What is an abortion?

An abortion is a safe medical procedure that functions to end an existing pregnancy.

You have likely heard a lot about medical and surgical abortions in the news lately, especially in the context of Roe v. Wade's overturning. Which procedure one undergoes depends on a multitude of factors, including personal choice, the length of the pregnancy and what's offered at a hospital or clinic nearby (and that might be in the next state over).

Here are some abortion databases that can help you find a trusted provider:

Abortion Finder is a database of hundreds of trusted and verified abortion providers in the United States. 

Plan C maintains a large database of verified abortion pill providers, including both telehealth services that provide support through the abortion process and online pharmacies that will mail you the pills with no additional support.

With three non-personally-identifiable pieces of information, which they don’t collect or store, I Need An A can give people seeking abortions the information most relevant to their individual circumstances, including local providers, financial assistance and info for those under 18-years-old. 

What is a medical abortion?

Medical abortions are procedures in which medication (i.e. prescription drugs) is used to end a pregnancy. Sometimes called “self-managed abortions,” medical abortions do not require surgery and are typically performed through the ninth week of pregnancy by taking two medications: mifepristone and misoprostol. Mifepristone works by blocking the hormone progesterone. Without progesterone, the pregnancy cannot continue to grow in the uterus. Misoprostol (which you take at home 24 to 48 hours after the first pill) induces cramping to empty the uterus.

For some, medical abortions may feel more private and less invasive since they happen in the comfort of your own home. In some instances, they are similar to a miscarriage, involve heavy bleeding and cramping, and may take longer to complete or require more appointments.

Medical abortions can be performed as soon as you find out you are pregnant. Your healthcare provider will use an ultrasound to confirm your pregnancy and how long you have been pregnant. If you are past nine weeks of pregnancy, there are other options for ending the pregnancy (see info on Surgical Abortions below). 

During a medical abortion, often you'll experience cramping and bleeding as the pregnancy passes – typically for a few hours – one to four hours after taking the second pill. You may also deal with symptoms like nausea, vomiting, fever, chills, diarrhea and headache, but particular side effects can vary based on how far along you are and how your body works.

A week to two weeks after a medical abortion, you'd typically need to visit a doctor's office for a follow up to ensure all the tissue is out of your uterus. According to some estimates, medical abortions have a success rate of around 93% to 98%, depending on how early you get the abortion.

Here is some abortion pill-related information, and resources:

Aid Access is a European site that connects you to an Indian pharmacy that sends abortion pills to all 50 U.S. states, regardless of abortion laws. Since the need for an abortion is time sensitive, and the process of getting pills sent from India can take a few weeks, Aid Access is also willing to prescribe abortion pills to people who aren’t currently pregnant in case they need them in the future.

HowToUse is a global organization and SASS (Self Managed Abortion; Safe & Supported) is the U.S. arm of global nonprofit Women Help Women. Both offer everything you need to know about both mifepristone-misoprostol and misoprostol-only abortions. 

Reprocare offers peer-based, trauma-informed emotional support to anyone having an abortion at home with pills.

If When How is law and policy advocacy organization with a free and confidential helpline that provides information and advice to people seeking to self-manage their abortions. 

Whole Woman’s Health is an independent abortion provider with clinics and virtual services in nine cities and seven states. 

Just The Pill services communities in Minnesota, Montana, Wyoming and Colorado by providing birth control, abortion pills and STI treatments. Online consultations/services are available, and they also offer support with travel arrangements and costs.

Abortion On Demand provides physician-supported medication abortion care online. Appointments are offered Sundays to Fridays for those in 20+ U.S. states. You need a positive pregnancy test and payment is between $240 and $290. Overnight shipping is possible, and comfort treatment is included.

Hey Jane offers fast, safe and affordable abortion pills shipped to your home. Consult with a medical provider within 24 hours. Medications are shipped daily at a cost of $249. Financial assistance is available and HSA + FSA are accepted. You can text their team of supportive providers at (405) 643-7957.

Mayday is a health education nonprofit with a mission to share information on how to access safe abortion pills in any state. Their info is based on input from doctors, reproductive health experts and lawyers. 

What is a surgical abortion?

During a surgical abortion, a healthcare provider surgically removes the embryo from the uterus. These abortions require mild sedation, local anesthesia (numbing the area) or general anesthesia (fully asleep). 

Surgical abortions typically have more extensive pain management options and are often available quickly and with few appointments. Some reasons womxn will opt for a surgical abortion are: personal preference, you’re too far along in the pregnancy for a medical abortion, or you’ve had a failed medical abortion.

The cervix* is gently opened with medication or medical instruments. A flexible tube that provides gentle suction is inserted through the cervix and is used to remove the pregnancy tissue from the uterus. The process takes roughly two to 15 minutes, and no cutting or stitches are needed.

For pregnancies of more than 12 weeks, you may receive medication or laminaria (sterilized compressed seaweed sticks inserted into the cervix to make opening the cervix easier) during your first appointment and then return to the clinic or hospital the next day for the abortion procedure.

For pregnancies of more than 19 weeks, you may get more medication or laminaria on days two or three and then return on days three or four for the abortion.

After the abortion procedure, you stay in a recovery area until the medical staff are confident you can go home safely.

If you are able to gain access to a safe abortion, here are some helpful pre-abortion considerations:

If you’re feeling anxious about your appointment, remember that abortions are safe procedures when performed under the care of a medical professional, and especially within the first 13 weeks of pregnancy (when more than 91% of abortions occur). 

Abortions carry fewer risks and complications than childbirth.

If you have a surgical abortion, make sure you’ve lined up a way to get home safely, as you can’t drive home from your appointment.

To relieve discomfort or pain after your procedure: 

Take a warm bath. Make sure the tub is clean before you use it.

Apply a heating pad to your lower abdomen or place a hot water bottle filled with warm water over the area.

Take over-the-counter painkillers as instructed.

After your procedure:

Stay well rested and hydrated.

Avoid any strenuous activity for the first few days. Light housework is okay but should be kept to a minimum – this includes not lifting anything heavier than ten pounds or 4.5 kilograms. You should also avoid running or working out.

Use pads to absorb any bleeding you may experience. Change the pads every two to four hours to avoid infection.

Avoid using tampons or inserting anything into your vagina* (this includes douching).

Avoid vaginal intercourse for two to three weeks, or until cleared by your healthcare provider.

Take other medicines, such as antibiotics, as instructed.

Birth control and condoms are highly effective at preventing unplanned pregnancies. Begin using a form of birth control right after your procedure. It is possible to get pregnant again even before your expected period* resumes. 

Here’s some additional and important (and frankly, a bit crazy/disconcerting to us) info:

Depending on your state, understand that your doctor may be required by law to give you written materials or counselling that includes false information about abortion, for example, that abortion can increase the risk of breast cancer (science doesn't support this) or that having a safe, legal abortion is likely to impair fertility (again, science does not back this up). 

If you feel like you are receiving incorrect information from your medical provider and want to learn more about abortions or your options beyond what we've covered here, we encourage you to explore the resources provided in this factsheet, or send your questions to @jemsforall. We'll try and answer – or direct you to someone who knows – as best we can!

More resources and support: 

Repro Legal Defense Fund provides bail and legal defense for people who’ve been investigated, arrested, or prosecuted for self-managed abortion.

The Miscarriage and Abortion Hotline is operated by a team of pro-abortion clinicians with years of experience caring for people who’ve had miscarriages and abortions. The hotline offers support to help self-manage miscarriage or abortion. You can call or text the hotline at 1-833-246-2632.

My Abortion Plan is a useful template created by Abortion Access Nashville, with links to additional resources to help fill out the plan. 

The New York Abortion Access Fund supports anyone who is unable to pay fully for an abortion and is living in or traveling to New York State by providing financial assistance and connections to other resources. You can call their hotline at 212-252-4757.

Offering help to individuals, partners, children and families, you can text Exhale Pro-Voice for nonjudgmental after-abortion support at 617-749-2948. Available in the U.S. and Canada. 

Connect & Breathe creates safe space to talk about abortion experiences by offering a talkline offering unbiased support and encouragement of self-care. ​​You can call their confidential, toll-free talkline at 1-866-647-1764.

Want to help by supporting an organization doing great work? Consider one of these donation opportunities:

With over 80 organizations in their network, The National Network of Abortion Funds removes financial and logistical barriers to abortion access by centering on people who have abortions and organizing at the intersections of racial, economic and reproductive justice. 

The Keep Our Clinics campaign provides funding to independent clinics to cover tangible expenses like increased security, building repairs, legal fees and community education and advocacy.

The Afiya Center advances the needs of Black women in health care, covering everything from abortion access to HIV programming to reproductive justice to maternal mortality. 

A Minnesota-based organization, Gender Justice engages in a number of initiatives, including ensuring reproductive health care for trans people.

Focused on the complete health and well-being of women, girls and Black femmes, New Voices For Reproductive Justice works in the Greater Pittsburgh region, and other areas of Pennsylvania and Ohio, to advance reproductive justice for Black communities and families. 

Apiary helps groups that provide logistical assistance and practical support, for example, with transportation, childcare and related costs, to people getting abortions.

Know of an org or resource that should be on this list? Please let us know @jemsforall