Bay Centre: Sexual Health Menu

Abortion Care

Service updates for appointments at WCH

  • If you have an upcoming in person appointment at Women’s College Hospital and you have a fever, cough, or new onset of shortness of breath, tested positive for COVID-19, or been instructed to self-isolate by Public Health please do not come to the hospital, call the clinic directly for more information. If you have travelled outside of Canada in the past 14 days and are fully vaccinated and have not been advised to isolate, you are welcome to come to the hospital for your scheduled appointment.
  • The hospital is open only to patients with appointments, please see our care partner & visitor restrictions information.
  • Your appointment may be changed to a virtual visit using the telephone or over video. Learn how to set-up a video visit.
  • You will receive a call from us with any changes to your appointment.
  • Masks are required to be worn at all times on WCH property. This includes, but is not limited to, parking areas, elevators and while waiting to be screened.

The Bay Centre at Women’s College Hospital provides an inclusive and holistic approach to abortion care services. We offer a broad range of abortion options in addition to comprehensive counseling, assessment and follow up. We strive to make the Bay Centre a safe space for all our patients. What matters to us is that you make a fully informed choice that is right for you. These services are for anyone who is experiencing an unplanned or unexpected pregnancy.

To confirm your gestational age or the number of weeks that you are into the pregnancy –  estimate using the first day of your last menstrual period. You can also use an online pregnancy calculator

online pregnancy calculator

  •  Counseling and Assessment

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    • During your initial appointment you will see a nurse, doctor, and possibly a social worker.
    • You may be asked to have an ultrasound and/or blood work. An ultrasound is an imaging test that uses high frequency waves to capture images from the inside of your body.
    • You will then be advised on your options for abortion care. We understand that this is a complex decision and provide counselling services to support you.
    • We provide interpretation services in a wide variety of languages for patients who need it. Family members and friends are not permitted to interpret for the patient. This is done to protect patient privacy and helps to ensure that your medical information is correctly interpreted and understood.
  • Medication Abortion

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    • A medication abortion is done using pills only.
    • It can be done up to 70 days (10 weeks) after the first day of your last menstrual period, or 56 days (8 weeks) since conception.
    • First, you will have a visit with a nurse. At that visit, we may order bloodwork and ultrasounds.
    • Next, you will meet with a physician who will discuss how and when to take the medication, as well as what to expect.
    • Following the medication abortion, we will arrange a follow up call with you to check how you are doing.

    Virtual "No Touch" Abortion:

    • A "no-touch" abortion is a medication abortion that may be helpful for those patients who do not want to visit the hospital during the pandemic or who face barriers to visiting us onsite. 
    • You will be required to complete a 10-minute questionnaire via myHealthRecord prior to your first appointment.
    • Your first appointment will be about 30 minutes and involve a telephone call with a nurse. The nurse will assess you and ensure you are a candidate for the virtual no-touch program.
    • Then you will be booked for a video visit with a physician. This appointment typically lasts for 30 to 45 minutes. During the video call with a physician, you will receive counselling on how and when to take the medication, as well as what to expect.
    • The doctor will fax a prescription to the pharmacy for the medicine you will need to take. They will then book follow up virtual visits, usually at 1 week and 4 weeks after you complete the medication abortion.
  • Surgical Abortion

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    • A surgical abortion is a procedure during which a pregnancy or pregnancy tissue is removed from the uterus. 
    • It can be done for any pregnancy starting at 42 days (6 weeks) after the first day of your last menstrual period, through to 25 weeks.
    • If you contact the Bay Centre for a surgical abortion, you will be booked for a pre-operative assessment at the Bay Centre. During this appointment you will see a nurse and a physician. You will also have an ultrasound to confirm the gestational age (i.e. number of weeks), and bloodwork. Once this appointment is complete you will be booked for a surgical abortion. You will be welcome to ask any questions.
    • We will offer an appointment with our social worker for additional counseling or to assist with additional concerns related to your abortion or pregnancy options care.
    • All patients undergoing a surgical abortion at Women’s College Hospital require a COVID swab within 48 hours of their procedure.
    • Our surgical abortions are currently offered 1-2 times per week. We work with a team of gynecologists and family doctors who provide the procedure. You will meet them the morning of your procedure and have a chance to ask any additional questions.
    • In general for surgical abortions at WCH, patients are fully asleep for the procedure. However, you can request to have no anesthesia, mild anesthesia, or to be fully asleep for the procedure. The anesthetist will discuss with you the options on the day of your procedure.

    Types of Surgical Abortion:

    • Manual vacuum aspiration

      This type of surgical abortion can be done up to 8 weeks of pregnancy. The procedure takes up to 10 minutes, and you are awake for it. We provide you with mild medications to help with pain, and a local anesthetic is used to freeze the cervix (the opening to the womb). This procedure is very safe; two visits are required (one for counseling and consent, one for the procedure itself).

    • Suction Dilatation and curettage

      This is a type of surgical abortion that can be done up to 14 weeks and 3 days of pregnancy.  It is done in the operating room,  and in general for surgical abortions at WCH, patients are fully asleep for the procedure. However, you can request to have no anesthesia, mild anesthesia, or to be fully asleep for the procedure. The anesthetist will discuss with you the options on the day of your procedure. A machine applies suction to help empty the uterus; this procedure can take up to 10 minutes. The procedure is very safe; at least two visits are required.

      If the pregnancy is beyond 10 weeks, you may need an extra appointment to insert a laminaria. A laminaria is a small firm rod that is placed inside the cervix several hours before your procedure. It swells and helps to open, or dilate, the cervix. It is also often referred to as a cervical tent, or cervical dilator.

    • Dilatation and evacuation

      This is a type of surgical abortion that can be done between 14 weeks and 4 days, and 25 completed weeks of pregnancy. This procedure is very safe. This procedure is very safe, it usually involves 2 to 3 appointments. If you are coming from out of town, please be mindful that you might need to find a place to stay for two or three nights. Bloodwork and an ultrasound will need to be completed during your first or second visit. Cervical preparation using laminaria tents is required to help to open the cervix.

      This procedure is not currently offered at the Bay Centre but is offered at other clinics in Toronto. If you think you require this procedure, you can contact:  

      If you do not live in Toronto, or want to learn about other clinics, please visit www.choiceconnect.ca.

       

    To learn more about the different abortion options available, see our chart.
    Abortion Options Comparison Chart

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  • What is complex decision-making and how do I decide what’s right for me?

    When a pregnancy is unplanned or unwanted, people sometimes feel overwhelmed by their emotions and alone. They may fear judgement from their family members, partner and peers.  Some people are certain they want an abortion. Others struggle to make this decision in a short time frame. This can be hard when some people need time to process emotions, think through decisions, and seek support from others.  It is important to seek support in making an informed choice that’s right for you. At the Bay Centre we offer pregnancy options counseling and psychological counseling. You can book an appointment at the Bay Centre without knowing if you want to proceed with an abortion. For more information or to get support contact 416-351-3700.

  • What are the risks of medication abortion? 

    Known side effects of the medications include nausea, vomiting, diarrhea, and fevers. You will be counseled on these and how to manage them. A medication abortion will lead to a few hours of heavy bleeding and pain. Ongoing heavy bleeding or hemorrhage is a risk and may require a visit to the emergency department. There is a risk of failure (2 to 5% of cases) or of retained tissue requiring further intervention with a procedure or more medications

  • What are the risks of surgical abortion? 

    Some period-like bleeding and pain is common after a surgical abortion. The risks of surgical abortion include infection, hemorrhage/heavy bleeding, retained tissue, and incomplete procedure (i.e. you remain pregnant). The likelihood of any of these risks are less than 1 per cent. Rarer risks include hematometra (trapped blood in the uterus), cervical trauma, and uterine perforation (a complication during the surgery itself where a hole is accidentally pierced through the wall of the uterus or womb).

  • Will I be in pain during my abortion procedure? 

    If you are having a manual vacuum aspiration (MVA) you will be awake with some mild pain medication. Pain is often described as mild to severe cramps. Bringing earbuds to listen to music can sometimes help. The pain does not last long as the procedure only takes a few minutes; ongoing cramps afterwards are common and can be treated with mild pain medications. If you are having a dilatation and curettage (D+C) you will be given anesthetic that puts you to sleep. You will wake up when the procedure is done.

    People having a medication abortion will experience cramps that can be quite strong when the abortion is happening. Your doctor will prescribe you some pain medications to take to help with this. Warm compresses like a hot water bottle, or gentle back massage, can help as well. The pain improves immediately after the abortion is complete.

  • How successful are medication abortions?

    A medication abortion, when using the regimen Mifegymiso (mifepristone plus misoprostol) is up to 99 per cent effective if less than or equal to 63 days pregnant and up to 95 per cent effective if up to 70 days pregnant.

  • How successful are surgical abortions?  

    Surgical abortions in the 1st trimester (up to 14 weeks) are 98 per cent successful. This means that up to 2 per cent of the time you might need a repeat procedure or to take medications like misoprostol.

  • Is there an alternative option to abortion between 14 week + 3 days and 25 weeks? 

    Yes, it is called an induction of labour. It requires admission to a hospital and can take 24 hours to 4 days to be completed. In Canada it is currently much harder to access. In general, it is considered safer to have a surgical abortion, as it is quicker, does not require a hospital stay, has a lower rate of retained tissue or retained placenta, and a lower risk of infection. People who need the products of the pregnancy examined with an autopsy or do genetic tests may be counseled for an induction of labour as there is less damage to the tissue.

  • This pregnancy was a miscarriage. Why is it called an abortion? 

    Abortion is the medical term used to describe emptying the uterus of a pregnancy. It applies to therapeutic abortions, when an abortion is done intentionally, and to spontaneous abortions, often called miscarriage.

  • I have a counseling and assessment appointment. How long will it take?

    In general, an assessment at the Bay Centre is roughly 3 hours long. That’s because we review your pregnancy options, your health history, do a physical exam, and ensure there is time to discuss your feelings about your decision, and answer any questions you have. This also includes the time required for bloodwork and an ultrasound, which are done to ensure your abortion is as safe for you as possible.

  • I am having a surgical abortion. How long does it take? 

    When you have your abortion at Women’s College Hospital, you need to arrive 2 hours before your procedure, and stay up to 2 hours after for monitoring. Although the actual procedure is short (10-15min), the total time you will spend at the hospital is generally around 5 hours.  Sometimes you may be asked to arrive even more than 2 hours before the procedure, depending on whether you need to have any extra preparation.

  • I am having a surgical abortion. Can I bring a support person with me? 

    During the COVID-19 pandemic, we are not allowing support people to accompany patients in the hospital, even for abortion care. However, you can use your mobile device to connect with them remotely during the counselling portion of your care and while you are in the waiting area for your procedure.

  • I am having a surgical abortion. What do I bring with me? 

    Please do not bring any unnecessary valuables. If your phone battery drains quickly it can be helpful to bring a phone charger. Warm/cozy socks usually help keep you more comfortable. You might want to bring a book, headphones, or something else you can do to keep busy while waiting. If you are planning to start an IUD or contraceptive implant at the time of your procedure, please remember to fill the prescription and bring the device with you. Finally, you need your health card or proof of insurance and proof of ID if not covered by OHIP.

  • Why do I need a COVID test before my surgical abortion? 

    At Women’s College Hospital, our abortion care is provided in the operating room. The anesthetic medication we provide can sometimes mean a patient needs an endotracheal tube placed, which is an “aerosol-generating medical procedure”. This is known to increase the risk of COVID-19 transmission. It is our protocol for ALL procedures and surgeries happening in operating rooms to have a COVID-19 test within 48 hours of the procedure. In the event of a positive test, you will be contacted and counseled on your options.

  • I have tested positive for COVID-19 but I also need/want an abortion. What are my options? 

    It is possible to still get an abortion after testing positive for COVID-19. Depending on your individual circumstance, your procedure may be delayed until you are considered recovered, or our team will discuss other abortion care options with you.

  • What can I expect after my abortion?

    Bleeding is common and will continue for up to 3-4 weeks afterwards. This can vary especially if you are starting a new contraception. Cramps are also common and get better with time. Acetaminophen and ibuprofen, hot water bottles, are often used to help reduce the pain. People with pregnancies over 18 weeks may get breast discharge, which is normal and will also get better with time.

  • Is it normal to experience grief and sadness after an abortion? How do I know if I need further counselling and support? 

    After an abortion many individuals feel a sense of relief, but it is also normal to experience guilt, shame, isolation, regret and sadness – all emotions encompassed by grief and loss, and due to a shift in hormones from the pregnancy.

    It is important to give yourself permission and the space to grieve. One struggle with abortion is that it is a disenfranchised loss, meaning it is a loss that society doesn’t always validate.  This means people don’t feel they have the same right to grieve the loss because it was their choice or because of the judgment and stigma around abortion.  It is important to remember that, though this loss is not identical to other losses, that does not mean it is not a valid loss.  It is an experience that you have the right to grieve.  It is part of you and your story, and you can feel, process, and integrate the complicated emotions that come with that.

    The sadness of any type of grief can become overwhelming at times, despite being normal and a natural part of the process. However, if after several weeks you find that your emotions are overwhelming, you are not able to stop thinking about the pregnancy or abortion and you are unable to return to your routine, it may be a good idea to seek professional support. Part of your care at the Bay Center is access to counselling post-abortion. For more information or to speak with the social worker on staff contact 416-351-3700. You may also choose to speak to a therapist or counsellor of your choice in the community.

  • Will having an abortion affect my ability to have children later on? 

    It is very unlikely for a surgical abortion to affect your future fertility. Some people worry about a condition called Asherman's Syndrome, which is when scar tissue forms in the uterus leading to menstrual issues and fertility problems. This condition is rare but is more likely to occur when there are complications after a vaginal delivery, miscarriage, medication abortion or surgical abortion, such as an infection. Most individuals who have an abortion go on to have normal pregnancies later in life (if they want to).  

    It is important to remember there are many factors that affect fertility. The most important one can be age. Infertility is defined as the inability to conceive after 1 year of trying. If someone is experiencing difficulties in conceiving after 1 year, or after 6 months if they are over the age of 35, we recommend they seek the opinion of a gynecologist and/or fertility specialist.

  • I do not live in Toronto and am not sure I can afford to travel there. What are my options? 

    National agencies such as the National Abortion Federation of Canada and Action Canada for Sexual Health and Rights have 24 hour Canada-wide toll-free access hotlines that can help direct you in terms of where your closest options are for abortion care. They also have small emergency funds that can help individuals address the challenges they may face in accessing care. Action Canada can often help navigate other barriers to accessing care, such as when people do not have passports and may need to travel to the US or have legal challenges that impact their ability to travel outside their region. For more information please visit their websites.

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