Pregnancy Options

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Dear Reader,
If this workbook is in your hands, you are probably pregnant and not sure what to do. You’re
in the right place. Read on. The people who put together this workbook support you no
matter what you choose. We have done our best to give you a realistic picture of all the
choices you can make—abortion, adoption, and parenting. You will find exercises to help you
make the best decision for you.
We have done our best to make this workbook inclusive to all individuals and included
information and thoughts on religion and spirituality, fetal development, and what can
harm a pregnancy. There is a special section called Taking Care of Yourself which includes
information on morning sickness, birth control, protecting your fertility, and healthy
sexuality. We have included a section for gender non-conforming pregnant people,
understanding that this can add an additional layer of complexity.
If you are having a difficult time with your decision, you may think you will never feel good
about your choice. We have found that those who are willing to explore what they think and
how they feel can help them find peace with their decision. So, get out your crayons, sharpen
your pencils, and do some “homework.” It may be the most important homework you ever
do.
Remember to listen to your heart and your own voice to find the right answer for you. Get
some help if you need it.
A word about language: We want to be as inclusive as possible for anyone involved in a

pregnancy experience. We sometimes use “women, people, and/or pregnant people”,
because we recognize that not everyone who gets pregnant identifies either as a woman
or as female. Instead of “he/she” or “him/her” you may see “they/them’’ which may seem
awkward at first but includes everyone who may have a pregnancy experience.
Thank you and good luck!
Peg Johnston Mercedes Sanchez

Southern Tier Women’s Health Services, LLC Cedar River Clinics
Creator of the Pregnancy Options Workbook
For copies of this and other publications, visit our online store at www.pregnancyoptions.info
Table of Contents
Section 1 Am I Pregnant? 1
Section 2 Getting Ready to Make the Decision 5
Section 3 Getting Support 15
Section 4 Deciding What to Do 21
Section 5 Parenting 31
Section 6 Abortion 39
Section 7 Adoption 57
Section 8 Pregnancy Stages 67
Section 9 What Can Hurt the Pregnancy? 71
Section 10 Spiritual and Religious Concerns 79
Section 11 Healing Work 85
Section 12 Taking Care of Yourself 91
Appendix Resources 101
Credits 105
Notes and Reflections 106

Pregnancy Options Workbook
Am I Section 1
Pregnant?
Where to Get a Test
A home pregnancy test is very accurate when you follow the directions. A home test or a test at a clinic is accurate
when you have missed a period by one day or more. Or, ten days after the day you probably got pregnant.
Check Out the Internet

The web has millions of listings and it is sometimes hard to find what you are looking for, and even harder to
find information you can trust, especially about abortion. Search in your local area by typing in “birth control” or
“adoption agencies” or “abortion clinic” then your city and state. Lots of places offer free or inexpensive pregnancy
tests. Examples: family planning clinics, Planned Parenthoods, women’s health centers, independent abortion clinics,
health departments, or your own doctor’s office.
Keywords on Search Engines (Google, Bing, Yahoo):

Add your city and/or state to these terms for services near you. Also ask family, friends, doctors, nurses, counselors,
and clergy for recommendations.
Abortion Clinics Pregnancy Resource Centers, Crisis

Pregnancy Centers, and All Help Centers
You will get abortion clinics listed near you.
Most abortion clinics will also do pregnancy These are organizations that provide testing but are
testing and will offer ultrasounds. Many also against having an abortion. They may be able to help
offer “options counseling” which may help those who want to continue their pregnancies, but their
you decide what choice is best for you. If main purpose is to talk women out of abortion. While
you search on abortion or abortion services, many facilities provide pregnancy testing or ultrasounds,
you will likely get organizations that oppose their staff do not usually have medical training and
abortion or are political or advocacy groups. research has found they do not offer factual information
or all options. Be sure you know what kind of place you
are going to.
Physicians and OB/GYNs Adoption Agencies

You can get a pregnancy test at a doctor’s Generally adoption agencies offer counseling about
office. They may be able to order an adoption but do not offer pregnancy testing or medical
ultrasound at the hospital or do one in the services.
office. Some doctors offer abortions or they
can give a referral.
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“How pregnant am I?”

“When was your last period?” Get used to this question! You will be asked it again and again. That’s because the
first day of your last regular period is the beginning of your cycle. This is your LMP [Last Menstrual Period]. Pregnancy
is generally counted from this date, even though you probably got pregnant 10 to 14 days later. Fetal age (or
gestational age) is two weeks less than LMP. Another way to estimate is by any symptoms of pregnancy, particularly
nausea, vomiting or “morning sickness.” Generally, nausea starts at 5–6 weeks LMP. Some people are farther into the
pregnancy than they think, so...
»» If you don’t remember the date of your last period

»» If your period was unusual—lighter or shorter than usual
»» If your cycles are not regular
»» If you have any doubt
Get an ultrasound (sonogram) or exam to know how far along your pregnancy is. Ultrasounds are available at your
doctor’s office, at an abortion clinic, or at the ER. Many crisis pregnancy centers offer free ultrasounds but be aware
that they are against abortion and may give you inaccurate information or try to pressure you. If you have insurance
it will probably pay for an ultrasound. If not, the usual fee is $50–$120. If your periods are regular, you can probably
estimate length of pregnancy from your last period.
“How do I know if I am miscarrying or having a tubal pregnancy?”

There are two ways to tell if a pregnancy is continuing, miscarrying, or if a tubal (ectopic) pregnancy has occurred.
An ultrasound at about 5 weeks LMP or more should be able to see evidence of pregnancy inside the uterus. If there
is a concern that the pregnancy is miscarrying or growing outside the uterus consult a doctor or clinic. Two blood
pregnancy tests that measure the quantity of hormones in your system 48 hours apart will help your doctor figure out
what is going on. Miscarriages (spontaneous abortions) will eventually lead to bleeding and clotting that may need
attention from a doctor or clinic.
A tubal pregnancy or ectopic is a pregnancy that does not drop into the uterus but continues to grow outside the
uterus, often inside the fallopian tube. When it bursts the tube it can cause bleeding or even death if not treated
quickly at a hospital. A tubal pregnancy can cause severe one-sided pain, pain that radiates up to the shoulder, or
weakness and fainting. Generally, tubal pregnancies should get discovered and treated before 7 weeks from the last
period (LMP). Treatment may be with a medication, Methotrexate, that will shrink the pregnancy or with surgery to
remove the pregnancy. Depending on the damage to the tube, there may be problems with getting pregnant again
with the tube on that side. Miscarriages do not affect later pregnancies.
You may have lots of questions about your pregnancy and how to decide what to do. The next section will help you
figure out what you are feeling and what you want to do.
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Am I Pregnant? | Section 1
fallopian tube
uterus ovary
cervix
vagina
3
4
Getting Ready to Section 2
Make the Decision

Everyone who is facing a pregnancy must answer one basic question...
Is this the right time for me to bring life into the world through my body AND
be responsible for that life?
Few decisions are greater than this one. No responsibility is as important as raising a child. No activity takes more
energy, more love, more patience, more of everything than having a child. No matter what you choose—carrying the
pregnancy to term and parenting, making an adoption plan, or having an abortion there is sacrifice and pain.
Here are some other questions to think about...

Do I want to have a baby (or another baby), now or ever?
Will the child have another parent who is present or “there” for you?
How important is it to have another person to help parent with you?
Can I afford to have a child?
What will happen to my goals, my hopes, my life?
What will happen to my partner’s life?
Can I raise a child by myself?
Who can help me raise a child?
How will my family react? My friends?
How will this affect my other children (if any)?
Is my body healthy enough?
This is the main question...

Is this the right time for me to be responsible for a child?
Consider all your options carefully. The next pages will give you some thoughts about how to make this important
decision. The three sections after that will help you think about your choices: parenting, an abortion, or an adoption.
And even though we might wish for another choice, there are only these three choices.
If this is hard for you, give yourself credit for dealing with one of the biggest questions about life. This can be a very
complex decision. Take your time. Go through each section one at a time. Make a safe place for you to think. Write
your thoughts down as much as you can. Ask for help when you need it. Take full responsibility for your decision. Don’t
let anyone else make it for you.
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Giving Yourself Time and Space to Think

»» Sometimes we don’t want to think about But, remember, this decision will affect the rest of
things and we try to keep ourselves busy so your life. You owe it to yourself to make time! When
that we don’t have time to think. you are pregnant, time makes a difference. If you are
even considering an abortion, please try to make
»» Sometimes we don’t have time because our your decision in the first 10–12 weeks (from your last
kids need so much of our time and energy. period). This will make it a safer, less expensive, and
»» Sometimes we are busy with school, work or easier procedure for you. If you need more time to
activities. come to terms with your decision and feel at peace,
that’s ok too, but having an abortion earlier in a
»» Sometimes we are hiding this decision from pregnancy means you may have more options in your
others and it’s hard to find the time and area. If you are considering continuing the pregnancy
space to think about it. to parent or for adoption, start prenatal care as soon as
possible.
Exercise: “How can I make time to think?”

I could ask to watch the kids for me.
I could skip .
I could stay home and think instead of doing .
I could talk with .
Other thoughts on making time for myself .
Exercise: Making a Safe Place

Now you will need a place that is free from interruptions (TV, other people, phone calls, texting). Can you hear yourself
think? Is there a safe place for you? (your own room, the park, the library, etc) Describe it. Write your answer here:
Now that you’ve got a time and place to go through this workbook, let’s get started. The next section deals with how
you are feeling.
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Getting Ready to Make the Decision | Section 2
Exercise: Are you in shock?

Are you having a hard time believing you’re pregnant? Take this test. For many, finding out that you’re
pregnant is very stressful.
How long ago did you start thinking you might be pregnant?
1 = rarely 2 = sometimes 3 = often 4 = all the time
I think about it when I don’t want to. How to Score Yourself

I have trouble doing my work.
16–30 indicates a mild reaction.
I won’t let myself get upset when I remember I have to decide.
31–45 indicates a moderate reaction;
I don’t feel like eating. you could benefit from the following
workbook.
I have trouble falling asleep or staying asleep because I don’t
know what to do.
46–60 indicates a severe reaction
I have waves of strong feeling about it. that may be keeping you from your
feelings. You need help.
I have dreams about it.
I stay away from babies.
I feel as if I’m not pregnant or it’s not real. Please note: If your score does not
indicate that you are having a severe
I try not to talk about it. reaction, but you still feel troubled,
consider talking to a counselor or
Pictures of babies come into my mind.
health care worker for help. Continue
I can’t stop crying. to finish the workbook and ask
and answer all the questions. Take
I’m aware that I still have a lot of feelings about it, but I don’t the time you need to make a good
deal with them. decision. Please read on.
I’m feeling a little numb.
My friends tell me I don’t laugh anymore.
Total (Add up your score)
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Understanding Shock
Have you ever known people who were in a car accident, even a minor one? Initially they often say, “I’m
fine.” Later, they might feel scared, shaky, or have trouble eating, sleeping, or doing work. Did they tell
the story of the accident over and over? Those people were trying to deal with the shock of the accident.
Telling the story is a way to understand what happened, and “catch up” to events that are too much to
take in.
Sometimes finding out that you are pregnant can be a “shock.” What we know about how people deal with accidents,
crimes, and natural disasters can help you too.
When we are in shock our rational side (head) and our emotional side (heart) can become divided. When we are in
shock, it’s like we are frozen or cut off from normal ways of dealing with stress. Part of us goes on automatic. The
feeling part of us goes into hiding or goes numb. In other words, the part that gets hurt or scared or overwhelmed goes
into hiding. The rational part that is strong and capable but cut off from feelings tries to take over and handle life.
The best way to make good decisions is to have both the head and the heart available. It is necessary to bring the
feeling part and the thinking part together to get out of shock. It is normal to be a little in shock when you find out
you’re pregnant. But it is important to get out of shock so you can make a good decision for your life.
The best way to do that is to tell the story of your pregnancy (just like any other overwhelming event). You can tell it to
a friend, a relative, your partner, or a counselor. Pick someone you trust who cares about you. Try to remember how
you were feeling at different times. Ask the person just to listen, not to judge, not to tell you what to do, nor tell others
without your permission.
The exercises on the following pages will help you get out of shock and help you make the best decision you can.
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Exercise: What are you feeling?

It’s not always easy to know what you’re feeling. Start with these basic feelings. Choose those
that apply and divide the circle up into pieces that represent which feelings you are having.
anger sad shame scared happy
Here are some other feelings and thoughts you might have (circle all that you are feeling).
confused overwhelmed confident stupid uncertain alive
happy unreal panic numb guilty comfortable
anxious relieved trapped strong embarrassed scared
like crying selfish resolved grieving relaxed peaceful
lost disappointed alone worried unloved other
Draw a circle and divide it into sections, Where on your body

then label the pieces with the feelings you are you feeling what
are having. you’re feeling?
Emotions seem like they
“sit” in a part of your
body. Put your hand
where you notice feelings.
Some feel it in their
stomach, or around the
heart, or they feel tension
in the neck or head or jaw.
Does it help to rub that
area? Take slow, deep
breaths?
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Exercise: Feelings Anger

How angry are you? (circle)
Ask yourself: “How do I feel? What does that • furious
feel like? Is there another feeling?” • annoyed
Here are some questions and exercises to help you • really mad
understand your feelings about being pregnant. If this • “I’m so mad I can’t speak”
seems too hard at first, take a break and come back to • I feel “mean”
it in a little while. • upset/angry
• hurt/angry
• “If I wasn’t so angry, I’d cry”
Who are you most angry at?
If you’re angry at someone, what do you wish they

could have said or done?
If you’re angry at yourself, why?
Are you expecting perfection from yourself?
Where did you learn you needed to be perfect?
What could you have done differently?
What can you do differently from now on?
What are some ways to express your anger?
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Sad Shame
What is the saddest part of this for you? (Clue: when Shame is something we learn very early in life.
you think about it or talk about it, this is the part that Somehow, we get negative messages about
makes you cry.) ourselves. It’s the feeling that there is something
“flawed” or “basically wrong with me.” (Clue: this is
the thing we wouldn’t want anyone to know about
us.)
Some things that people might feel ashamed about

are: sex, having an affair, abortion, making a mistake,
Do you have a sense of loss? being poor, being a victim of sexual or physical abuse,
or just being different. It may be hard to overcome
these feelings and you may find it helpful to talk to a
trained counselor.
Is there a shameful part of this for you?
What are you losing?

Is this feeling familiar? Does it remind you of another
time in your life?
Did anyone try to make you feel this way?
There may be more than one thing. You might feel

that whatever you choose, you’ll lose something.
Write down what you think you are losing:
What is a more positive message you can give

yourself? Sometimes it helps if you pretend you’re
talking to your best friend. How would you respond if
they told you the same story?
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Scared Happy
Fear is a common feeling when we are facing
Happiness is feeling content like “everything is right.”
something new or when we are feeling alone. What
“No problem!”
are you afraid of?
I’m happy because:
When have you been really scared in your life?

The best part is:
Is anyone else happy or unhappy?

What helps you feel less scared?
Does what make you happy make someone else

unhappy? Who? Why?
What have you done before to deal with those fears?
What could happen to your relationship to that

person?
Who can you ask for help?

How do their feelings change depending on your
choice? If you decide to parent?
What information could help you feel less scared?

Or have an abortion?
(Example: An explanation of what the doctor does)
Or choose adoption?
Do you sometimes feel panic?

Do you feel like you understand yourself a little better
now? If not, some of the exercises in the next sections
may help. Complete them and return to this section.
Are you worried about pain?
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Exercise: Write or draw your story about being pregnant

Sometimes it helps to actually write out or draw your story, especially if you don’t have a lot of people to talk to.
Include: how you got pregnant, who you got pregnant with, how you knew you were pregnant, how you felt when you
found out, who you told, how they reacted, and anything else important to you.
When you’re done, tell a trusted person the story. Choose that person carefully; it’s important to both understand
yourself and be understood by someone else. Ask them to listen and try to understand you, not to judge or give their
opinion. The next section looks at who can support you. If you don’t have anyone to tell, you can call All-Options at
1-888-493-0092 to talk with someone confidentially.
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Getting Section 3
Support
Although this decision is yours—hopefully with the help of your partner or family (whatever that means
to you)—you need support. The best support comes from people who will listen to you, offer their
feedback, but not tell you what to do. They should not judge you, but will try to support you no matter
what you choose. They shouldn’t tell others without your permission.
Think about who would be a good person to tell. In the past,

“i told two or three people
»» Who was the friend or family member was most supportive?
and they told two or three.
»» Who didn’t tell your story without your permission?
it was a nightmare. i got
»» Who didn’t judge you?
totally lost in the whole
»» Who isn’t always criticizing other people?
»» Who have you already told?
thing.”
»» Who else might be helpful?
»» Would telling this person be hurtful to them? “i’m not usually that close
to my dad but he really
helped me.”
Asking for Help
A tip about asking for help: If you are worried about what people will say, “at first i thought my
mother would freak, but she
tell them what you need. For example, you could say:
»» “I really need you to listen.” was really ok.”

»» “It would help me if you could...”
»» “I want to talk to you, but I need to know you won’t tell anyone
else.”
»» “I’m worried that you will judge me (or get upset), but I want to tell
you something.”
Another thing to remember: Give the people time to have their own feelings
and try not to be too upset if they say things that are not supportive. Most
people react to unexpected news and then calm down and can be more
helpful. Also, tell them in a private setting, not in a public place or while
they are driving. If you are worried about a violent reaction, have someone
else there who can protect you and have an exit plan ready.
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Exercise: Telling/Not Telling

Telling Parents and Family
If you are young—or even if you are not—you may be wondering whether to include a parent or caretaker in your
decision. In many states a parent or legal guardian of a minor (under 18) must be notified or give consent if you want
to have an abortion, place a child for adoption, or seek medical care. Even if you decide not to tell them, it’s good to
imagine what they might say or think. For information about whether your state requires that your parents be told
before an abortion ask your local clinic or family planning agency.
• What’s the best thing they would say or do?

• What’s the worst they would say or do?
Here are some things to think about:

• I want to tell:
• They would probably think:
• They would probably say:
Here are some reasons young (and not so young) people give for not telling their parents/guardians. Are any of these
similar to your situation? (Check all that apply)
My parent/guardian(s) would yell at me, maybe throw me out, or be violent.

My parent/guardian is sick, or having a hard time right now, I don’t want to add to their troubles.
My parents/guardian would be upset. And then I couldn’t make up my own mind.
I feel it’s my decision and my life and I just don’t want to involve them.
I think they would support me, but I want to make this decision on my own.
If I tell them they will make me (raise the baby, have an abortion, place the baby for adoption).
My parents/guardians will ground me and not let me see my partner.
They will be disappointed in me.
I really want to tell my parent(s) but I’m afraid of
Other
Look at what you have checked. Is not telling them better for you or better for them? Remember, this is a big event in
your life. If you need them, ask for their help.
You should involve a parent if: The handout Mom, Dad, I’m Pregnant offers help in
telling a parent or caretaker you are pregnant. The
• you would feel safer if they knew “Mom, Dad” page at www.abortionconversationprojects.
• you need their advice org/conversations/ includes helpful tips for you, your
• not telling them would hurt your relationship with them parents or caretaker(s), your partner, and their parents
• not telling them would make you feel bad or dishonest too. The handout for you and your parents is in English
• you need their help with money for a doctor, and Spanish.
transportation, support, or because it is required
Note: In some states notifying a parent is required to get
If you cannot tell a parent/guardian about being pregnant, is an abortion. It is possible to request a judicial bypass by
there another adult or family member you can tell? telling a judge that you are mature enough to decide for
yourself. Ask for help at an abortion clinic.
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Getting Support | Section 3
Telling a Partner/Boyfriend/Spouse
Some couples come together in making this decision and some pull apart. The best situations happen when both
of you can talk honestly about how you feel and listen to each other without blame or hurt. The website www.
abortionconversationproject.org/especially-for-men/ may be helpful to them.
Is your partner saying any of these things? (Check all that apply)
I can’t afford a child. See you later.

How do I know it’s mine? I’m too young.
What ever you do, I will support you. I’m too old.
I’m not ready. I’m worried about you.
I’m scared. I’m not sure what to think.
I want you to have my baby. I can’t be a good provider right now.
Write what you partner is saying:
What do you wish your partner would say?
Telling Friends
Most people have one or two friends to support them
“i don’t know what i would have done
in their decision. Choose wisely. Tell them what you
need. Ask them to listen, not to tell you what to do. Ask
without my girlfriend. she could listen
that they not tell anyone else without your permission. when my boyfriend couldn’t.”
Telling a Counselor
Sometimes you need to talk to someone outside the situation, someone who understands, who can explain things,
and who will listen to you—in other words, a counselor. If you’re already seeing a counselor, bring it up in your next
session.
Family planning, Planned Parenthood, and reproductive or women’s health clinics usually have counselors on staff
who offer options counseling. Or they can refer you to a counselor who can see you quickly. Sometimes a teacher,
guidance counselor, religious leader, your doctor or nurse can be helpful.
No matter who you talk to, remember that they are human and can make mistakes. You should feel that they listen
to you, treat you with respect, give you accurate information, and let you make up your own mind. They should not
threaten to tell anyone else without your permission or call you when you don’t want to be called. If you are not
comfortable with a particular counselor, see someone else.
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Exercise: My Support Team

My support team (people who will listen, not judge):
If you have told any of these people, what did they say?
What do you wish they would say?
Can you tell that to them?
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Getting Support | Section 3
A Note For Gender Non-Conforming Individuals
“I don’t identify as a woman and yet I’m pregnant. How do I get help?”
If you don’t identify as female, but find yourself pregnant, you may have confusing feelings or find your decision
difficult. Any discomfort you may have with your body may come to the surface and demand your attention. Often a
pregnancy decision brings up powerful feelings that may be unexpected. Take your time to consider all your feelings. If
you have a counselor or support group talk to them.
You may worry about accessing sympathetic reproductive care. If you don’t have a regular doctor or clinic that can
help you find care, do some research on clinic webpages. Call the doctors or clinics in your area and ask to speak to a
manager. Ask if they have experience treating transgender individuals. Ask them to respect your name and pronouns.
Ask for what you need to feel comfortable. You may want to have a friend or advocate do this research and/or
accompany you for appointments.
Take some time to de-brief after each appointment and get the support you need. Are there takeaways from your
experience that can give you insight into issues in your life?
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Deciding Section 4
What to Do
The decision about this pregnancy is yours. Think of yourself as a “gatekeeper of life.” You can decide
whether or not a new life will come into the world through your body. This is your right, but more than
that, it is your responsibility. Only you can decide whether you are ready to be responsible for raising a
child. Only you know what your plans and dreams are for your life. Deciding about a pregnancy may be
difficult for you, yet, no one is better able to decide than you.
Decision-Making in Your Family
Take a minute to think how decisions get made in your family.
»» Did everybody have a chance to talk about it?
»» Or did one person just decide?
»» Did everybody get mad?
You may feel like you don’t know how to make such a big decision.
»» How do you make decisions?
»» Is it difficult for you to decide what to do, even simple decisions?
»» Do you feel you have to be “perfect”?
»» Are worried that you might make the wrong choice? If so, you may need more help and support in thinking
through this decision. This is a decision about your life and it has to feel OK for you.
Is there someone pressuring you into one decision or another? Do you fear their hurtful
or violent reaction? (see section on abuse below) Do you feel they would be angry or
disappointed? While we care about those closest to us, you have to “own” your decision.
»» You can decide the way you’ve seen your family do it or you can decide a different way.
»» If deciding is very difficult for you, please read the following and get more help. You have already done some
exercises to help you decide. The exercises on the following pages may help you even more.
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Heartsick? Did you have any miscarriages?
Some people know what they need to do but they feel • How far along were you?
heartsick. In other words, their head says one thing,
but their heart feels sick or heavy. Or, they know what • Were you very sad?
the right choice is for them but their head is confused.
If this describes you, please take some more time • Did people around you help you?
to work out how you feel. Or, consider talking to a
counselor. It is possible to connect your head and your • How do you feel now?
heart. It is possible to feel OK about yourself and your
decision.
Did you have any abortions?
Have you ever been pregnant before? • How old were you?
• Have you ever been pregnant before? Your past
experiences may influence how you feel about this • Did someone else make your decision for you?
decision. If you have never been pregnant, skip to
the next section. • Was it difficult? Physically? Emotionally?
• Did you have physical or emotional problems

Did you have one or more children? afterwards?
• How old were you?
• How did you feel then?
• Did someone else make your decision for you?
• How do you feel now?
• Was it difficult? Physically? Emotionally?
Did you place a child for adoption?
• How old were you?
afterwards?
• Did someone else make your decision for you?
• Was it difficult? Physically? Emotionally?
• How do you feel now?
• Was each baby healthy?
afterwards?
• Was each pregnancy difficult or easy? Describe any

problems.
• Was the baby stillborn? Do you know if there is a • How do you feel now?
problem that could happen in another pregnancy?
(Talk to a genetic counselor or your doctor.) No matter what happened—an abortion, deciding to
parent, making an adoption plan—did you feel able to
make your own decision about the pregnancy? Or, did
you feel someone else made the decision for you? Do
you feel resolved or at peace with what happened? If
not, what is still difficult? How has being a parent, or
22 not being a parent, changed your life?
Deciding What to Do | Section 4
Other Pregnancy Stories “when the lady at the clinic first told
• If you haven’t been pregnant before, have you me i wasn’t ready and had to go home and
think about it, i was angry. i wanted it to
heard stories about or been present for the
pregnancies of family or friends?
• How about your mother’s pregnancies or a close
relative? be over. i thought i could have my feelings
later. i worked through the exercises and
now i feel comfortable, positive, and not
Think about these stories about pregnancy—
childbirth—abortion—adoption—miscarriage—
stillbirth—infertility (not being able to have a child)
ashamed or guilty about my decision.”
Write the name of that person and her story on another
piece of paper.
Whenever we are pregnant, we remember other

“the saddest part is that i can’t return to
pregnancies or stories about pregnancy. These
stories will bring up feelings. How do these feelings
that place before the pregnancy.”
about your past, or about someone else’s experience,
“i thought i had to go through it for my

influence how you feel about this pregnancy? By
remembering these stories you can understand how
this feels different or the same. If there are feelings you
need to deal with, you might want to seek the help of a husband. now i know i am doing the right
counselor.
thing for me.”
Each pregnancy is unique. Every time is a different
time for you.
“i felt so bad, i really thought i was
going to die. but, after i talked to the
counselor and did some of the homework, i
felt better. still sad, but ok.”
23
Dealing With an Abusive “i was pretty sure he got me pregnant on

Relationship purpose. i didn’t want to be pregnant, but
If you are in a relationship with a partner who is abusive,
the decision about how to proceed with a pregnancy can he threatened to kill himself. his mother
be even more difficult or challenging. Your partner may
have strong feelings about continuing or not continuing
said this baby was the best thing that ever
the pregnancy. You may have found out that you were happened to him. i felt so stuck.”
pregnant after leaving the relationship and wonder if you
should try to work things out. Or, you may ask how you
would manage being a single parent. You may worry about “i would leave the house after we fought,
what might happen if your partner found out you had
an abortion. For your physical and emotional safety, you
but we had two puppies and if i left, he
might feel like it’s important for your partner not to know wouldn’t feed or walk them for days to get
that you are pregnant. There’s a lot to think about.
back at me. when i got pregnant, i thought
Sadly, abuse and partner violence are actually common
experiences. The Center for Disease Control estimates that
about him alone with a baby and it really
one in three women will experience some form of partner scared me. it broke my heart, but i knew i
abuse in her lifetime. Abuse can take many forms. When
most hear the word, they think about physical abuse— couldn’t bring a baby into that.”
slapping, hitting, pushing. Abuse can also include name
calling, mind games or accusations, forcing someone
to have sex or be intimate when they don’t want to,
“i wasn’t sure that i wanted the baby and
sabotaging birth control, controlling someone’s finances, i didn’t know if i was going to keep it
or not, but he posted on his social media
embarrassing them in public, withholding medical care or
trying to disrupt relationships with your friends or family.
If your relationship is or has been violent, controlling

that i was pregnant for everyone to see. he
or abusive, it is important to know that the stress of a called my parents and told them before i
could. ‘now you can’t have an abortion,’
pregnancy is likely to cause this to increase. According
to ACOG, approximately 20% of women seeking care in
family planning clinics who had a history of abuse also
experienced pregnancy coercion and 15% reported birth
he said, ‘because everyone will know.’”
control sabotage.
“having sophie was the thing that helped
You deserve to be physically and emotionally safe. You
deserve a partner who does not hurt you. Even though you me get out of the relationship. i wasn’t
may feel embarrassed or want to deal with this privately,
now is a really good time to talk with friends, family, a
strong enough to leave by myself, but when
counselor or a local domestic violence agency about i felt like i needed to protect her, i went
what’s been going on. They will help you understand your
rights so that you can make the best decision for yourself to the local women’s shelter and asked for
and your life. To find the nearest services, call 1-800-799-
SAFE (7233).
help. it has been hard and he’s said and
done some really hurtful things, but i got
24 myself out.”
Exercise: What if.... then Exercise: Draw a picture of

what? your life
Finish the sentence: “What would happen if...?” and Draw a picture of your life in one year with, and then
put that answer in the middle of a large drawn circle. without, the child from this pregnancy. Use a separate
sheet of paper.
Draw another circle next to it and answer the question,
“Then what might happen...?” Draw a picture of your life in five years with, and then
without, the child from this pregnancy.
Continue for as many times as you can, and as many

answers as you can think of. Use additional paper as
needed. Start with each option you are considering.
(Example: What if I had a baby. Then, I would take a
year off school. Then, my partner would... etc.)
“i used to have a lot of girlfriends, but they didn’t like they way he treated me. they didn’t even
know about the pushing and the hitting. my one friend said that she just couldn’t sit and listen
to how he bossed me around, so she stopped talking to me. another friend told me that if i respected
myself, i wouldn’t put up with it. i felt like i had to choose between them and my baby’s dad. i
haven’t talked to any of my girlfriends for about a year now.” 25
Exercise: The Pie

How big is the part of you that wants to choose parenting,
an abortion, an adoption? Draw a circle. Divide the “pie” into
sections. Label the parts of the pie, “parenting” “abortion”
“adoption.”
How big is the piece that is what you want for each option?
Draw circles for each option and label what other people, including yourself, want. How big is the piece that belongs
to what others want? Put their names in their pieces of the pie. For example, in one circle, your mom and your partner
might be more than 50%. What about you?
Parenting Adoption Abortion
boyfriend
me
mom me
me mom
mom
boyfriend boyfriend
Parenting Adoption Abortion
26
Exercise: Pros and Cons (Yes and No)

Write your list of pros and cons for each option: parenting, adoption, and abortion.
Pros Cons
Choosing to parent
Choosing adoption
Choosing abortion
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“What if I think I made the wrong choice?”

Deciding about whether or not to have a child can feel like such a big decision that it feels impossible to make a
decision that you can live with. Before you make a final decision, it is worth asking, “What if I feel like I made the wrong
choice later?”
»» How will you feel? How would you know that you made the wrong choice?
»» Can you forgive yourself? Who will support you?
»» What will others say or do?
»» Who will help you through your questioning?
Return to the decision making exercises, especially the “What if” exercise and ask the above questions for each option.
Now ask yourself, “How can I get better if I regret my decision?” Sometimes we expect that our lives should be perfect
or that we will never make a mistake. But, we forget that not everything is completely within our control, and that
we humans are not perfect. If you see yourself as a “perfectionist” and having a hard time, you may benefit from
discussions with a counselor or therapist.
Write a letter to your future self and remind yourself the situation you were in, how you felt, and how you wanted to
make peace with your pregnancy decision. The letter can remind you that you were trying to do the right thing for
all concerned. It can remind you that you were trying to make a good decision for your life and your family, with the
information you had at the time.
Think about the idea of forgiveness or compassion. If you feel you need to be forgiven, who should you ask forgiveness
from?
»» God, the “baby”, yourself, someone else?

»» Who will help you if you are in an emotional crisis?
»» Can you tell them your fears now?
»» Is there a counselor or clergy person you can talk to?
»» Finally, what might comfort you if you feel you made a mistake?
Some find comfort in ritual (See Healing Work in this book and the Abortion Resolution Workbook at www.
pregnancyoptions.info)
See also Healthy Coping After an Abortion www.abortionconversationproject.org. Or call All-Options for help in
decision-making at 1-888-493-0092 or go to www.all-options.org/find-support/talkline/
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Dealing With Regret

Some people look for meaning in the hopes and goals that guided their decision in the first place. It may be difficult to
understand now, but ask yourself, “What is the gift of this pregnancy?” “What have I learned about myself?” “Has this
experience made things clearer to me?” You may need to return to these questions after some time has passed.
»» What have you learned about yourself and your strengths?

»» What have you learned about your life? Your relationships? Your goals?
»» Some find that it helps to “count their blessings”—their children, the love of others, their home or work.
»» Some find that they make resolutions about the future—about birth control, about relationships, about
listening to their own voice.
It is possible that no decision will feel completely right or good. Sometimes we have to do the least bad thing and
know that we are doing the best we can do. Sometimes we realize that life is not fair, and no option is good. It is
possible to think that we made the right choice but still feel very sad about it, or guilty.
Feelings about a pregnancy decision are normal; after all, it is a big decision about life. It’s important to find ways to
express your feelings. This will help you resolve your feelings and get back to your life.
Pregnancy Decision-Making
It may be that even with all this work, we can’t really know what it’s like to have a child of our own, or to experience
abortion or make an adoption plan. Sometimes it seems that we put more time and research into what car we want or
what food to eat! Get the facts. Examine your intentions for your life. Listen to your true feelings and find someone to
tell your truth to. Make a decision with your head and your heart.
Guided “Day Dreams”

Guided imageries or visualizations are a way of using your imagination to understand feelings. It’s like a daydream
with instructions. This and other guided daydreams are on the internet at www.pregnancyoptions.info, both in words
and recorded. This exercise may help you form pictures in your mind or you may just get a sense of things. There is
no right or wrong way to have this experience. Let yourself experience the feelings that come up. Listen to your inner
wisdom. Take your time.
This is a powerful tool to connect your head with your heart. Find a place where you can be comfortable and where
you won’t be interrupted or disturbed. Each guided daydream takes about 10–15 minutes. Think of the place you are
most peaceful, and you will know where to go. After you have practiced the guided daydream, you will know that you
can create peace and relaxation any time you want to. Just notice your breathing, allow your body to relax, and in your
mind’s eye, go to a place that is beautiful and peaceful and safe.
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30
Parenting Section 5
Some questions and possible answers to consider...
“What should I do first if I want to continue “Do I have to quit smoking and drinking?”
this pregnancy?”
Those who do not drink, smoke, or do drugs have
Find a doctor, clinic, or midwife as soon as you think a lower risk of stillbirth, SIDS (Sudden Infant Death
you might be pregnant. Ask friends who are recent Syndrome), premature birth, small or sick babies, and
parents which doctors or midwives they liked. Or some birth defects. Stop as soon as possible. Stopping
search the internet under “Physicians-Obstetricians” anytime during the pregnancy will help prevent
sometimes known as “OB-GYN in your town.” Or problems for your baby. If you feel you can’t stop
consult your hospital for a birth clinic. If you think you drinking alcohol, smoking, or using drugs, ask your
can’t afford to see a doctor, ask your county Medicaid doctor or clinic for help.
program about a special program for pregnant people.
“What about my medications?”
“What is a nurse-midwife?”
If you think that you may continue the pregnancy, call
They are nurses who are specially trained to deliver your physician or psychiatrist to see if the medications
babies and give care during pregnancy. Midwives can you are taking are safe for a developing fetus. Your
give you lots of support during the pregnancy and doctor may tell you it is safe to continue or may
during labor. They prefer low intervention delivery and suggest a different medication while you are pregnant.
less “high tech” monitoring and medication. Nurse-
midwives work with a doctor if you need a higher level “Can I do it alone?”
of care. A doula, often works with midwives to offer
emotional support before, during, and after a delivery. This is one of the most important questions to ask
yourself. Will you have support in raising a child? What
about your partner or parents/guardian or extended
“Are there things I should or shouldn’t eat?”
family? It is very difficult to take care of a child alone.
What you eat affects your pregnancy, so eat as well as And remember, support comes in many forms—
you can and take pre-natal vitamins as soon as you financial, emotional, physical such as housing, and
can. In the first few weeks, it’s good to have lots of folic social such as friends and childcare.
acid, vitamin B12, and other minerals and vitamins to
prevent certain birth defects. Generally, you want to “What kind of financial support is available
eat good food—fresh or frozen fruits and vegetables, from welfare/social services?”
lots of dairy foods, proteins, and whole grain foods.
You want to stay away from junk food and fried or fatty There are programs like Medicaid that will help with
foods that don’t give you much nutrition. Also, avoid or medical costs. Your County Social Services department
reduce caffeine in coffee, tea, or soda if you can. may be able to help with very basic living expenses.
Both parents of the baby will be expected to provide
financial support. WIC (Women, Infants, and Children)
can help with nutritious food during pregnancy and
up to age 5 for the child. There may be other forms of
assistance in your community. Private agencies like
Family and Children’s Society and other groups may
be able to help.
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“Can I make it through labor?” “What is it like being a parent?”

The average length of labor for a first pregnancy is It’s probably not possible to imagine being a parent
between 12 and 24 hours. It is understandable to until you have a child. It is truly life altering to have
fear labor, but fear of labor should not be the most a baby. As the child grows and develops their needs
important factor in your decision. There are many change. During the first several years, parenthood is
choices in delivering a baby. A low intervention a 24/7 responsibility and it can seem very challenging
delivery is having a baby without any pain and stressful. Later, there is school and activities and
medications. Or your doctor may offer some pain a lot of demands on your time. And when the teenage
medications. Or you can have complete pain relief with years come children are trying to be independent
an “epidural anesthesia” where you are numb from and you are trying to protect them. At each stage, it’s
the waist down. Talk these over with your doctor or important to be able to give nurturing love and to
midwife. handle your own feelings and get support for yourself.
Parents sacrifice a lot but they feel it’s worth it to do
“What is labor like? Can you describe it?” things for their child. Having a child will change your
life.
It might be different for everyone. Each step may take
more time or less time and everyone has a different “Will I be depressed after giving birth?”
pain tolerance. Most labor is do-able. At first, the
contractions are not so bad and you can smile. The It is completely normal to have a lot of feelings
next stage is painful—you can still function but it’s including mild depression, sometimes called “baby
hard. Then you reach what they call “transition” where blues” in the week or so after delivery. There will be
it is very difficult and you may not think you can do it. a lot of changes in your life and new responsibilities.
It’s like swimming in a rough ocean with waves hitting In 80–90% of all pregnancies people report that they
you one after another. This generally lasts about two cry a lot and feel moody during the first week. About
hours. Then you feel an urge to push, and this part is 10–20% may have “post partum depression” which
better because you feel like you can work with your makes them feel sad or find it hard to function. This
body. When the baby’s head starts to “crown” or can last for several weeks or up to a year or more.
come out you may start to feel overwhelmed by the Remember, you and your body have gone through
stretching, pushing, and burning feelings. But this only a lot. And your life has changed in big ways. You will
lasts 10 minutes or so, and then the baby comes out. probably feel tired a lot and will have to be responsible
for your baby’s every need. If you feel depressed and
Contractions work by pulling up on the cervix to open it doesn’t go away after a week or two, talk to your
it wide and by pushing down on the baby to push it doctor or midwife. Usually support, lifestyle changes,
out. The cervix has to open 10 centimeters (about 4 1/2 and counseling can help. Sometimes some medicine,
inches). The first part of this opening process, up to 5 or rarely, hospitalization is needed. If you can’t think
centimeters, takes a longer time and is easier than the clearly, are anxious or feel panic, or fear that you are
last half. The last part of the dilation happens quickly, going to harm the baby, call your doctor or mental
usually in about 2 hours. health crisis line immediately.
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Parenting | Section 5
Exercise: Parenting
»» What dreams do you have for yourself? (like college, career, travel, marriage?)
»» What is your dream about having a family?
»» Where do you see yourself in 5 years? In 10 years?
Your life now

»» Have you ever done any baby-sitting or childcare?
»» What did you like about it?
»» What didn’t you like about it?
»» What do you do on an average Saturday or Sunday?
»» What do you look forward to?
»» Could you give that up and stay at home with the baby?
»» Could you take a baby with you to those activities?
»» If you are still in school, can you continue?
»» If you are working, when will you want to return? When will you have to return?
»» Who will take care of your newborn?
»» Who would take care of your child if you get sick?
»» Are your friends having babies?
Your partner, if present

»» Do they want to be a parent to this child?
»» Do they have children already? How many?
»» Do they spend time with their children? How often?
»» Do they provide financial support for their children? Do you know how much?
»» Do you want or expect them to help you raise your child? Do they want or expect to?
»» Whether or not you are in a romantic relationship with them, could you work together to parent your child?

»» Do you trust them to take care of a child? Do they drink, take drugs, are they violent?

»» If they are not part of your baby’s life, what can you tell your child about their other parent?

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Exercise: Support—Who can help?

What kind of support can you expect from each of the following people? (Check all that you think might happen.)
Check out these committments with the people involved.
My Partner My Sibling ( )
Live with us? Provide baby-sitting? Everyday? Weekends?

Get up in the middle of the night? Once in a while?
Change diapers? Buy things for the baby?
Read books to the child? Let us live with them?
Play games with the child? Give us money regularly?
Help with homework? Play with the child?
Financial support until the child is 18?
Take care of the child when I need a break?
Take care of the child 50% of the time?
My Parents My Friend ( )
Provide baby-sitting? everyday? weekends? Provide baby-sitting? Everyday? Weekends?

once in a while? Once in a while?
Buy things for the baby? Buy things for the baby?
Let us live with them? Play with the child?
Give us money regularly?
Play with the child?
Partner’s Parents Other Relatives ( )
Provide baby-sitting? everyday? weekends? Provide baby-sitting? Everyday? Weekends?

once in a while? Once in a while?
Buy things for the baby? Buy things for the baby?
Let us live with them? Let us live with them?
Give us money regularly? Give us money regularly?
Play with the child? Play with the child?
34
Exercise: Family History
»» At what age did your parent/guardian(s) have children?
»» At what age did your grandparent(s) have children?
»» How about other family members?
»» How was this for them? (Ask them if you can.)
»» Find out how they felt about it then and how they feel about it now.
»» What kind of support did they have?
Some Questions for Support People

If you are expecting support from anyone, check with that person. Some may say, “I’m done, I raised my children.”
Others might like the idea of helping out with a child. How much can they realistically help financially? How much time
do they really have that they are willing to give you? It’s a good idea to have an open conversation and ask them how
they would like to be a part of your child’s life and what they can realistically be responsible for. That way, you won’t
have unrealistic expectations.
Are you financially ready to have a child?

Having a child is expensive. You may get help with medical bills from insurance or social services. Diapers, food and
formula, clothing, baby equipment, and childcare are expensive but there may be places where you can get them for
free or inexpensively. In the future, you will also need to provide books, classes, and school expenses. You might want
to price some of these items to get a better idea about how much things cost.
35
Comments from people about birth and raising a child.
“my head and my heart have finally come together with this decision, and i
finally feel at peace with myself. i know it will be a long and trying road
ahead but i will endure....”
“giving birth was much harder than i “it seems like i went from paying off my
thought it would be.” college bills, to paying for pre-school, to
paying off the orthodontist, to setting
“giving birth was much easier than i aside money for my kids’ college. it never
thought it would be.” ends!”
“my child is the light of my life.” “all these girls come back to school and
talk about how cute their babies are. they
“i could not have done this alone.” never talk about how hard it is. it’s not
easy.”
“although the baby’s father could
have helped me more, i’m the only one “i feel like i’m 37 instead of 17. i have
responsible.” no life.”
“my baby changed my life in ways i never “some nights are so hard i don’t know
dreamed of.” how i’ve gotten through them.”
“i can’t imagine my life without

my kids.”
36
37
38
Abortion Section 6

“What is an abortion?” Later in a pregnancy, a D & E (dilation and evacuation)
technique is used. The opening to the uterus is opened
An abortion is the removal of a pregnancy from your large enough for the clinician to remove the pregnancy.
body. A miscarriage is called a spontaneous abortion, In a few cases, an induction procedure is used after 20
meaning your body stops the pregnancy on its own. weeks. The cervix is opened over a day or more, then
labor is induced, causing a miscarriage. 89% of all
“Are abortions safe?” abortions are done in the first 12 weeks of pregnancy.
Abortions by procedure or pill are very safe, especially
when done early in pregnancy and under modern
“Will it hurt?”
medical conditions. Many studies have shown that We all have different experiences of pain and
having abortions in the first twelve weeks is many discomfort. In most methods, there are usually a few
more times safer than having a baby. Even abortions minutes of cramps. As the pregnancy continues the
after 18 weeks are less dangerous than having a baby. procedure will take a little longer. It is normal to fear
pain, but fear of pain should not be the most important
“Is it legal?” factor in your decision. You will probably be offered
sedation and/or medication to help with pain. Please
Abortion by a doctor or clinician is currently legal in ask.
every state of the United States but access to services
may vary from state to state.
“How much does it cost?”
Some states may have a waiting period or rules about Call the clinics in your area. An abortion in the first
receiving certain information before your abortion 12 weeks generally costs $500–$900. Many forms of
or requiring that the parents of a person under 18 be insurance cover it, although Medicaid covers in only
informed of their decision. Call a clinic in your state to some states. If the cost seems really low, find out if lab
find out the most recent laws. fees and medication are included. Ask if there is time
set aside to ask questions and to recover afterwards.
“How is it done?” Find out which clinic or doctors are recommended
by friends, independent abortion clinics, Planned
There are a few different ways. The most common Parenthood, or Family Planning Services. A quality
is vacuum aspiration where a clinician dilates, or clinic where you will be respected is important.
opens, your cervix and removes the pregnancy with
a suctioning. This procedure often takes less than 5 If you are having financial problems, is there someone
minutes in an office. you can borrow money from? Do you have a credit
card, or could you use someone else’s and pay that off
Another option early in a pregnancy is abortion with over time? The National Network of Abortion Funds
medications. Two different medications are used— has many local funds that can offer financial help—
mifepristone and misoprostol. The first one stops the www. abortionfunds.org. Call the National Abortion
pregnancy from growing and the second helps your Federation Hotline at 1-800-772-9100 for a clinic and
body pass the pregnancy. The symptoms are just like a funding.
miscarriage. It takes two or more days and you might
have a lot of bleeding, clots, and cramps.
39
“How do I find a doctor?” “How will I feel afterwards?”

To find the closest clinic or doctor, search the web Most people feel very relieved after they have an
under abortion clinic + your city and state or at abortion, and they usually feel pretty good physically
directories like www.abortioncarenetwork.org, www. too. Whatever fear they might have had about the
abortionclinics.com , www.abortion.com, or www. medical part is over, and a big problem that has been
prochoice.org. You can also ask your doctor, clinic, taking up a lot of attention has been taken care of. It is
or other friends and family what they know about completely normal to have other feelings too.
different clinics.
How you will feel afterwards probably has a lot to
When you call, you might ask: do with how you feel before the abortion. If you are
unsure about your decision take more time to consider
• Is there counseling? Will someone answer my your choice and review the previous sections. Is it
questions? really your decision? Do you have a sense of peace? Are
• What do you offer for pain? you afraid of needing forgiveness? Are you just feeling
kind of numb? (If so, go back to feelings section) Do
• What state regulations are there?
you need more support?
• What is involved in the visit? How long will I be at
the clinic? Are you very sad? It is not unusual to have feelings
• How much will it cost? Do you accept insurance? of grief or loss, as well as other feelings about an
Are there extra fees? Is there financial assistance? abortion. Take the time to work on your feelings
Does the fee include a follow up examination? about abortion before you have one. Then you will be
Medications? Lab work and ultrasound? better prepared for whatever feelings you might have
• Is there a 24 hour answering service if there are afterwards. If you are having really difficult feelings
problems? after an abortion, there is help.
• If you’re calling several clinics, how did they make If you have an abortion will you feel guilty? Sad?
you feel? Did they answer your questions? Don’t be Relieved? Angry? Ashamed?
afraid to ask questions.
Write a little about each feeling you might have and
“Does the baby feel pain?” how you will deal with those feelings if they occur.
Medical experts generally agree that the fetus cannot “Can I do it myself?”
feel pain until there is a more developed brain and
nerves which starts to happen at or after 27 weeks. Where abortion is not legal or easily accessible, people
Many doctors who perform abortions make sure the can try to obtain a medication called misoprostol or
fetus dies before the actual abortion begins just to be Cytotec which can cause a miscarriage, but it would be
sure it feels no pain. Ask your doctor or clinic if you good to partner with a clinic or medical professional to
have a concern about this. be sure it is complete and you do not bleed too much.
There are medical risks such as too much bleeding,
incomplete or failed abortion, or a tubal pregnancy.
There may also be legal risks depending on the laws
in your state. Please call a clinic or hotline number for
advice or to find a clinic. See also www.womenonweb.
org.
40
Abortion | Section 6
“I always said I could never have an “Is it murder?”

abortion.”
You have probably heard some people say abortion
If you think you are not ready to have a baby, abortion is murder. That’s what the people who want to make
is one option to consider. There are a lot of opinions abortion illegal usually say. Some people say abortion
about abortion and about people who have abortions. is murder without really thinking it through. Abortion is
You may not have considered yourself someone who legal, so clearly the law does not see it as murder. The
would have an abortion…until right now. All of this can law says to murder means you have malicious intent or
make it difficult to process your feelings about your you really want to hurt or harm someone. People don’t
choices now. It’s important for you to find out the facts choose to end a pregnancy because they want to harm
before you make your decision. For instance, did you children; it’s usually the opposite, because they don’t
know that abortion is one of the most common—and feel they can take care of a child or have other children
safest—medical procedures in the U.S? Approximately they have to take care of. People who choose abortion
1 million abortions are performed annually in the are good people making the best decision they can for
United States. You probably know someone who has all concerned.
had an abortion: About 1 in 4 people who can get
pregnant will have an abortion by the time they are 45. Abortion ends a pregnancy. The embryo or fetus is
It may be surprising to you to learn that 59% of those removed by the abortion procedure. Most people do
who had abortions already had at least one child and not believe that removing an embryo or fetus is the
that 51% were on birth control. All kinds of people same as killing a born person.
have abortions.
But that doesn’t really answer the question of whether
“I think abortion is my choice, but I am it is right or wrong for you. That’s a question you have
to answer for yourself.
heartsick over this.”
It is normal to sometimes think and feel many Do you believe that having an abortion is like killing a
different ways about any pregnancy decision including newborn or a 2 or 3 year old child, or like killing a friend
abortion. Like a lot of other challenging times in life, of yours? Can you end a pregnancy out of love? What is
your head (the logical, practical part of you) might a person? When does a fetus become a person?
be saying one thing, while your heart (your feelings)
seems to be saying another. You might think that These are tough questions, but it’s good to look at
abortion is the best thing you can do right now, but them to see what you really think. Most people find
you still feel sad or conflicted about this choice. You that their beliefs change when they are in a complex
might think you have to have an abortion, but don’t situation like this. Take the time now to explore what
really want one. You may not even want to think about you really believe.
it at all—just get it over with.
You deserve to have peace of mind. Take some time to

do the exercises here and the previous sections. They
will help your head and your heart come together so
you can make a decision you feel good about.
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“Am I a bad person for choosing abortion?” “I want to have an abortion, but my religion
As you think about this question, notice how much
says that it is wrong.” “I used to think
you want to do what is good and right. Wouldn’t life be abortion was wrong but now I think it is my
easy if good and bad were always simple? best choice.”
Most people make some choices in life that do not
Some believe that abortion can be a very good and
agree with their religion. Maybe even having sex or
responsible choice. Others believe that abortion can
getting pregnant went against some of the rules of
be wrong. Still others might say that a person can be
your religion. We can feel very uncomfortable and
good, even when they are making difficult decisions.
guilty if we think we are living the wrong way.
Many people say they feel selfish for having an
What do you believe? What would it be like to pray to
abortion but there is a difference between taking
God and truly listen to what God has to tell you? If you
care of yourself and only thinking of yourself. Usually
have trouble hearing God’s guidance, you may want to
people who are considering an abortion think about
talk with a religious person who respects that you have
their whole family, what they can offer a child, and
to make your own decision.
their own life goals. And, it is important to consider
your own goals and dreams in life.
Have you prayed for guidance? If yes, do you feel you
have received guidance? What is the guidance? If you
Millions and millions of people all over the world
have ever done something you thought was wrong in
and throughout history have made the decision that
the past, how have you made up for it? Do you believe
abortion is the best thing they could choose in their
your God is loving and compassionate? Can God see
situation. But only you can judge whether the choice
into your heart? Some people believe God loves them
you are making is right for you. What does your
and will be with them even in difficult times. Some
conscience say to you about abortion? Can abortion be
people believe God thinks abortion is wrong, but will
moral? What good can come out of having an abortion?
forgive them. And sometimes our religion is more
flexible than we think.
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Exercise: “Will I regret having an abortion?”

The vast majority of people who have abortions do not regret their decision. However, research shows that there are
warning signs that certain people may have a harder time resolving their feelings after an abortion. If you are worried
about how you will feel afterwards, answer the following questions:
1 = Not true for me, 2 = Somewhat true for me, 3 = Really true for me
I believe abortion is the same as murdering a born person
I am not sure if I am making the right decision
I don’t want an abortion, but I have to have one
I know I will regret having an abortion
My parents/guardian are rejecting, critical, or abusive
My partner is abusive, rejecting, or controlling
I think God will punish me for having an abortion
I will not be able to forgive myself for having an abortion
No one is giving me emotional support right now
Someone else is forcing me to have an abortion
I am never going to think about it again after it’s over
I suffer from depression or diagnosed personality disorder
I am a perfectionist and I can’t forgive myself for getting in this situation
Total (Add up your score)
If your score on this self test is more than 26, you may need to do more work or talk to a counselor. Go back and
complete all the exercises in the Decision-Making section if you need to. Even if your score is below 26 and you feel
conflicted, reach out for help.
*We are grateful to Anne Baker formerly of Hope Clinic for her work, Predictors of Poor Coping After an Abortion
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Abortion Pill or Abortion Procedure

A comparison between the Abortion Pill (Medication abortion with Mifeprex™ and misoprostol) and the Abortion
Procedure (Surgical abortion with vacuum aspiration)
How far along in the pregnancy can I be?
Abortion Pill Abortion Procedure

• Up to 10 weeks LMP (70 days). Success 92–97%, • Vacuum aspiration is used up to 14 weeks LMP.
may decrease as length of pregnancy increases. Some doctors start at 5 weeks LMP.
How long does it take for the abortion to be complete?

• Usually 1–2 visits plus required follow-up visit. • 1 visit plus follow-up exam (may be
• Day 1 for Mifeprex™, 24–48 hours after for misoprostol. optional).
• The pregnancy may not pass exactly when expected or • Actual abortion less than 5 minutes.
desired. • Follow-up in 2–3 weeks at abortion
• Heavy bleeding after misoprostol lasts 4–8 hours for most; facility or other doctor or clinic of your
days for some to complete. choice, if you want or need it.
• Continued or sporadic, lighter, bleeding, more like a period
for 14-16 days is common.
• Ultrasound at follow-up in 7–14 days after Mifeprex™ will
make sure abortion is complete.
How painful is it and how much bleeding?

The amount of bleeding varies from person to person and with length of pregnancy.

• Heavy bleeding, cramping and clots are common • During the procedure cramping may be intense
during the abortion process for 4–8 hours. for the last minute or two but improves quickly,
• Afterwards, bleeding like a period is common for over the next 15 minutes. Pain meds or sedation
an average of 14 to 16 days. may be available.
• Cramping and bleeding afterward should be
like a period and could be lighter or heavier
depending on your body.
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Can the abortion fail?

• Success rate varies from 92–97% by day 14. An • Over 99% successful. If it fails, suctioning will
abortion procedure with vacuum aspiration may need to be repeated.
be necessary if it fails. • Early surgical abortion may require an
• An ultrasound is helpful to determine whether the ultrasound afterwards to be sure pregnancy is
abortion is complete. gone.
Can I still have children later in life?
• Regardless of method, abortion is about 20 times safer than childbirth. Infections are the greatest threat to
fertility, not abortion. Research has shown that future childbearing is not at risk, unless there are very rare,
serious complications such as an injury to the uterus or loss of the uterus.
What are possible serious side effects (complications)?

• Both Mifeprex™ and misoprostol have been • Surgical abortion has been formally studied for
formally studied and used safely. at least 40 years.
• Mifeprex™ will not end ectopic or tubal • Injury to the uterus is rare in the first trimester.
pregnancies which, if undetected, can be Excessive bleeding is rare. Infection and
dangerous or fatal. retained tissue, which would require antibiotics
• Need for blood transfusion (rare). or a re–suctioning, happen in less than 1% of
abortions performed.
• Some people may be allergic to medications.
• Vacuum aspiration will not end ectopic or
• Infections are rare but possible. Watch for fever or tubal pregnancies, which, if undetected, can be
severe flu-like symptoms and seek help quickly. dangerous or fatal.
45
What are the common side effects?

• Nausea, vomiting, diarrhea, cramping, bleeding, • Cramping, bleeding
headache, dizziness, fever or chills, anemia (rare) • For some, light-headedness, nausea, sometimes
associated with anesthesia or pain medications
How much does it cost?

• Sometimes higher than surgical. Prices vary. • May be less than medical abortion. Prices vary.
Check what is included and what is the fee for a Check what is included. Range $500–$900
procedure if it fails? Range $500–$900
What are the advantages of each method?

• Mifeprex™ induces a miscarriage-like • It’s quick, predictable, and over in a few minutes.
process. • It’s highly successful, usually more than the abortion pill.
• It is effective and safe for very early • If available, it’s effective and safe for very early
pregnancy. pregnancy.
• Avoids shots, anesthesia, instruments, or • There’s less bleeding for less time than with abortion pill.
vacuum aspiration, unless it fails. (Blood
work may be required. Injection may be • Less time cramping than with other methods.
needed if your blood type is Rh-. Vaginal • Performed by a doctor/clinician with the support of
ultrasound may be required). medical or counseling staff, which may seem more
• Being at home may seem more comforting and private.
comforting and private. • Some involvement of your support person may be
• Your support person can be there with possible.
you during the abortion process. • If you are trying to keep your abortion from a partner or
parent, it may be better.
• Avoids medication, except for pain relievers and
sedatives.
• It can be done later in the pregnancy than other
methods.
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Who should not use one of these methods? (What are the contraindications?)

Don’t use the abortion pill if you: • Some medical conditions or allergies to
anesthesia may require a surgical abortion in a
• Have an IUD in place. hospital setting. Definitely discuss your medical
• Are more than 10 weeks LMP (depends on the history and any concerns that you have when
opinion of your doctor and state regulations). you schedule your appointment.
• Diagnosed with any of these medical conditions:
• allergy to the medications Mifeprex or
misoprostol
• blood clotting problems or are on blood
thinners
• chronic adrenal failure
• chronic systemic corticosteroid use
• inherited porphyrias (blood problems)
• severe anemia (lack of iron in the blood)
• possible ectopic pregnancy
• uncontrolled seizures
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What are the disadvantages of each method?
• It takes 2–3 or more days to end a pregnancy. • A doctor must insert instruments inside the
• It is not completely predictable. There is some uterus.
uncertainty about when you will bleed and pass • Anesthetics and drugs to manage pain during
the pregnancy. the procedure may cause side effects. (Serious
• Bleeding can be (but not always) very heavy and problems are rare.)
lasts longer than with surgical abortion. • There are possible complications such as too
• There can be rare complications such as too much bleeding or infection, although they
much bleeding (hemorrhage) which may need a occur in less than 1% of cases. Rarely, there
surgical procedure, or infection, which may need is injury to the uterus, which would need
antibiotics. hospitalization.
• Cramping can be severe and lasts longer than • You may have less control over the abortion
with surgical abortion. process and who is able to be with you during
some parts of the process.
• 2–3 visits are required.
• The vacuum aspirator makes a noise. If
• It fails more often than surgical abortion but is still available, a manual aspirator is silent.
very effective.
• It may not be done as early in the pregnancy
• It cannot end an ectopic (tubal) pregnancy. as with the other methods depending on the
• It may cost more than a surgical/procedural doctor/clinician.
abortion, especially if it doesn’t work. • It cannot end a tubal (ectopic) pregnancy.
• May not be a good method if you are trying to
conceal abortion from others.
• Advisable to have support when you take the
medications.
How will I be affected emotionally?
• Some people are anxious waiting for the abortion • Some people are anxious in a medical setting or
process to complete. with the idea of surgery.
• Viewing the pregnancy tissue may be difficult.
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Exercise: “Which method is right for me?”

Answer these questions using the following scale:
4 = strongly agree, 3 = agree, 2 = disagree, 1 = strongly disagree, 0 = not applicable/don’t know
Abortion Procedure
People who have these preferences/concerns are often more comfortable with an abortion procedure.
I really want to get this over with.
I want the method that is more of a sure thing.
My schedule is really busy. I can’t afford much downtime for this.
I am trying to hide this from my partner/parents or housemates
I am leaving town in the next week or so.I live far away, or have a crazy schedule, so it would be hard
to get back here for a follow-up exam.
I’m under 18 and my parents don’t know I’m pregnant or that I am having an abortion.
I have difficulty speaking English, especially over the phone.
My partner (or someone else) is upset and is trying to stop me from having an abortion.
I have a bleeding disorder/I am on corticosteroids (ex: prednisone)
I get very nervous about medical stuff. I worry that something dangerous might be happening.
Uncertainty drives me crazy; I really need to know what’s going on and whether it will work.
I am responsible for children or others and I don’t have anyone to help me with that.
I live out in the country and/or don’t have easy access to transportation.
I feel safer in a medical facility with a doctor and nurses around.
Total Points: People who have these concerns are often more comfortable with the in-office procedure.
Abortion Pill
People who have these preferences/concerns are often more comfortable with the abortion pill.
I dread going to the doctor. I always get very anxious.
Pelvic exams are very difficult for me. I can never relax.
I would like to include my partner or other person in the whole process.
I like the idea that a miscarriage is more ‘natural.’
I have had a miscarriage with a lot of bleeding before so I know what that’s like.
I live close by and coming back for a follow-up exam would be no problem.
I am under 18 and my parents know all about what I am doing.
I would really like to take my time with this process and experience it.
I don’t panic or freak out with pain or bleeding.
I am usually very good at following directions about my health.
I know it’s hard to predict how this experience will be for me and I’m OK with that uncertainty.
My regular period bleeding is heavy. I am OK with lots of clots and bleeding.
I have easy access to a phone, transportation and I live pretty close to medical help if I need it.
I don’t have responsibilities for others and can clear my calendar the day after my appointment,
and if need be, the following day too.
I would do anything to avoid needles or shots.
Total Points: People who have these concerns are often more comfortable with the medication,
or abortion pill. 49
Exercise: Your Experience of Abortion

If you have decided that abortion is the best choice for you, and you have chosen a doctor or clinic to help you, then
you are ready to plan the day of your abortion.
This exercise can help you plan what you will do and how you would like to feel before and after your abortion. After all
the time it takes to make a decision, and work through all your feelings, the actual visit to the clinic can be the easiest
part if you are prepared.
“What do I want to know before I go?”

If you are still feeling unsure or scared about anything, call the clinic and get your questions answered before you go.
It’s normal to be a little nervous. It will make things easier if you share your thoughts and feelings with the staff at the
clinic.
Other helpful suggestions

Some things to make it easier. Which ones would be helpful for you? (Check all that apply)
Make sure to leave plenty of time for getting there

Get good directions
Visit a few days before so I am comfortable with the place and people
Have someone I trust who will go with me
Take something to read/work on/play with while I am waiting
Get realistic information about how long I will probably be there
Follow the directions the clinic gives me about eating and drinking
Wear layers of comfortable clothing so I am OK if it’s hot or cold.
Shower or bathe before I go to help me feel fresh
Find out if there might be protesters so I can prepare myself
Make sure I have transportation to and from the clinic
Make sure I am clear about the medical fees and I have my money, Photo ID, or insurance information ready
Write a list of my questions so I am sure they all get answered
Buy a box of maxi-pads and medicine for cramps (like Ibuprofen or Tylenol).
Try to be open to help and information from staff
Be proud of my strength and bravery even if I feel stressed out
Other
50
Exercise: Worrying About Pain?

Nobody wants to feel pain, but pain is a part of life, and usually part of ending a pregnancy. Our ideas about pain can
be very complicated. It might be interesting to explore the issue of pain in your life if you are worried about how much
pain you might feel.
1) Period cramps: What are your period cramps like? (1 = mild, 10 = severe)
Use a 1–10 pain scale where 1 = mild cramps (you’re aware of them but you can still do normal activities) to
10 = severe cramps (cramps where you cannot do anything and the cramps are the worst you ever felt, and pain
medication doesn’t seem to help.)
Describe your experience of period cramps:
2) Pain relief: What helps you when you have cramps?

pain reliever like Ibuprofen, Midol, or Tylenol
going to bed
a heating pad or microwavable bag
someone sitting with me or sympathizing
a back rub or massage
having something hot to drink
distracting myself with an activity
other
3) Feelings about pain: How do you feel emotionally when you are in pain?
alone
frantic
sad
upset
irritable
scared
exhausted
sorry for myself
ashamed
numb
out of control
distracted
angry
frustrated that I can’t do things
I feel like crying/screaming
other
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4) Support: Do the people supporting you understand what you need when you are in pain?
Do they understand these emotions? Yes No
Have they been around you when you are in pain? Yes No

If you could have anyone at all with you who would it be?
Why? How would they help you?
5) Past experience: What are your past experiences with pain?

Examples: “I never have cramps and nothing bad has ever happened to me, so I’m worried about how it will
feel.” Or, “I have had a lot of surgeries and although I do OK, I really dread it each time.”
Tell your story:
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6) Negative feelings about the situation: Difficult emotions make pain feel worse. For example,
getting a tattoo or your ear pierced is painful but it’s more tolerated because it’s something
you want. Having an abortion can bring up a lot of feelings, some of them negative.
Do any of these match what you are feeling? Put an X next to the examples that are most like what you are feeling.
What follows each example is a possible way to change how you are thinking about this experience.
“I really feel stupid and irresponsible.”

Even if you could have done things differently, remember that pregnancy is always a risk when you have sex.
Sometimes we take more risks than we mean to around sex. Resolve to make a plan to protect yourself better
and move on with your life. Even if it’s true that you could have been more responsible, it doesn’t mean that
you deserve pain.
“I shouldn’t have been with that person and now I’m paying for it.”
Sometimes it helps to figure out the reasons for our behavior (Example: “I was lonely”, “I misjudged the
situation.” ). Whatever the reason, it seemed like a good idea at the time. If you are feeling guilty (like you did
something wrong) find a way to make things better. Getting pregnant, however, is not a punishment, and no
one deserves pain, even if you didn’t live up to your own standards.
“No one can know about this. I am so ashamed.”

When we are trying to hide something, we carry an extra burden of feelings: dread, fear, shame. Instead of
imagining the worst possible reaction from someone, imagine the best. They might say: “I’m sorry you’re in
this situation, but I know you will make the best decision for your life.” Even if the worst is true, does it mean
that you deserve to be in pain? No, it doesn’t.
“I’ve heard so many awful things about abortion. I’m really scared. What if...”
Our society is in great conflict about abortion so it’s no wonder that there are a lot of scary stories out there.
But statistics show that abortion is one of the safest medical procedures, no matter what the method. There
is a risk to everything, including riding in a car. So, learn as much as you can and let reality help you. Fear and
tension can make everything feel worse so try to keep your fears in perspective.
“I feel terrible about doing this, but I really have no choice.”

No one ever wanted to be in this situation, even though 1 in 4 of all women will have an abortion someday.
Once you are pregnant, and don’t want to be, you are making what you believe is the best choice for your life
under the circumstances. You are not a bad person and you don’t deserve to be in pain. Write what you are
feeling about this situation. Then rewrite a more positive message to yourself.
“I have had abortions before and I feel like a bad person.”

More than one abortion is quite common for several reasons. Our bodies are designed to get pregnant.
It is estimated that we have 350 to 400 opportunities to get pregnant in our lifetimes. Birth control is not
100% effective, and some people can’t take the most effective ones. Also, there is no evidence that multiple
abortions affect future fertility or your health. Each time you are pregnant, you must make the best decision
for you, your family, and your life. And you don’t deserve to feel more pain.
53
Pain Relief
Your doctor or clinic will probably offer some pain medications or something to relax you. Please ask about what pain
relief is available for you.
Deep breathing can help make the medications work even better. Many people use some version of deep breathing
to relax and work through pain. One way is to breathe in to the count of 7, hold your breath for 7 counts, and slowly
release your breath to the count of 7. Another way is to start with your toes and tense each set of muscles to the count
of 1–2–3–4–5 and then relax to the count of 1–2–3–4–5. Do each set of muscles—legs, buttocks, abdomen/stomach,
shoulders, arms, jaws, eyes/face, breathing in and out with each set. As you do the exercise, try to imagine your fear
and pain going away every time you breathe out.
Emotional Health
Emotional health is an important part of our overall health. It allows us to cope with life’s challenges and enjoy
life’s pleasures. Being pregnant can shift our perceptions of ourselves, our relationships, and the future in powerful
ways, regardless of whether we decide to parent, have an abortion, or make an adoption plan. Any choice can bring
upheavals in our lives, strong feelings, and difficulty coping. You may want to explore all of the factors that went
into your decision. Abortion Resolution Workbook, (a workbook in this series at www.pregnancyoptions.info) may be
helpful if you are having a hard time. There are also talklines, counselors, and clergy to help you.
Forgiveness
For some an important part of the process before an abortion is forgiveness. It may be easier to sense forgiveness from
God, or a spiritual being, or even the spirit of the pregnancy, than from yourself. Not being able to forgive yourself or
another can keep you emotionally stuck. If you can, look for forgiveness wherever you need it.
One way to find forgiveness for yourself is to do a guided daydream. Guided imageries or visualizations are a way
of using your imagination to understand feelings. It’s like a daydream with instructions. A Guided Day Dream on
Forgiveness and other guided daydreams can be found online at www.pregnancyoptions.info, both in words and
recorded.
Important: If you are having strong feelings of regret or sadness that don’t get better, get help!! Warning signs include:
crying all the time, problems with sleeping or eating or not being able to concentrate. See Healing section and consult
a counselor.
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Exercise: After Your Abortion

What I’d like to do to take care of myself For example, be with friends who understand, have a nice meal, be quiet, have
a ceremony. Who will you ask for support afterwards? Tell them how you would like to take care of yourself.
Telling Someone
Some people who have had abortions feel ashamed and want to keep the abortion a secret. That means that we don’t
usually hear about it from our mothers, relatives, and friends. If you have decided on abortion, it could be powerful for
you to share your experience with others. Your story can help others who find themselves facing difficult decisions. If
you could, who would you really like to tell about this?
Name them
What would it take for you to tell them?
Risking honesty
Courage
Caring
Love
Pride in yourself
Openness
Trust
What else?
How would you explain your decision to have an abortion to someone else?
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56
Adoption Section 7
“What is adoption?” “Where do I go for help?”

Legally, adoption means surrendering your right You can either go to an adoption agency (which
to parent your child and giving someone else the is called an agency adoption) or you can go to an
permission to take on the legal right and responsibility adoption lawyer (which is called a private adoption).
of parenting your child. Adoption isn’t giving away your An adoption agency will help you think through all
child, giving up on your child, or selling your child. It is the questions you may have about adoption and help
making a well-informed, life-long plan for your child, a you be sure that adoption is right for you. In a private
plan that many times can still includes you being a part adoption, you can ask these same questions of your
of their lives in some way. lawyer. Whether you meet with an agency or a lawyer,
you have the right to receive unbiased, nonjudgmental
“I could never do that!” counseling about your decision. If you feel that you
want to go ahead with an adoption plan, the agency or
If this is your first response, don’t worry. You are not your lawyer will help you with the adoption process.
alone. Many people think they could never choose Consider adoption agencies that respect all of your
adoption as an answer to an unplanned pregnancy. choices, including abortion, adoption, and parenting
But lots of times, people don’t really know much and don’t forget that you can choose your family, stay
about adoption other than what they read online or in touch with them, and many of your expenses can be
see on TV. And that usually isn’t a true picture of how paid. The best agencies and attorneys put you at the
adoption works. After finding out about what adoption center of the plan and let you lead the way.
really is, sometimes people feel differently about it. So,
before you make up your mind, learn more about what
“How do I find them?”
adoption can offer you and your child. Read on!
Adoption agencies are not all alike, and neither are
“I don’t think I could bear not knowing what lawyers. It is a good idea to look around for an agency
happened to my child.” or lawyer that feels right for you. Check out their
websites or social media and read their reviews. Are
In the past, people who made the decision to place they open to all pregnancy options available to you,
their child for adoption often never saw the child or are they open to all families (some agencies don’t
knew what happened. But things are totally different allow gay or lesbian families to adopt), and do they
now. For example, you have the right to choose the promote open adoption? Also make sure they are
adoptive parents for your child. You can also meet saying things like you get to choose the family, stay in
the adoptive parents and make decisions about touch with them, and many of your expenses can be
how much contact you would like to have with your paid. Agencies and attorneys are not hard to find, there
baby as he or she gets older. Contact can range from are thousands available to help you—but the best ones
frequent visits to occasional letters or phone calls and put you at the center.
this arrangement can change over time. You can also
choose not to have any contact if that would feel better
to you. The important thing to know is that you have
choices.
57
“What will happen if I answer a classified “Will someone still want my baby even
ad?” if….?”
These ads are placed by couples or individuals who No matter the situation, there is a family for your child.
would like to adopt a child. They are hoping to talk If you want help with addiction or anything that might
to parents in order to try to plan an adoption. This is have you worried about your pregnancy, your adoption
just one way to find an adoptive family for your child. professional can connect you to resources. Being
Sometimes parents find each other through mutual honest about what your reality is takes courage and
friends or relatives. Sometimes ministers or doctors should be received in a non-judgmental way. Again,
help families connect. If you choose to work with remember that there are thousands of agencies and
an adoption agency, they will have several waiting attorneys, so if you feel any judgment at all—you can
adoptive families you can choose from. If you don’t walk away.
want to choose an adoptive family yourself, many
adoption agencies can help. Whether you find adoptive “What are my choices in adoption?”
parents yourself or work with an adoption agency to
find an adoptive family, be sure you have experienced That depends on what you want. Remember, you lead
professional support (either an attorney or an agency) the way. You have several options. You can choose to
to help you plan the adoption. The best plans include a have an open adoption. This is when the parents tell
team of people making sure the plan is done in a legal each other about themselves and have some contact
and safe way, making sure you have the support you with each other. How much is up to you and the
need, and making sure you have the connection and adoptive parents. Some people like to meet each other
love you deserve. face-to-face and be able to keep in touch with each
other by letter, phone calls and even visits after the
“I can’t afford to pay for this!” adoption. That’s a fully open adoption. This is the most
common form of adoption.
You shouldn’t have to. No matter whether you work
with an agency or a lawyer, you should not have to pay Other people prefer to learn about each other through
for any adoption services. Any good adoption agency their adoption agency or their lawyer. They might not
or lawyer should be willing to meet with you to explain meet each other or call each other directly, but they
their services and answer your questions free of are still able to keep in touch with letters and pictures
charge. Then, if you decide to go ahead with adoption, they send to each other through the agency or lawyer.
expenses including legal expenses, medical expenses, This is a semi-open adoption.
and sometimes living expenses are paid for by the
adoptive parents. A closed adoption is one in which the parents are
given some information about each other before the
adoption, but they do not contact each other— ever.
“Can I get money for myself?”
No. It is illegal for parents to be paid to complete You have the right to choose which kind of adoption
an adoption. In most states, expenses related to would be best for you. Almost all pregnant people
your pregnancy including legal expenses, medical choose some sort of openness (in fact 85% or more
expenses, and living expenses that may help you carry of pregnant people choose open adoption plans). In
a pregnancy to term can be paid for by the adoptive some states it is even possible to make this a legally-
parents. Laws are different from state to state so you binding arrangement.
should ask your adoption professional to explain the
laws of your state. It is very important that you choose an agency or
lawyer that is willing and able to help you have the
type of adoption you want. If an agency or attorney
does not offer what you want, find another agency or
58 attorney that does.
Adoption | Section 7
“Which is better—open or closed “I am considering adoption because I am

adoption?” too far along for an abortion.”
No one can say for sure, but there is more and more In other words, adoption isn’t your first choice but
evidence that open adoption can be a good choice it’s too late now for an abortion. Perhaps this leaves
for everyone—first parents, adoptive parents, and you feeling like you don’t have a choice, that you are
adoptees. Some say that it is easier to go through forced to choose adoption. If that’s the case, you might
with the adoption plan when it is open. They look be feeling frustrated, pressured, fearful, even angry
forward to hearing how their child is doing and worry because you feel pushed into adoption.
less because they receive letters and pictures and
may visit with the child and adoptive family as well. But you still do have a choice—between adoption
Many adoptive parents say that it helps them to know and parenting. Think hard about these two choices.
the parent(s) and to be able to answer their child’s Is one clearly more comfortable or more possible
questions honestly. And children who have grown up for you than the other? Does one offer you and your
in an open adoption say that they think it is has been child more of what you want and need? Whether you
better for them to know who their parents are and not choose adoption or you choose to parent, realize
always wondering.. that this is your decision. Sometimes, we face very
tough decisions in life. This is truly one of those tough
There is no right or wrong way to do this. It is choices, but it is still a choice.
important for you to decide what you think would be
best for you and your child. Don’t choose adoption because you feel forced,
because you feel you have no choice, or because you
“Can the child find me in the future if he or don’t know what else to do. Do choose adoption if
she wants to?” it seems like the best decision you can make now
for yourself and your child. Only you know if that is
Many states have adoption registries in which families true for you. No matter what you decide, adoption or
can register if they are in a closed adoption but would parenting, the knowledge that you had a choice and
like to be contacted by each other in the future. If both that you made the best decision you could, will help
register their agreement, then the registry can help you.
you get in touch with each other. You can also write
a letter to your child stating that you would welcome “Can I change my mind and not go through
any contact from them in the future, and then ask your with the adoption?”
adoption agency or adoption attorney to put this letter
in the adoption file. You should sign a release stating Yes, parents have the right to change their minds
that you want the agency or attorney to give your child within a certain time limit. The parent must sign a legal
this letter if the child asks for information about you. paper that says you are willingly giving up all your
parental rights to this child. Until you sign this paper,
More recently, families are finding each other by you may change your mind. Once you have signed the
testing their DNA through a service or searching online. consent paper, states have different laws about the
These are good things to keep in mind as you are time you have to change your mind. Ask your adoption
making your plan. professional.
59
“Does the birth father have any legal “How will I feel after the adoption?”
rights?”
For many, the most immediate feeling is relief that the
The laws are different in each state. Father’s rights may pregnancy is over. Some parents say they feel a sense
depend on whether you are married to the person, of loss because they have had to say good-bye to their
whether or not they have provided financial support, child and the grief that they feel is often fairly intense.
and other factors. Ask your adoption professional to But they also tell us that they have a mix of feelings—
explain your state’s laws and then make a plan that feeling good about their decision for the child, feeling
you feel comfortable with. Choosing an agency or worried that they have made a mistake because they
attorney who is going to create a safe and legal plan is feel so sad, feeling angry that they weren´t ready yet
important, but again your needs and desires should to be a parent, feeling relieved when they hear about
remain at the center. the child´s progress, feeling happy about the family
they chose. You will also need to heal after delivery
“Can I hold the baby after she/he is born?” and it may take a while before pregnancy hormones go
back to normal. If you feel you are depressed, contact
Of course! You are the parent of the child. You should your doctor or nurse midwife. It is a time of many
be treated no differently than any other parent. That feelings, some that are very hard to get through all
means you have the right to hold, feed, change, or take by yourself. That is why it is important to have people
pictures of the baby and even name your baby. You around you who are very supportive of you.
can also make medical decisions and even room-in
with your baby if you so choose. You can plan the birth Check the feelings that you have as you think about
day and decide all these things as well as whether you adoption now:
want the adoptive parents to be there. The hospital is
your time and your space so what happens and who is
scared
there is totally up to you.
relieved
Let your adoption professional know about your uncertain
plans so that the two of you can work together to angry
communicate this plan to the hospital where you will hopeful
deliver. Also know that even though the plan has been
communicated, you can change it at anytime. It is your turned off
plan. sure of myself
nervous
“How will adoption affect my life?” sad
other
Good question! Now that you know more about
adoption, it’s time to think about whether or not it
could be a good choice for you and your child. There
are a few things you should think about here.
60
“Why does everyone want me to get “How will adoption affect my child?”
counseling?” When parents make a decision to place their child for
It is always a good idea for parents to have an adoption adoption, they usually do it with a great deal of love
counselor who can support you both while you are and concern for their child. It is not a selfish decision.
trying to decide what to do and after you make up your Most parents feel very worried about whether or not
mind. Adoption counseling is a bit different than other their child will be all right. This is why some parents
kinds of counseling. This is not the kind of counseling feel so strongly about having at least some openness in
where you are trying to improve the way you feel or the adoption so they can know how their child is doing.
how you get along in life. In adoption counseling, you
talk about what you need to deal with this pregnancy. Adopted children will have many questions about
Your counselor’s job is to tell you about adoption as their adoption and about their parents. They often
well as all the other options you have. A counselor want to know what their parents looked like, where
should be able to help you find resources so that their parents are now, if their parents are ok, why they
you can make whatever choice you want to make. A chose adoption, etc. No matter what the questions
counselor can provide support when you are sad or are, research shows the healing for adopted children
angry or confused. happens best when they have truthful answers to
those questions.
Most importantly, the counselor is not there to judge
you, or push you to do anything you don’t want to Adults who were adopted as children tell us that it
do, or be critical of your choice. Sometimes, your is very helpful to have answers to these questions.
counselor is the only person who isn’t trying to make It makes it easier for the child to understand why
up your mind for you. they were adopted and to know who they are. Even
in a closed adoption, some of these answers can
After surrendering a child, parents have strong feelings. be provided at the time the adoption takes place.
The grief that follows an adoption is sometimes more Although many parents worry that their children will
difficult than expected. Having a counselor that you think that they didn’t care about them because they
know and trust can be helpful if you’re having a hard placed them for adoption, the opposite is actually true.
time with your feelings. Most adoptees have no trouble understanding that
their parents made an adoption plan because they
Counseling should be provided for you free of charge cared so deeply about them and wanted the very best
either by the adoption agency or a private counselor for them
paid for by the adoptive parents.
Giving a complete medical history can be very helpful
to your child later in life. It may not seem like much,
but information about you can be the most important
gift you can give to your child. What would you want
a child to know about you? Take some time to write
down some information about you, your family, your
partner, and their family. Explain to the child why you
have decided to make an adoption plan. Explain any
medical or genetic conditions that may run in your
family. If you are making an adoption plan you might
want to write this down for or create a video or audio
recording for your child to look at later.
61
Exercise: Adoption
»» Do you want to be a parent right now?
»» Why or why not?
»» Do you think you can handle the demands of being a parent right now? What would those demands be?
»» Are you able to go through pregnancy and birth?
»» Do you think you would be able to permanently choose adoption?
»» Why or why not?
»» What are your hopes and dreams for your future?
»» What are your hopes or dreams for this child?
»» Would adoption help you fulfill any of those hopes and dreams for yourself or your child? Which ones?
»» What about your partner? Are they aware of your pregnancy?
»» If not, do you want to tell them? Why or why not?
»» If they already know, what do they want you to do?
»» Would he be willing to agree to an adoption?
»» How would a decision to place the child for adoption affect your relationship?
»» How would adoption affect your relationships with others?
»» Adoption isn’t always popular among family and friends. Would your family and friends support you if you
decided to make an adoption plan for your baby?
»» Write the names of those family members and friends who would support:
62
Write down your thoughts and feelings about:
Closed Adoption Semi-Open Adoption Open Adoption

(No conact) (Letters and pictures sent (Direct contact with the
through someone else) adoptive family)
Exercise: Adoption Planning

»» What qualities would you want in a family who adopted your child?
»» What questions would you want to ask them?
»» What are absolute no’s for you?
»» When you think about a plan that would leave you with the most peace, what does it look like? What do you
need?
»» What do you imagine is your ‘ideal’ adoption plan after placement happens? What do you need?
»» Who do you see as your team in your plan? Who will be there to support you?
63
Letters
This is an example of a letter of goodbye from a birthmother to her baby.
Dear Baby Kathleen,
I am writing to say goodbye to you. I hope someday you will read this and understand. This is the hardest
thing I have ever done in my life. When I found out I was pregnant my heart sank. I knew I couldn’t have
you. My life is not together enough to have a child— not in any way— financially, emotionally. I don’t even
have my own place right now. And the father isn’t interested in commitment at all. He is a carpenter and
he travels from job to job.
But, I also knew I couldn’t have an abortion. I did that once and I had a really hard time with how I felt
afterwards. So this time I decided I would make someone else happy. I met your new parents a while ago
and I think they are wonderful people. I feel like I’m really doing something good for them—and for you. I
know you are in good hands and that they will love you and care for you.
I come from a big family—Irish—and I have three sisters and a brother. My mother doesn’t know anything
about this—no one does. She couldn’t bear knowing she had a grandchild somewhere. She works in a
restaurant and is a great cook—especially Italian food. All of us look alike, or that’s what people say. Right
now I clean houses and waitress sometimes. I’m good at both jobs, but I like making people’s houses
sparkle.
I just haven’t settled down on what I’m supposed to do in life. Maybe this is it—letting Elaine and Mike
raise you. Good luck, little one. I wish I could see you grow, but I know you are going to be great. I love
you.
—Deirdre
A birthmother in a videotaped message to her son just after birth.
Hello Darien,
I just want to tell you I love you very much. I wanted a special life for you and I personally picked your
mommy and daddy. Maybe at some point in our lives we will have a chance to meet—maybe. And if so,
and that’s what you want, I’ll share why I had to do this, but I did this because I love you very much.
—Tisha
64
“when i first told my friends what i was thinking of, they said, “you can´t
do that!” but they didn´t understand. they knew less than i did and i didn´t
know very much.”
“once the baby was born it was very “our adoption agency was fabulous. they
different. this little baby that was growing explained that whatever i wanted to
inside me was finally out and in the happen with the adoption would happen. the
world, and decisions needed to be made and agreement was completely between myself
finalized.” and the adoptive parents.”
“he looks so happy and he´s right at home. “i wanted to make my own decision, but
you can just see the joy and love in at the same time, i almost wanted someone
everyone´s eyes. they made him his family. it else to make it for me, because it was such a
is hard. tears fill up but i know he´s happy difficult choice.”
and that´s the most important thing.”
“at first i was in shock. i thought that i

would have an abortion and go on with
things, but i was afraid to tell my mother.”
“i wanted to meet the parents and get to

know them and talk and laugh with them.
because we chose an open adoption they were
able to be there at the birth.”
65
66
Pregnancy Section 8
Stages
Many people need to know about the stages of pregnancy and development of the pregnancy before they
can make their decision. Or, you might just be curious to know how a sperm and an egg end up as a baby!
Fetal Development
“How big is it? Is it formed?”
Clinicians date the pregnancy from the first day of your Last Menstrual Period (LMP), which is the beginning of your
cycle. Most conceptions happen two weeks after your last normal period. The following descriptions are based on the
actual age of the embryo or fetus. This is usually two weeks less than age by LMP. (The LMP age is also listed here.)
Example: If your last period was 8 weeks ago, the embryo is 6 weeks old. But your doctor may consider you 8 weeks
along, because your cycle started then.
How pregnant are you?

First day of your last menstrual period? Today’s date
How many weeks between these two dates?
The growing embryo or fetus is two weeks less. It is now weeks old. This is called the gestational age.
(Number of weeks since period less 2 weeks = gestational age)
Conception
Conception begins when the egg and sperm meet at the top of the fallopian tube after intercourse. After the egg and
sperm become one, the new cell begins to divide. The cells divide and form two joined cells. These two cells divide
again and again. By the time the conception reaches the uterus it is now made up of 8–12 cells. This ball of cells drops
into the uterus and begins to find a spot to attach on the wall of the uterus. This takes 5 days from conception.
Implantation
Over the next 10 days, some of the cells have the job of attaching themselves into the top layer of the lining of the
uterus. Other cells begin to work together to start forming an embryo. Growth happens when cells divide. The embryo
eventually grows into a fetus.
The sex was decided when the sperm fertilized the egg. There are two kinds of sperm, X bearing sperm and Y bearing
sperm. Sex is determined by the type of sperm. If fertilization happened with an X sperm then the fetus will be female.
If it was a Y sperm then the fetus will be male.
67
Fetal Development
Weeks 2–4 (4–6 LMP)

The embryo begins to take shape. It
goes from looking like a ball of cells to
the shape of a curved tube. By the third
week, the embryo grows a ridge that goes
almost all around. Over the next 8 weeks,
the ridge will grow and begin to form the
spine and the early brain. In the fourth
week, a very small tube is formed inside
of this embryo. This tube is the first step
of many, many more steps that forms a
heart. The embryo is the size of a poppy
seed.
1st month 2nd month 3rd month

Week 5–6 (7–8 LMP)
The embryo will grow from the size of an
apple seed to the size of a blueberry in
these two weeks. The embryo begins to float in clear liquid inside the sac. The fetus begins
to form limb “buds” which, over the next 4 weeks, grow into arms and legs.
Week 7–8 (9–10 LMP)

The fetus will first be as big a raspberry and eventually become the size of a small grape. In
this two week period the part of the fetus that will eventually be the face begins to form the
shape of eyes and ears. The fetal heart has grown from a tube to a four chambered heart.
The liver, kidneys and pancreas have begun to form.
Week 9–10 (11–12 LMP)

During this time the fetus grows to the size of an average strawberry. The eyes, ears, nose
and mouth continue to form. The soft skeleton is forming and muscle tissue begins to collect
around it.
Week 11–12 (13–14 LMP)

By the 12th week, the fetus has grown to 2–3 inches. The skeleton begins to harden. Blood
vessels form in various parts of the fetus and begin to connect to one another.
68
Pregnancy Stages | Section 8
4th month 5th month 6th month 7th month 8th month 9th month Birth
4th Month: 13–16 Weeks (15–18 LMP)

By the end of this month (16 weeks) the fetus will measure about 10 centimeters, or about 4 1/2 inches. The stomach,
intestine and colon have formed. The four chambered heart begins to build up muscle cells. Blood cells formed in the
bone marrow begin to collect in the vessels. The skin covering the body begins to thicken and hair appears. The inner
ear forms. The kidneys are formed and working. The reproductive organs have been forming over the last couple of
weeks.

By the end of this month the fetus will be at least 12 inches long. The nose takes a more defined shape as cartilage (the
soft bone) appears.

During the sixth month fetus weighs about 2 lb. and is 14 inches long. At this stage of development the various organs
have formed. The following months will see increase in body fat.
7th Month–9th Month

Over the next three months the fetus will gain at least five pounds and grow another 6–7 inches. In the eighth month,
taste buds form in the mouth. The lungs continue to make many small pockets to allow for breathing after birth.
69
70
What Can Hurt Section 9
the Pregnancy?
Birth Defects
Birth defects can happen for many reasons. Each pregnancy carries a 3–5% chance that the child will be born with a
birth defect. In other words, every pregnancy has at least a 95% chance that a baby will be born without a birth defect.
Some birth defects are minor like a skin discoloration. Some are considered major like a heart defect. Many can be
corrected.
Causes of birth defects may be:

»» Inherited conditions that are passed down in families or through a parent
»» Accidental changes to the genes at the time the egg or sperm were forming
»» Exposures to some kinds of medications, diseases, chemicals or something in the environment
»» Possible interaction between genes and something in the environment
»» Unknown
Exercise: Birth Defects

If you are worried that your baby may inherit a condition or your pregnancy has been exposed to something harmful,
talk to your healthcare provider or ask to talk to a genetic counselor. Genetic counselors help women and families
understand their chance of passing on a known condition in the family.
»» Do you know of an inherited disease or condition in your family? Describe:
»» Do you or anyone in your family have a birth defect? Describe:
»» Do you have a child that has a genetic problem? Describe:
Exposures
Some birth defects are caused by certain substances, or agents, like drugs, chemicals, alcohol, viruses, and by some
medical conditions that a pregnant woman may have. These agents or “teratogens” should be avoided or controlled, if
possible. If you are wondering if something you were exposed to can harm the pregnancy, keep reading.
71
Exercise: Exposures
Have you used a medication, drug or alcohol, or been exposed to a chemical or radiation (x-ray)? Have
you had a virus since your last period (LMP)? To understand if your exposure to something might increase
the chance for a problem to the pregnancy, it is important to answer some questions related to your
situation.
»» What were you exposed to—the agent or substance

»» How much were you exposed to—the dose
»» How often you took or were exposed to the agent—the frequency
»» How long was it used for or how long exposure occurred—dates of use/dates of exposure
»» When during the pregnancy was there exposure to the agent(s)—gestational age
The gestational age is based on the first day of your last period, not when you actually became pregnant. Or, the
gestational age can be based on an ultrasound, if you’ve had one. Gestational age is important in order to know how
old the embryo or fetus was/is during the time of exposure. (It is not always possible to know this.)
For each agent you think you may have been exposed to (medication, substance, chemical, infection, etc.), write down
the following information. Some exposures may not fit these categories neatly; it is still helpful to provide as much of
this information as possible.
Agent Amount/Dose Frequency Date(s) Gestational Age
Examples
Amoxicillin 750 mg 1x / day 6/1–6/8 7–8 weeks
Albuterol inhaler 4 puffs / day throughout pregnancy 0–9 weeks
Alcohol 5 drinks / day weekends till 6/15 0–9 weeks
After you have filled this out, share this list with your healthcare provider, a genetic counselor, or contact a teratogen
information service.
Special Note: Most exposures occurring within the two weeks after the day of conception are not expected to affect the baby’s
development. Exposures during this time may, however, produce miscarriage.
72
What Can Hurt the Pregnancy? | Section 9
Common Agents Alcohol

Here are a few common exposures and the level of risk Time of exposure to avoid: Anytime in pregnancy
to the developing fetus. This is only a partial list. If your
pregnancy has been exposed to one of these, please Greatest risk: Fetal Alcohol Syndrome (FAS) is
discuss this with your doctor. You can find additional the leading cause of mental retardation in the
information about exposures in pregnancy through the U.S. Children who have FAS have growth delays,
organizations listed in the Resources section. Or you nervousness, possible heart defects as well as learning
can call a genetic counseling service at your medical and behavior difficulties. Heavy drinking also increases
center. risk for subtle changes in the face as well as other birth
defects. Daily or excessive alcohol use (over 5 drinks
In alphabetical order: per day) can harm the fetus. Lesser but frequent use
of alcohol in pregnancy may also affect the baby’s
development. There is no agreement on a safe level of
alcohol use in pregnancy.
Acne Medications
(Isotretinoin or Absorica®, Amnesteem®, Uncertain risks: binge drinking or occasional social
Accutane®, etc.) use. Risk in this situation is dependent on the stage
of pregnancy, amount of alcohol and what type of
Isotretinoin is mainly prescribed for severe acne but alcoholic beverage was consumed. This is not a risk-
may also be prescribed for other conditions affecting free situation. You need to have a medical professional
the appearance of the skin. Because isotretinoin is review your exposure.
known to harm the developing embryo/fetus, getting
this medication requires a doctor to tell patients about Antibiotics
the risks for birth defects from this drug. If you are
taking this medication you are probably familiar with Streptomycin is one antibiotic known to affect the
the I-pledge program. However, in spite of required fetus’ development.
precautions to prevent pregnancy while being treated
with isotretinoin, some pregnancies may still happen. Time of exposure to avoid: The first 12 weeks
Retin A is a topical form of this drug and poses a much
lower risk, but may still pose some risk. Greatest risk: After 4th week of pregnancy
Risks: Birth defects affecting the brain, heart and/ Risks: There is an almost 10% risk that the ears of the
or face have been reported. There is also a greater developing fetus can be affected. Sometimes deafness
chance of miscarriage. The risk can only be determined may occur but this is considered to be a less frequent
through a careful review of your exposure and the result of exposure to streptomycin during pregnancy.
medical information. However, it is not possible to determine if hearing will
be affected when exposure occurs. It is important to
discuss your specific antibiotic exposure with your
doctor.
73
Anticonvulsants Cigarette Smoking

(Medications to control seizures) Risks: Those who smoke in their pregnancy have an
increased chance that the pregnancy will end in a
There are many different kinds of medications for
miscarriage or stillbirth. The babies are sometimes
seizure conditions. Some are also used for treating
born with low birth weight and this can be a factor for
mood disorders. It is important to learn if the
delay in the growth and development. Babies born
medication you are taking is known to carry a risk.
prematurely to mothers/maternal parents who smoke
Valproic acid (Depakote®) is one medication that has
heavily have a greater risk of developing infection
been shown to increase the chance for birth defects,
than when they do not smoke. Heavy smoking also
as has topiramate (Topamax®). Taking a combination
increases the chance for bleeding complications during
of anticonvulsants can increase the chance for a birth
the pregnancy. Risks for complications rise with the
defect. These medications may not be avoidable.
number of cigarettes smoked per day and how far into
Seizure medications are required to prevent other
the pregnancy the smoking occurs.
complications in pregnancy. Some anticonvulsant
medications are safer than others during pregnancy.
Cocaine or “Crack”
Risks: Depending on which anticonvulsant was used
Most pregnancies exposed to cocaine do not have
in the pregnancy, there is a risk for heart defects, spina
a birth defect. Birth defects reported mainly affect
bifida, cleft lip (with use in the first trimester) and
urinary tract and genital development. Other birth
mental and physical delays.
defects have been reported.
Cat Box/Toxoplasmosis Risks: The risks from cocaine increase with greater
use. Children that were exposed to cocaine during
It is possible that exposure in early pregnancy to the
the pregnancy have a higher frequency of behavioral
parasite, toxoplasma gondii found in cat litter boxes
problems. The greatest risk for pregnant users of
may increase the chance for birth defects. If you have
cocaine is to experience bleeding and an increased
been around outdoor cats often before pregnancy
risk for miscarriage and stillbirth. Risks are higher with
and throughout your life, chances are you have
higher amounts.
already been exposed to this infection, often without
symptoms, and have developed immunity against re-
infection. If you are concerned that you may have been Diabetes
exposed, a test is available to determine whether there
Diabetes can affect anyone at any age. Some forms of
is active infection.
diabetes require the person to take insulin. Whether
you take insulin or not, there is a known increased risk
Time of exposure to avoid: Six months before
for birth defects for women with poorly controlled
pregnancy through the first 12 weeks.
blood sugar.
Risks: About 30% of those who become infected with
Risks: Many different kinds of birth defects can occur,
this parasite in their early pregnancy will pass it to
but the most common are spinal cord defects (spina
the fetus. If the infection reaches the baby, the baby
bifida), heart defects, skeletal defects, and defects in
is at risk for brain malformations, deafness, vision
the urinary, reproductive, and digestive systems. Those
problems, and mental retardation.
who are able to control the diabetes have an excellent
chance of avoiding this risk.
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Marijuana Thyroid Medicine

Marijuana is not expected to increase the chance for There are medications that are prescribed for over-
birth defects. However, heavy use may increase the active and under-active thyroid. If you are taking
chance for disorganized thinking for the exposed synthroid, (also known as Levoxyl®, levothyroxine or
offspring. Smoking marijuana regularly may increase thyroxine) because of under-active thyroid function,
the chance for pregnancy complications such as: taking this medication is not expected to increase
premature birth, low birth weight, stillbirth and small risks to your pregnancy and it is actually helpful.
length, small head size, and death in the newborn Methimazole, a medication used to treat over-active
period. Babies that are born prematurely or with low thyroid, has been reported to increase the chance for
birth weight can have higher rates of learning problems some birth defects. Some questions remain about
or other disabilities. There is not enough information whether it is the medication or the poorly controlled
available about marijuana use in pregnancy and it is thyroid function that contributes to the risk for birth
best avoided. defects. Ask your doctor if the medication you are
taking is known to increase the chance for birth
Psychotherapeutics defects.
(Medications for psychological conditions)

Viruses
There are many different medications that are used
to help people with mental health conditions. Many Some examples: Rubella (German measles), chicken
antidepressant medications don’t appear to increase pox, cytomegalovirus, Zika
the chance for birth defects. A medication used to treat
bipolar disorder, lithium, may increase the chance for Time of exposure to avoid: The first 12 weeks of
birth defects of the heart. It does not happen to all pregnancy, except Zika
fetuses exposed to lithium.
Risks: Those who are exposed to one of these virus
For many medications there is not enough information during the first half of their pregnancy, and who never
available to determine if they increase risks or not. The had been exposed before, may develop the illness.
benefits of taking psychotherapeutic medications may During this time, the embryo or fetus is also exposed.
outweigh the risk the mother’s untreated condition If the viral infection occurs during the development of
could have to the pregnancy. It is important to tell the early brain, this can result in brain deformity and
your doctor that you are pregnant if you are taking mental retardation. The risk of birth defects from the
medication for depression, anxiety, PTSD, or for any Zika virus can happen with exposure any time during
other psychological condition. the pregnancy.
75
Workplace Exposures What about exposures to the

If you work where chemicals are being used, it is father/paternal parent?
your legal right under OSHA (Occupational Safety
and Health Administration) to have full disclosure of In general, exposures to the paternal parent are not
what the chemicals are and if they are known to affect expected to increase risk to pregnancy. Unlike the
health or pregnancies. Once you receive the list you mother/maternal parent, they do not share a blood
may need to call a genetic counseling service in your connection with the developing baby. An exposure to
area to review the documents for you. Or, you may the father/paternal parent may affect the quality of the
contact a teratogen information service. sperm which could affect the ability of the sperm to
fertilize the egg. Paternal exposures do not generally
increase the chance for birth defects.
X-Rays/Radiation
We are exposed to radiation in lots of ways—at work,
in our homes, and when we have an x-ray or CT scan.
A critical aspect of x-rays is dosage or amount. Most
diagnostic x-rays expose a person to levels of radiation
that are not expected to pose a risk to the developing
baby. Concern arises when a pregnancy is exposed
to high amount, likely to be the result of an unusual
situation or radiation treatment for cancer.
Time of exposure to avoid: The first trimester
Greatest risk: At the time of implantation of the

dividing egg, and up to day 10.
Risks: There is an increased risk for miscarriage. For

those pregnancies that have had significant x-ray
exposure there is risk for developmental delay, mental
retardation and a small increased chance for childhood
cancers. If you have had significant x-ray exposure, you
may want to discuss this with your doctor or a genetic
counselor.
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Spiritual and Section 10
Religious Concerns
What is Spirituality? People use many different names for their spirituality. One name is God. Others
are Creator, Holy Spirit, Greater Truth, Higher Power, Voice Within, Inner Light, Loving Spirit, or Infinite
Wisdom.
Exercise: What are your spiritual “our spirituality is wise and loving, and we
or religious concerns? usually know when we are honoring it. when we
(Check all that apply) step away from our spirituality, we may actually
I’m afraid I will go to Hell feel pain and feel like we have betrayed ourselves.
I don’t want to be “separated” from God sometimes we know this from our dreams, our
I’m afraid I’m doing the wrong thing and
intuition, or how we feel. it’s important to
God will punish me discover your own truth and honor it.”
I’m afraid God, or my baby, won’t forgive me
I’m not sure how my minister or friends

“families who have dealt with a loss such as
at church would think of me miscarriage, abortion, placing a child for
I’m not sure God can forgive me for more adoption, infertility, stillbirth, or a denaial
than one abortion of adoption may choose to speak to a religious
I think I should repent, but I don’t know how counselor about the confusing emotions of
I am not sure I can forgive myself grief, guilt, anger, joy, and relief. no two loss
Other
experiences are identical, and yet all share some
similar responses.”
Resources “making a choice about your pregnancy can be a

Faith Aloud (www.faithaloud.org) offers help on their gift of learning and growth.it is an invitation
website and can offer individual counseling through
the All Options Talkline (www.all-options.org) The for you to develop a larger vision of yourself. it’s
Religious Coalition for Reproductive Choice (www.rcrc. a way to practice compassion and loving kindness
org) may also be able to refer you to a clergy counselor.
toward yourself.”
religious coalition for reproductive choice
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What Different Religions Say

Here are some thoughts from many religions and beliefs about someone making their own choice and particularly
about abortion. Religions and those who are part of a particular religion often have more variation in their beliefs than
the “official” position on issues. The following thoughts from a variety of groups and individuals may be helpful to your
thinking.
Protestant Faiths Black Protestant Ministers

What the Bible says: “What is a good woman?” The We are Black Ministers, and we are writing to remind
biblical tradition repeatedly offers a clear idea of free you that God loves you—no matter what!—and that
choice for women. In the Bible, good women make you are always a part of the caring community of Black
many complex and important decisions. Fertility is people. As you make your decision, meditate on God’s
not one of the attributes for which women are praised mercy and love. Who shall separate us from the love
in the Bible. Instead, women are praised for their of Christ? For I am sure that neither death, nor life,
wisdom. Praise for the goodness of women who wisely nor angels, nor principalities, nor things present, nor
manage their situation is found all through things to come, nor powers, nor height, nor depth, nor
the Bible. A woman is admired for the anything else in all creation, will be able to separate us
way in which she rises above difficulty. from the love of God.—Romans 8
The heritage of Jesus in the gospel Excerpted from “Black Ministers Support Your Right To
of Matthew cites four specific women as Choose,” pamphlet from Religious Coalition for Reproductive
foremothers: Tamar, Rahab, Ruth, and Choice, 202-628-7700, www.rcrc.org
Bathsheba. Each of them was considered
a social outcast. Each woman experienced a serious
threat to her well-being. Each, in order to manage her
situation, risked going against what was “normal” Judaism and Abortion
for their time. In so doing, each woman rose above
difficulty and won respect within the community. In the Jewish tradition, there is an overriding concern
for the sacredness of life, but there is no one rule that
None of the choices made long ago by these biblical talks about the morality of abortion. In general, the
women were easy. Their moral and their sexual woman is valued: her life, her pain, and her concerns
decisions were not clearly right or wrong, but they are take priority over those of a fetus. An existing life is
remembered in the religious record as women who always sacred and takes priority over the life
wisely handled difficult situations. of a fetus, which is seen as a potential
person. The majority of Jewish legal
Adapted from “How Good Women Make Wise Choices” by Rev. sources say that abortion is permissible
Nancy Rockwell, pamphlet published by Religious Coalition if the well-being of the mother is at risk.
for Reproductive Choice, 202-628-7700, www.rcrc.org
From “Abortion: Perspectives from Jewish
Traditions” Religious Coalition for Reproductive
Choice, 202-628-7700, www.rcrc.org
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Spiritual and Religious Concerns | Section 10
Islam (Muslim) and Abortion Buddhism and Abortion

There are no verses in the Quran (“Ko-ran”) In Buddhism, as in most world religions, there are
specifically about abortion. But the general many viewpoints and beliefs about abortion and
teachings of the Quran refer to the sanctity women’s right to choose it. As a Buddhist of 13 years,
of all life. The verse, “Hence, do not kill and a patient educator working in abortion
your children for fear of poverty” (17:33) is care for 4 years, I believe there is a
often referred to as opposing abortion. This morally and theologically sound pro-
verse was originally meant to prohibit the killing of choice philosophy within the tenets
newborn females, which was a practice in Islam before of the Buddhism of the Lotus Sutra.
Mohammed’s time. Theologians from all religious backgrounds
have been continuously debating the
In Islamic teaching, the soul is said to enter the fetus question of when life begins in order to decide whether
at 120 days (four months) after conception. In some abortion is allowable within the confines of their
schools of Islamic law, this makes an abortion before religion.
120 days, less bad than one after that time.
Questions regarding the nature of life bring to mind
There are a very few reasons for abortion in Islamic two most basic ideas about life in Buddhism. First, life
teaching: If the woman’s life or long-term health is is believed to be eternal; without beginning or end. Life
threatened by the pregnancy, and if a nursing infant is and death are two sides of the same coin, and just as
threatened by its mother’s next pregnancy. *In the past, nature passes through the seasons of spring, summer,
Muslim physician-scholars wrote about abortion and its fall, and winter, human beings pass through cycles
uses. Al Razi (d. 923 A.C.) wrote that abortive medicines of life that are continuous and eternal. Buddhism
could be used if a very young woman was raped, or if also teaches that life is sacred, and to be protected
carrying the fetus to term would kill the mother. Ibn at all costs. In between these two fundamental
Sina (d.1037 A.C.) wrote, “At times it may be necessary tenets lies a large gray area in which we as Buddhists
to have an abortion: 1) when the pregnant woman is are challenged to find our own wisdom to apply to
young and small and it is feared that childbirth would
the challenge of making a decision regarding an
cause her death, or 2) when she suffers from a disease
unplanned pregnancy.
of the uterus (that would) make it very difficult for the
fetus to emerge.”
The reason I am Buddhist and pro-choice is this: in
both philosophies women are trusted to make wise
The sayings of the Prophet Mohammad (SWT), called
decisions for the struggles they come upon in life,
The Hadith, mention miscarriage when a pregnant
based upon their own innate wisdom. And in both
woman is injured by another, and require payment
philosophies, women are able to determine the
for this injury. This is called Al Kaffarah, penance or
course of their lives through these decisions. If you
atonement. Kaffarah as atonement for an abortion
are struggling to make a decision regarding your
would be fasting for two consecutive months. In Islam,
pregnancy, or are looking for a way to heal spiritual
fasting means you cannot eat during the day, but you
can eat at night. When a woman is having her period wounds after an abortion, know this: you have within
she is not allowed to fast (it would be too hard on her you the ability to turn this difficult time into one of
system) so she fasts an extra few days at the end of the growth, and eventually happiness.
two months.
(Muhammad Sa’id Ramadan al Buti, Tahdid al Nasl,
Like every religious tradition, Islam has very strict Damascus: Marktabah al Farabi, 1976, pp. 96–99). **(Abdul
teachings, as well as more open ideas of those same Fadl Mohsin Ebrahim, Abortion, Birth Control, & Surrogate
teachings. Each woman must come to her own Parenting: An Islamic Perspective. Indianapolis: American
understanding of her faith. And she should remember Trust Publications, 1989, p.92).
that in Islam, “God is merciful.”
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In Buddhism, there is a concept called the Ten Worlds, Catholicism and Abortion
or ten basic life states. They are, from lowest to highest,
Hell, Hunger, Animality, Anger, Tranquillity, Rapture, The official Catholic Church doctrine teaches
Learning, Realization, Bodhisattva, and Buddhahood. that abortion is morally wrong. According to the
At each moment of life we are manifesting one of these organization, Catholics For Choice, “This is not, as
life states. In conjunction with this is the idea of the most Catholics think, based on the belief that the fetus
Mutual Possession of the Ten Worlds; that within each is a person. The Church has no firm doctrine on when
life state is the potential to manifest the other nine. the fetus becomes a person. Thus, this teaching has
Human beings are constantly shifting between these never been proclaimed as infallible by the Pope. The
states. As Buddhists, we strive to elevate our basic life Church is also more than the Pope and the Bishops.
tendency, striving towards Buddhahood. It includes all the people of God. Clergy, theologians
and laity work together to develop church teachings.
The important thing to realize is that no matter where Many theologians and lay people feel that abortion can
you are at, you have the ability already in you to be sometimes be a moral decision and that conscience is
happy, have closure, and be at peace with whatever the final arbiter of any abortion decision. The Church
decision you have made or will make. Buddhism also teaches that the conscience of the individual is
holds that each person´s life is infinitely valuable supreme. If you carefully examine your
and precious. That you hold, or have held, life within conscience and then decide abortion
you does not deny this fact of your life. It is important is the most moral act you can do at
to remember that you have the power to shape this time, you are not committing
your life, attain your dreams, and change difficult, a sin.” As with all religions,
painful circumstances into knowledge, wisdom, and individuals must decide what
ultimately, happiness. their conscience says and their faith
— Jennifer Benson advises. In fact, Catholic women choose
abortion in the same proportion as non-
Catholic women.
Catholics for Choice “You Are Not Alone”, www.

catholicsforchoice.org
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Spiritual and Religious Concerns | Section 10
“This is also the great benefit of confession as a sacrament: evaluating case by case and
discerning what is the best thing to do for a person who seeks God and grace. The confessional
is not a torture chamber, but the place in which the Lord’s mercy motivates us to do better. I
also consider the situation of a woman with a failed marriage in her past and who also had an
abortion. Then this woman remarries, and she is now happy and has five children. That abortion
in her past weighs heavily on her conscience and she sincerely regrets it. She would like to move
forward in her Christian life. What is the confessor to do?
“We cannot insist only on issues related to abortion, gay marriage and the use of contraceptive
methods. This is not possible. I have not spoken much about these things, and I was reprimanded
for that. But when we speak about these issues, we have to talk about them in a context.
The teaching of the church, for that matter, is clear and I am a son of the church, but it is not
necessary to talk about these issues all the time.”
— Pope Francis, America Magazine Sept. 30, 2013
A Pagan View of Pregnancy Decisions

Paganism is a pre–Christian tradition that believes the decision, the second after the
that all life—humans, animals, plants, the earth—are decision has been made and the
part of a Web. When we make difficult choices, we third a year and a day after the
look at many things: where we are in our lives, what decision, to complete the cycle.
our relationships are like, how good our support is,
how old we are, our financial situation, our family, our The first ritual is to help you
spiritual beliefs, our hopes, our dreams, our fears etc. decide in line with karma, and
As pagans, we honor the web and understand that we with the involvement of the divine.
are all connected by and to one another. We consider That means acting from your highest
the entire web, but our greatest attention naturally motivations and being open to what The Gods say.
falls on our own part of the web. Your highest motivation may be about family or your
education or career—whatever is important to you. The
Pagans tend to believe that souls can move from one second ritual acknowledges whatever your decision is,
body to another. So, abortion shuts a door, but that and thanks The Gods for their participation and their
door is only one among many. That is not something blessings. It also includes discussing the decision with
to be taken lightly, and this soul is considered part the soul associated with the fetus, thanking it for the
of the web. Like most other spiritual people, Pagans life lesson and asking for its blessings. Whatever the
tend to believe that the big events in our lives have decision, it is important to realize that its effects are
“karmic” meaning. A pregnancy can carry all sorts of lifelong. Therefore, it is useful to perform a third ritual,
messages, which may be best served by opting in favor a year and a day after the first one to acknowledge this
of abortion, adoption or a baby. effect. The third ritual should recognize the karmic
message and thank The Gods for the blessing of this
What is the lesson of the pregnancy? We ought to life lesson.
approach a pregnancy decision with an awareness of
the web, and with love and self-acceptance. Ideally, Adapted from “What Would the Goddess Say? A Pagan
you would have three rituals, the first to help make Approach to Abortion” by Beth Goldstein.
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Healing Section 11
Work
Whenever there is an attachment or a connection that is broken, there can be feelings of loss. Many
people are surprised at how difficult the grieving process can be. Grief is different for everyone. There is
no set timeframe. There is no right or wrong way to grieve. Allow yourself time to grieve if you need it.
Talk to others who understand. Be gentle with yourself.
We don’t always talk about loss or grief in our culture and people don’t always know what to say. If someone dies, we
take comfort from others through the rituals our culture offers. We might get flowers, or sympathy cards, or people
might drop in and bring food, or pay their respects. There is a funeral or memorial service.
Pregnancy loss, in our culture, is not often looked at this way, and so many find themselves alone with feelings of loss
and grief. They may even feel that they don’t deserve sympathy or that they did something bad and that is why they
feel sad or guilty.
But, the loss of a pregnancy or infant, through abortion, miscarriage, stillbirth, or adoption can be experienced as a
major loss and deserves its own grief process. Sometimes the anniversaries of a loss or the pregnancy due date bring
on feelings of sadness. Sometimes we are also grieving a lost relationship or even the idea of being pregnant and
having a family.
Because most of our traditions do not help us with this kind of grief, we are finding that we must “make it up” or invent
our own rituals. This might include other people or it might be very private. It might be as simple as lighting a candle.
Or writing something. Or it might be a ritual filled with symbols and music and poetry.
In the following section you will find rituals from other cultures and ones that others have created for themselves.
These events help the acknowledge our loss and think about it in a way that helps us heal. There are additional rituals
in the Abortion Resolution Workbook at www.pregnancyoptions.info.
“whether we experience it or not, grief accompanies all the major changes in our lives.
when we realize that we have grieved before and recovered, we see that we may recover this
time as well. it is more natural to recover...than to halt in the tracks of grief forever...
our expectations, willingness, and beliefs are all essential to our recovery from grief. it
is right to expect to recover, no matter how great the loss. recovery is the normal way.”
judy tatelbaum
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Ceremony to Release Spirit Life—Taino Clan

The woman who has spirit life within also knows the responsibility of motherhood.
She does not accept this gift lightly. She knows that to accept motherhood is to make a
commitment to insure the nurturing needed for that life to grow.
Mother Earth provides for our needs and the needs of all her other children, season
after season. So, too, the path of motherhood requires a woman to nurture, teach, and
heal her children as long as they are in need of her special care.
Sometimes a woman will find spirit life within her womb when she is not in a position
to take on the nurturing responsibilities. The woman knows in her heart that the time
is not now. She cannot sustain this new life. Then she asks for a ceremony of releasing
spirit life.
There is a sadness, of course, at this releasing. But there is also honor. The woman
expresses her thoughts as well as listening to the spirit voice within. She speaks
with this spirit life many times. Spirit and woman are both in agreement with this
separation. For the good of all, the spirit life gives itself away.
This ceremony can also be performed when the spirit life decides that the time for entering the earthwalk is not now.
In this case, the woman miscarries. The releasing ceremony eases the spirit connection between her and the spirit life
that was once inside her womb.
The path of each Earthwalk is exactly as long as we need it to be. Some of us have longer paths than others. For these
young lives, there is always another opportunity at another time. Life begins... life ends... life begins again... all a part
of the turning of the Great Spiral.
Mizuko Kuyo—Ceremony for Water Babies

Buddhists believe that babies who die in infancy, during miscarriage or abortion
do not have a soul. They think they are in the “river that separates the world of life
and death.” They see them as “water babies” who need help to get to the other
side. Jizo is the protector of travelers, helping the water babies get across the river
from life to death, and be at peace.
At Buddhist temples and in the countryside there are Jizo statues. A woman or a
couple adopts one of these statues and inscribes a name on it. Then they dress it in
red “bibs” (traditional clothing for Buddhist monks) or offer it toys or presents that
they make. Sometimes they pour water on it to quench its thirst. It’s important to
them not to forget the baby that died. They may visit the Jizo statue for many years
and eventually bring its real life brothers and sisters to honor its memory.
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Healing Work | Section 11
Writing a Letter
Many find that they are talking to the spirit of the child inside them, sometimes out loud and sometimes in their
heads. If you realize you are doing this, you are not alone. It may be useful to write your thoughts down on paper. You
could tell how you came to the decision. Some ask for forgiveness. Some thank the spirit for the wisdom or thoughts
they have had about life. Some say how much they love the baby.
If you are placing your child for adoption, you might want to have the parents give your letter to the child at a certain
age. You might want to write one letter for your grief process and one to give to the child. In this one you might also
include family health history.
In working out grief, some counselors suggest that you write another letter to the person you were at the time you
made your decision. Understanding, compassion, and forgiveness might be part of what you offer that person.
Sometimes it is useful to imagine you are talking to your best friend.
And then, some “listen” to what the spirit child is saying and write that down. One woman who chose an abortion
reported that it said, “Don’t worry, I’m a spirit, I can come back in any form.”
These letters can be very healing. When you are done with them you can make a decision to keep them in a safe place,
or share them with someone who can understand. Some choose to bury the letter or burn it, thus “releasing” it back
to the earth. You might want to do this after a guided daydream exercise, visit the website www.pregnancyoptions.
info. You might want to wait a while to do this work or do it several times, whatever feels healing to you.
Guided Daydream on Loss

Loss or grief are associated with abortion or adoption. For some, it may be mild. For others, it may be deep. Yet our
society has no formal way to get support from others or get recognition for our feelings. You may even wonder if you
have a right to be supported. After all, you may think, “It was my choice.”
If you are having any of those thoughts, take a moment to remember how the process of deciding what to do with a
pregnancy has been for you. Can you have compassion for yourself and appreciate the love and care with which you
have made this decision? You deserve understanding and comfort no matter what your choice.
This guided imagery is designed to help you recognize what losses you may be feeling, and to release them gently. To
read or listen to one of three guided day dreams, go to www.pregnancyoptions.info.
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People’s Stories
These are actual stories of those who have told us how
“it was right before christmas when i lost
they have created a way to grieve. my baby. so i got a christmas ornament and
every year i put it up and it reminds me of
“i had a long conversation with the spirit that child that couldn’t be.”
child that i was carrying and we decided it
couldn’t be. for me, it was like throwing a “i had a very hard time with my decision but
star back into the sky. sometimes i look at i thought abortion was best for me and for
the night sky and think, maybe that one is my baby. but it didn’t mean that i didn’t
my star.” care. i found a pendant that had two halves
of a heart. i wear one and i buried the other
“i collect enameled boxes. so i took my very half to remind me that something of me was
favorite box and wrote a little note in it lost.”
to the baby. then my mother and i buried it
in the garden. we both cried, but it really “i did a ceremony by the river. i collected
helped me.” some feathers and put them in a little
white silk cloth, closed it with a ribbon,
“my father died a few months ago. we were and threw it in the river with a white lily
very close. he always used to tell me to go and a red rose. i’ve also sown seeds of wild
down by the river and watch it go on its way flowers next to the river. this helped me feel
to its destination, the ocean. i knew that more peaceful, to remember, but also release
my father was at his destination, heaven, some of the pain, and to feel all right. my
and that he would take care of my baby.” notebook also helps me.”
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Healing Work | Section 11
“i got a helium balloon and carried it “i had a terrible time for about a year, then
around for a while. it made me happy. then i i wrote a poem to the baby and went to the
released it and said goodbye.” highest hill around where there would be a
good wind. i read the poem out loud, then
“when i was making my decision someone ripped it into little pieces and let the wind
gave me a beautiful polished stone. i held take it. i still grieve but it was a good
it during the abortion and kept it for long thing to do.”
while after. then i walked down to the river
one day and threw it as far as i could. i felt “it was difficult for me to cry even though
peaceful.” i felt terribly sad. someone suggested that
i take some time and just be sad. so i did.
“this may sound strange, but on the due date i took one whole day and wrote about my
that would have been, i get a cupcake like it feelings, listened to some music that always
was a birthday. it’s ok.” makes me cry, and basically, said ‘goodbye’.
also i didn’t eat until sundown, but then
my food tasted so good. now i still think
about it but it doesn’t feel like i’m all
bottled up.”
“one of my favorite places to walk and to

think is this old orchard near my school. so,
i decided to plant a tree there, an apple tree.
i’m probably moving away, so i can’t watch
it grow, but in my mind, it’s growing.”
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Taking Care of Section 12
Yourself
No matter what you choose, there are some things you need to know to take care of yourself. In
this section, you will find some advice on dealing with morning sickness, on birth control, and
protecting yourself against sexually transmitted diseases, including HIV/AIDS. You can also learn about
endometriosis, fertility, and how to be sexually “healthy.” And finally, there is a section on continuing to
take care of yourself emotionally.
Morning Sickness
Most have nausea when they are pregnant. For some, it is very severe. For some, it lasts longer than just the morning.
Usually, it lasts from the 5th week to the 12th week of pregnancy, but it can last the entire pregnancy. There are
many patterns of morning sickness. There are some prescription medications that help and you should discuss your
symptoms with your doctor or at your clinic. Diclegis is a time release medicine that contains Vitamin B-6; Zofran is
another common prescription medicine for nausea.
There are some other safe remedies suggested by alternative medicine and home remedies. The real danger to you is
in getting dehydrated. If you can’t hold any water or liquid down at all for more than a day, call your doctor or clinic.
Folk Remedies
Small sips of water mixed with salt and baking soda can be very helpful. Many find that eating dry crackers like
Saltines and a bit of apple works to stop nausea. Sometimes eating crackers first thing in the morning, before you get
up, works well. Some women have found relief from taking Vitamin B-6 or Iron. Peppermint or ginger, in the form of
tea, gum, or candy sometimes settles the stomach. Ginger capsules may be helpful—usually 250 mg 4 times a day.
Other suggestions: Avoid greasy and fried foods. Avoid the smell of cooking and other strong smells. Try smelling fresh
lemon, or lick lemon slices. Drink liquids warm or at room temperature. Eat only small amounts of raw food such as
salads, raw fruits and vegetables. Steamed vegetables are easier on your stomach. Bland foods such as oatmeal, rice,
pasta, bagels, or bread usually digest well. Eat any foods that taste good to you. Also, try not to get overtired. Avoid
loud noises, crowded places, or too much activity.
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Birth Control: Getting Pregnant Only When You Want to

It is possible to get pregnant again right after childbirth or an abortion. To protect against infection, you
should not have intercourse for two weeks after an abortion and for 4–6 weeks after childbirth to reduce
your chance of infection. But after that time period, even if you are breastfeeding, it is possible to get
pregnant. Right now, you may not want to think about having sex, and that is ok. In the future, you may
decide to have sex again, and if you do not want to get pregnant, you will need a birth control method
that really works for you.
What types of effective birth control methods are available?

The Pill or Oral Contraceptives are a combination of Nuva Ring™ is another way to deliver the same
two hormones—estrogen and progestin. The pill is the hormones as the pill. It is a small plastic ring you put
most popular form of birth control in the US. inside your vagina (where you would put a tampon)
and it slowly releases hormones. The vaginal ring stays
Some people have side effects with the pill. Most in place for 21 or more days. You will remove the ring
are minor like bleeding in the middle of the cycle, in the 4th week and then take it out and have a period.
nausea, or a change in mood. A very few are serious It’s a good method if you do not want to remember to
like migraine headaches, vision problems, and stroke. take a pill everyday and if you are comfortable putting
There are many different kinds of pills and usually your it in and taking it out of your vagina. You can take it out
doctor or clinic can help find one that works for you, for an hour or so if it bothers you during intercourse.
without side effects. Remember, it is the warmth of your body that pulls the
medicine out of the ring. Store the ring in a cool place
The pill works best for those who can remember to and when rinsing it off use cool water.
take it every single day at the same time every day.
Most people find that morning is easier to remember, Ortho Evra™ or Xulane™—”The Patch” is another way
because they can make it a part of their morning to deliver the same hormones as the pill. You put a new
routine. There are other benefits to the taking pill, patch on once a week for three weeks. You do not wear
including some protection against ovarian and a patch during the fourth week when you then have a
endometrial cancers, shorter and lighter periods, period week, and start again. The patch is good if you
regular periods, and a quick return to fertility after you not want to remember to take a pill every day. The
stop taking the pill. Ask your doctor or clinic for more patch may not be effective if you are overweight. Ask
information. your doctor or clinic for more information.
Some medications may interfere with the effectiveness Depo Provera™ (medroxyprogesterone acetate)—
of the pill—like some antibiotics, other medicines, “Depo” or “The Shot” is an injection of the hormone
as well as St. John’s Wort herbal remedy. These progestin which you get once every 12 weeks. Many
medications include: Rifampin (used to treat like the shot, because they do not have to remember
tuberculosis), Phenobarbitol (sedative and anti-siezure to take a pill every day. Some report weight gain and
medicine), Phenytoin, Dilantin, Carbamazepine, irregular periods with the shot. Depo has no estrogen
Tegretol (anti-seizure medications), and Griseofulvin in it, so it may be better for those who have nausea
(potent anti-fungal). Ask your doctor or pharmacist. or estrogen side effects with the pill. Being able to get
pregnant again after a long time using this method
may—or may not—take several months.
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Taking Care of Yourself | Section 12
IUD’s: Paragard™, Mirena™, Skyla™, Liletta™— Female Condoms are a plastic sheath that a female
The IUD stands for Intra Uterine Device and is used partner can put in their vagina before vaginal sex.
throughout the world. The IUDs currently sold in The female condom is made of polyurethane, a safe,
the United States, are good for up to 5 or 10 years effective alternative to latex. It also covers more of
depending on the brand. The IUD creates a poor the vulva, so it provides some additional protection
climate inside the uterus for getting pregnant. One against skin-to-skin contact sexually transmitted
advantage of the copper IUD, Paragard™, is that there diseases.
are no hormones. Some women report that their
periods are heavier with a Paragard™ IUD. The other Spermicides come in many forms including foam,
three IUD’s are coated in a small amount of hormone, inserts, film, ovals, and a sponge. Spermicides are
which may lighten your period. It has recently been not very effective by themselves, and some male or
approved for younger women who want to delay child female partners are allergic to them. Spermicides may
bearing for up to 5 or more years. It is ideal for people also increase your risk for HIV infection. The research
who do not want more children but who do not want to shows that frequent use of the spermicide causes
get a tubal/sterilization. Your doctor or clinician must lesions in the vaginal walls, and scientists believe these
insert and remove the IUD in their office. Return to lesions allow HIV additional opportunities to pass
fertility can be quick. into the bloodstream causing infection. Spermicides
are available at a drug store near the condoms in the
Nexplanon™ is a single rod filled with hormone that is Family Planning section.
inserted under the skin, inside your arm. The hormone
is the same as the one in Depo Provera™ so if you are Diaphragm or Cervical Cap or Caya™—The diaphragm
interested in an implant try the shot first to see if it and the cervical cap are made of rubber and fit over
agrees with you. A doctor or clinician must insert the the cervix so that sperm cannot get through. They
implant in your arm and later remove it in their office. come in different sizes, so you need to go to a doctor or
It is effective for up to 3 years. There may be problems clinic to get fitted for one although there is a one size
with bleeding throughout the month or, rarely, fits “most” diaphragm available. You will also need to
removing the implant. learn how to put it in. Spermicides must be used with
the diaphragm and the cap.
Male Condoms are a “barrier” method. They are called
that because they put up a barrier or wall between the Sterilization—When a female partner is sterilized,
sperm and the egg. The most common and effective it is a surgical procedure called a “tubal” or “tubal
barrier method is the latex male condom, which the ligation.” The fallopian tubes that connect the ovaries
male partner puts over their penis. Condoms are to the uterus are cut or tied so that sperm cannot
also the only method that can help prevent sexually reach the egg to fertilize it. There are other methods
transmitted diseases, including AIDS/HIV. When used that don’t require surgery but close the tubes from
correctly and consistently, the latex male condom is inside the uterus in an office procedure. You should
98% effective in preventing pregnancy and sexually only choose a sterilization if you are sure you don’t
transmitted infections. If you or your partner have want more children. It is very difficult and sometimes
a reaction (itchy, redness) there are male condoms impossible to reverse a tubal. A tubal is generally done
made of polyurethane. Male condoms made of animal in a hospital but does not need an overnight stay.
skin or for novelty use are not effective in preventing
pregnancy or sexually transmitted diseases.
93
Sterilization for a male partner is called a vasectomy. What’s the most effective method?
The tubes are cut between the entrance to the penis
and where the sperm are stored. It is considered a The best birth control method is one that will be
permanent method. It can be performed in a doctor’s easiest for you to use and has little or no side effects
office. A vasectomy does not reduce sexual pleasure for you. It may take some time and patience trying
for the man and does not affect his ability to ejaculate to find the best one for you. The most effective
during orgasm. It can take up to 3 months to be non-permanent methods are Nexplanon 3 year
effective and a repeat sperm count is very important. hormonal implant or the 5 or 10 year IUD. The Pill, (or
other hormonal methods like the Patch or Ring), or
Emergency Contraception (EC) or the Morning After injectable hormones like the Depo Provera a 3 month
Pill—This method using the hormone levonorgestrel hormonal shot are also effective when used properly.
is used after unprotected sex to prevent ovulation if it However, none of these birth control methods will
has not already happened. That’s why you should use protect you against sexually transmitted diseases,
it as soon as possible after unprotected intercourse. EC including HIV/AIDS. Only latex condoms when used
is a good method to use if you forgot to use a condom, correctly and consistently can give some protection
the condom broke, or you were forced to have sex from sexually transmitted diseases. Please remember
when you did not want to. Emergency Contraception that no method except abstinence, is 100% effective
is a large dose of one of the hormones in birth control in preventing pregnancy and sexually transmitted
pills. If your ovaries have not already released an diseases.
egg, it can prevent it. It is taken within 12–120 hours
(sooner, better) after unprotected sex. This medication
will disrupt your menstrual cycle. It is available in
pharmacies and clinics without a prescription. There
is another EC called Ella which may be more effective.
You do need a prescription to obtain Ella. Info at www.
NOT-2-LATE.com. Or, ask your regular doctor to write a
prescription “just in case you need it.”
94
Sexually Transmitted Diseases If you have had sex without a condom, sex with more
than one person, or sex when a condom broke, you
and Infections should get tested. Your doctor, family planning clinic,
or county health department can do a test for you. If
STDs (Sexually Transmitted Diseases) also called STIs
your test is positive, take all the medicine they give
(Sexually Transmitted Infections) are diseases that
you and go back to get re-tested. You can get STD/STIs
can be spread through oral, anal, or vaginal sex with
more than once. Your partner and everyone that you
an infected sex partner. Many STDs/STIs are curable,
each had sex with should be tested and treated.
and other STDs/STIs are treatable. Sometimes you
can have an STD with no signs or symptoms, or the “What if I get AIDS?”
symptoms may go away. Either way, you will still have
the STD until you get it treated with a medication. AIDS (Acquired Immune Deficiency Syndrome) is
caused by HIV (Human Immunodeficiency Virus), a
“What can happen to me if I get an STD/ virus that attacks your body’s immune system, so you
STI?” can’t fight off many infections and cancers. There are
treatments available to help people live longer and be
Some STDs/STIs infect only your sexual organ. Others, healthier. These treatments work better when HIV is
such as HIV, hepatitis B, and syphilis, cause general discovered early, so testing is very important. You can
body infections. get infected with HIV during anal, oral, and vaginal sex
or sharing needles for any reason. HIV can be passed
• If untreated, chlamydia and gonorrhea can from mother to child during pregnancy, labor and
spread to your uterus and fallopian tubes causing delivery, or from breast feeding.
pelvic inflammatory disease (PID). PID can cause
permanent damage leading to pelvic pain, Testing is usually free at your county health
infertility, and potentially ectopic pregnancy
(pregnancy in the tube or outside the uterus). department or available at AIDS programs, doctor’s
offices and clinics. Your partner should also be tested.
• Hepatitis B can cause permanent liver damage or
liver cancer. “How can I protect myself?”
• If untreated, syphilis can cause heart disease, brain
damage, blindness, and death. Not having sexual intercourse at all is the only 100%
• All STDs/STIs, except trichomoniasis, can be spread way to protect yourself from STDs/STIs. If you are
from mother to child during pregnancy and/or sexually active, practice safer sex:
childbirth.
• Use a latex or polyurethane condom every time
you have sex.
“How do I know if I have a STD/STI?”
• Be prepared. Always carry a condom with you.
You don’t know if your partner has an infection by • Both you and your partner should get tested for
looking at him/her/them. Most people who have an STIs including HIV before you have sex.
infection have no symptoms. Some warning signs
• Get tested again if either of you has sex with
include:
someone else.
• Sores, bumps or blisters near your mouth, genitals, • Learn how to talk about protecting yourselves
or anus before you start a sexual relationship.
• Burning or irritation when you pee • Learn the correct way to use a condom.
• Itching, pain, unusual discharge in genital area • Remember that alcohol or drug use can impair
• (For women) pain in lower belly with or without a your judgment about safer sex.
fever
• (For women) bleeding between periods
95
Protecting Future Fertility

Protecting your fertility (your ability to conceive and carry a pregnancy to term) is important. One out of every six
couples may have a problem that will make it very difficult to have a successful pregnancy. If you have been trying to
get pregnant for more than a year and are unsuccessful, consult medical help. There are many reasons for infertility
and they involve men as often as women. It is also important to know that you can prevent most things that will harm
your chances of getting pregnant. Here are the most common things that threaten fertility.
1. Sexually transmitted diseases/infections (STDs or STIs) are very common among people who are sexually
active, especially with multiple partners. Condoms are the only protection against sexually transmitted diseases.
If untreated, chlamydia and gonorrhea can spread to your uterus and fallopian tubes causing pelvic inflammatory
disease (PID). PID can cause permanent damage leading to pelvic pain, infertility, and potentially ectopic
pregnancy (pregnancy outside the uterus).
2. Smoking has been found to affect the egg as well as the sperm. The nicotine and carbon monoxide found in
tobacco smoke have been linked to health and pregnancy problems such as irregular menstrual cycles, ectopic
(tubal) pregnancies, and a greater chance of miscarriage.
3. Hazardous chemicals and radiation If you work around any hazardous substances it may affect the fertility of
both males and females. Ask your employer for OSHA information on every chemical you work with.
4. Medications. There are a few medications that can affect fertility, though usually not permanently. If you are
considering a pregnancy in the near future, ask your medical practitioner about any medication you are taking and
any known risk to fertility or pregnancy.
5. Family history of miscarriage or infertility. If there are people in your family or extended family who could not
get pregnant, had several miscarriages, premature births, babies that died or had birth defects, you should discuss
this with a doctor specializing in infertility or a genetic counselor. (To find a genetic counselor, go to www.nsgc.org)
6. Endometriosis is a disease that causes severe pain during the menstrual period. Endometriosis is believed to be
caused by cells from the lining of the uterus growing on the ovaries or other organs. This can cause scar tissue.
Endometriosis can be treated so talk to your doctor or clinic.
7. Excessive dieting or exercising can lead to problems with your hormones. Eating disorders or a very low level of
body fat can cause temporary fertility problems in some women.
Previous abortions or miscarriages do not cause infertility. Uneventful abortions, have not been shown to cause a
problem with getting pregnant again. One or two miscarriages do not necessarily mean you will have a problem in the
future. If you have had three or more miscarriages, you should consult a doctor who specializes in fertility.
“What can I do?”

Keep track of your period for several months. How long is your cycle? Count from the first day of your period until
the next period. If the cycle is 40–50 days long, or less than 20 days long, tell your medical practitioner. Also keep
track of any symptoms, and ask your family about any history of these problems. Info from Ferre Institute www.
infertilityeducation.org (Includes videos about infertility signed for the deaf.
96
Menstrual Problems
Is your menstrual period causing problems in your life?
Have you ever missed school, work, sporting events, or social activities because of menstrual cramps? When you have
your period, do you have any of the following: heavy or irregular bleeding, nausea, diarrhea, constipation, stomach
problems or pain, bad menstrual cramps? Do you ever have painful sexual intercourse?
If yes, ask your doctor about a disease called ENDOMETRIOSIS (end-oh-me-tree-oh-sis). It is not something you
get from sex. There are things you can do to get better. You should consult a doctor who specializes in treating
endometriosis and learn more about it. Some things you can do:
»» Regular exercise
»» Improve nutrition, especially reducing fatty food and increasing fruits and vegetables
»» Take pain medicine that is intended for menstrual pain relief
»» Birth control or hormone therapy
»» Surgery
»» Talk to your doctor about what happens to you and what help there may be for you.
Endometriosis Association, 1-800-992-3636, www.endometriosisassn.org
Sex and Sexuality in Your Life

Feeling sexual is a part of being human. Each group or culture has different messages and rules about how to be
sexual. Sometimes it seems like what we feel and what we are told are very different. Your feelings and experiences of
sexuality can change over time. Researchers are looking at ways females/young women become sexually healthy. Here
is what they think:
Sexual health is...

• Knowing how you feel—emotionally and in your body.
• Accepting your feelings as okay.
• Making responsible and safe choices in relationships.
• Making choices based on what you want, not being pressured to do what others want.
See also SPARK (Sexualization Protest: Action, Resistance, Knowledge) www.sparkmovement.org. SPARK Movement is
a girl-fueled, intergenerational activist organization working to ignite and foster an antiracist gender justice movement
to end violence against women and girls and promote girls’ healthy sexuality, self-empowerment and well-being.
97
Sex and Sexuality in Your Life

What’s the difference between having Where can you get information about sex,
sexual feelings and acting on sexual birth control, STD/STI testing?
feelings?
Search the internet under Birth Control, Sexually
Most people experience sexual feelings but each Transmitted Infections. Call your County Health
person chooses to act on them differently. You get to Department or local family planning clinic. Ask your
decide what’s right for you. What’s important to you? health teacher at school. Read books. Use the internet.
What’s the best way to take care of yourself?
Who can you talk to about sexual feelings?
How can you express your sexual feelings? Your parents/other family. Your friends. Counselor at
clinic. School counselor or nurse.
Dancing, holding hands, kissing, touching yourself
(masturbation), and having sex with someone
are some answers to this question. What are you How can you avoid partners who abuse
comfortable with? you or push you into things you’re not
comfortable with?
How can you protect yourself from
Say no—it’s not OK. Remember, “Yes means yes; no
unwanted pregnancy? means no.” Tell others what is going on. If you feel you
Can you ask for what you need to feel safer? See are being abused call the National Domestic Violence
sections on birth control. Learn to talk about these Hotline at 1-800-799-7233 for help.
things with your partner. Talk to your doctor/nurse/
clinic. Where can you get medical help and
information if you need it?
How can you protect yourself from diseases,
If you don’t have a doctor or clinic already, find one.
including HIV/AIDS? Read books and pamphlets from school, health
Not having intercourse, using a condom, talking with department, library. Use the internet to find accurate
your partner about it. medical information.
How can you take care of your body?

Get annual check-ups, including testing for disease.
Eat good food. Get enough sleep. Don’t smoke, drink
alcohol, or do drugs. What do you do now? What else
could you do?
98
Exercise: Exploring Your Feelings Afterward

If you have had an abortion, made an adoption plan for your baby, or if you had your baby and are raising it, you are
probably having feelings about it. You may feel you have changed. You may have strong feelings about other people in
your life, especially your partner or your family. You may be feeling overwhelmed.
When there is a lot of change or stress in your life you need to pay attention to your feelings. You also need support
from the people around you. Support means that they will check in to see how you are feeling. It means they will listen
when you want to talk. It doesn’t mean that they will read your mind! Sometimes we find it difficult to talk about this
stuff, but we have to ask for what we need. Ask for help. Talk about your feelings.
If you are having feelings that disrupt your life (trouble sleeping, eating, concentrating, or crying often), you probably
need more help. If you have delivered a baby and are feeling depressed or anxious, talk to your doctor or midwife. If
you have made an adoption plan and are feeling depressed, you can also talk to the adoption counselor. If you have
had an abortion another workbook in this series may help: Abortion Resolution Workbook offers more information and
resources. (www.pregnancyoptions.info) Or, call a talkline: All Options 1-888-493-0092 or Faith Aloud 1-888-717-5010.
After abortion only: Connect & Breathe 1-866-647-1764 or text line Exhale at 617-749-2948.
The decision about whether to bring life into the world gives us a chance to look at our own lives. Remember, all
decisions about pregnancy require some sacrifice.
How can you make the sacrifice worth it?
What are your goals in life? (Examples: finish school, get a job, provide for your children, spend more time
with them, etc.)

What must happen to reach your goal?
Qualities you like in yourself:
Things you want to change:
What losses have you experienced?
What have you gained? (What are the “gifts” of this decision-making process?)
What kind of life will you create for yourself now?
99
100
Resources Appendix
Abortion Resources National Abortion Federation offers resources to

help women think through their options, a map of
Talklines safe abortion providers across the United States, and
a national fund which can help assist with the cost of
All-Options Talkline offers toll-free, confidential, abortion procedures. www.prochoice.org
nonjudgmental and unconditional support if you are
trying to make a decision about a current pregnancy, National Network of Abortion Funds hosts a list of
need support around fertility, pregnancy, or parenting, state and local abortion funds that can help with the
or want to talk about an experience (past or present) cost of abortion. www.abortionfunds.org
with abortion, adoption, or pregnancy loss. Available
in English and Spanish. 1-888-493-0092, www.all-
Storytelling Websites
options.org
2 Plus Abortions helps to raise awareness about the
Exhale Pro-Voice After Abortion Support Textline common experience of people who have more than
specifically for people who are seeking unconditional one abortion experience. It offers a compassionate and
support and space to process after their abortions. loving community with affirming messages for those
617-749-2948, www.exhaleprovoice.org/after- who wish to share their stories about their multiple
abortion-support/ abortions. www.2plusabortions.com
Faith Aloud wants every woman to feel supported Shout Your Abortion is a decentralized network of
and confident in her pregnancy decision and offers individuals talking about abortion on our own terms
spiritual support, resources and counseling by trained and creating space for others to do the same. Abortion
clergy. 1-888-717-5010, www.faithaloud.org stories can be read on their website or on their social
media platforms. www.shoutyourabortion.com
NAF Hotline Fund is a free and anonymous
resource for abortion funding support and unbiased We Testify is dedicated to increasing the spectrum of
information about abortion. Available in multiple abortion storytellers in the public sphere and shifting
languages. 1-800-772-9100, www.prochoice.org the way the media understands the context and
complexity of accessing abortion care. www.wetestify.
NAF Hotline Referral Line will connect you with a org
staff member who can direct you to quality abortion
providers in your area. This is not a funding line. Pamphlets
Available in multiple languages. 1-877-257-0012, www.
prochoice.org Abortion Conversation Projects offers several
handouts in English and Spanish for women choosing
Informational Websites abortion and those that support them, including You
are a Good Woman, Healthy Coping After an Abortion,
Abortion Care Network allows you to search a Will It Hurt? Mom, Dad, I’m Pregnant, and Especially for
network of independent clinics to find an abortion care Men. www.abortionconversationprojects.org
provider or clinic near you. www.abortioncarenetwork.
org Abortion Resolution Workbook is a workbook to
support and guide through unresolved feelings that
some people may experience after their abortion.
www.pregnancyoptions.info
For more help and information, please go to www.pregnancyoptions.info 101

The Pregnancy Options Workbook
Adoption Resources Parenting Resources

Talklines Talklines
All Options Talkline offers toll-free, confidential, All-Options Talkline is staffed by trained peer
nonjudgmental and unconditional support if you are counselors who provide nonjudgmental support for
trying to make a decision about a current pregnancy, folks calling to discuss all pregnancy experiences,
need support around fertility, pregnancy, or parenting, including parenting, abortion, adoption, miscarriage,
or want to talk about an experience (past or present) and infertility. Calls from loved ones are also
with abortion, adoption, or pregnancy loss. Available welcomed. English and Spanish. 1-888-493-0092
in English and Spanish. 1-888-493-0092, www.all-
options.org Informational Websites
Choice Network is a pro-choice, non-profit licensed Aha Parenting is filled with advice and FAQs for
agency, that supports those making a pregnancy parents raising kids through every stage, from newborn
decision and, if the choice is adoption, empowers to adolescent. www.ahaparenting.com
them to make a plan that puts them at the center.
1-866-989-1466, www.choicenetworkadoptions.com Childbirth.org is a great resource for learning
about childbirth and child care, with information on
Friends in Adoption is a pro-choice, non-profit pregnancy, labor, postpartum depression, caring for
licensed agency, supporting people making a babies, and more. www.childbirth.org
pregnancy decision with accurate information and
no judgment. Regardless of your decision, FIA offers Mother to Baby outlines information about health
kindness and respect and will support you while risks and exposure to drugs and chemicals during
you consider your options. 1-800-982-3678, www. pregnancy and breastfeeding. www.mothertobaby.org
friendsinadoption.org
102 For more help and information, please go to www.pregnancyoptions.info

Appendix
Birth Control and Sexual Health Mental Health Resources

Resources Crisis Text Line is a free, 24/7, confidential text
message service for people in crisis. Text HOME to
Birth Control Comparison Chart offers detailed
741741. www.crisistextline.org
comparisons to all birth control methods. Created by
Cedar River Clinics. www.birth-control-comparison.
National Suicide Prevention Lifeline is available 24
info
hours per day. If you are experiencing a mental health
crisis and are considering suicide, you can call 1-800-
National Herpes Hotline 919-361-8488 and National
273-8255 for immediate trained support.
AIDS Hotline 1-800-CDC-INFO are both free,
anonymous, and confidential places you can go to
Self-Care Day is a website with suggestions and
ask experts about STD prevention, symptoms, and
guidance for individualized and effective self-care.
treatment.
www.selfcareday.com
National STD Hotline 1-800-227-8922 Free and
confidential.
Sex Etc. offers comprehensive sex education and

discussion for and by young people, including
questions about sex, sexuality, sexual orientation,
relationships, pregnancy, STIs and birth control. www.
sexetc.org
For more help and information, please go to www.pregnancyoptions.info 103

Gratitude
To all of you, who have experienced pregnancy uncertainty, for your courage
and wisdom. Thank you for showing us the way.
104
Credits
Thanks to the following for their help and advice.
This Version of Workbook Original Workbook

Thank you to an anonymous donor. Sharon Foster Aaron, CSW
Adoption Section
Margaret R. Johnston, Editor
Southern Tier Women’s Health Services Anne Baker, Hope Clinic
Parents/Partner Sections, adapted
Mercedes Sanchez, Editor
and Meagan Douglas Jennifer Bensen
Cedar River Clinics “Buddhism”, Religion Section
Heather Ault, Graphic Design Luba Djurdjinovic, MS, Genetic Counselor

www.heatherault.org Stages of Pregnancy,
What Can Hurt Your Pregnancy,
We appreciate the feedback and Decision-Making
of the following reviewers:
Beth Goldstein
Karen Thurston “Pagan View”, Religion Section
www.2+abortions.com
Margaret R. Johnston, Editor
Jennifer Katz, PhD
SUNY Geneseo, Connect & Breathe Jennifer Marshall
Help with Taking Care of Yourself
Parker Dockray
All Options Talk-line Terry Sallas Merritt, Editing
Leah Chamberlain Mark Roth, Pregnancy Risk Network

What Can Hurt the Pregnancy?
Molly Rampe
Choice Network Adoptions Charlotte Taft/Shelley Oram, Imagine Consulting
Abortion Section, Guided Day Dreams
Additional support from
Southern Tier Women’s Health Services Ava Torre-Bueno, CSW
and Cedar River Clinics. “Islam” Religion Section
Pamela Wilson
Help with Parenting, Adoption and
Decision-Making Sections
Cara Kangas, Reviewer
105
Notes and Reflections
106
107
108
This guide is distributed by
Cedar River Clinics and is also available online at
Copyright 1998. Revised in 1999, 2002, 2006, 2009, 2015 by Margaret R. Johnston
and 2020 by Cedar River Clinics.
Distributed by Cedar River Clinics

263 Rainier Avenue S, Suite 200
Renton, WA 98057
1-800-572-4223
www.CedarRiverClinics.org
[email protected]
Links to the website may be freely made.
Portions of this workbook may be copied for individual use but may not be sold
or reproduced in quantity without written permission.

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A word about language: We want to be as inclusive as possible for anyone involved in a

Thank you and good luck!

Peg Johnston Mercedes Sanchez

Section 2 Getting Ready to Make the Decision 5

Section 3 Getting Support 15

Section 4 Deciding What to Do 21

Section 8 Pregnancy Stages 67

Section 9 What Can Hurt the Pregnancy? 71

Section 10 Spiritual and Religious Concerns 79

Section 11 Healing Work 85

Section 12 Taking Care of Yourself 91

Appendix Resources 101

Notes and Reflections 106

Check Out the Internet

Keywords on Search Engines (Google, Bing, Yahoo):

Abortion Clinics Pregnancy Resource Centers, Crisis

Physicians and OB/GYNs Adoption Agencies

“How pregnant am I?”

»» If you don’t remember the date of your last period

“How do I know if I am miscarrying or having a tubal pregnancy?”

Make the Decision

Here are some other questions to think about...

Is my body healthy enough?

This is the main question...

Giving Yourself Time and Space to Think

Exercise: “How can I make time to think?”

I could stay home and think instead of doing .

I could talk with .

Other thoughts on making time for myself .

Exercise: Making a Safe Place

Exercise: Are you in shock?

1 = rarely 2 = sometimes 3 = often 4 = all the time

I think about it when I don’t want to. How to Score Yourself

I stay away from babies.

Total (Add up your score)

Exercise: What are you feeling?

anger sad shame scared happy

confused overwhelmed confident stupid uncertain alive

happy unreal panic numb guilty comfortable

anxious relieved trapped strong embarrassed scared

like crying selfish resolved grieving relaxed peaceful

lost disappointed alone worried unloved other

Draw a circle and divide it into sections, Where on your body

Exercise: Feelings Anger

Who are you most angry at?

If you’re angry at someone, what do you wish they

If you’re angry at yourself, why?

Are you expecting perfection from yourself?

Where did you learn you needed to be perfect?

What could you have done differently?

What can you do differently from now on?

What are some ways to express your anger?

Some things that people might feel ashamed about

Is there a shameful part of this for you?

What are you losing?

Did anyone try to make you feel this way?

There may be more than one thing. You might feel

What is a more positive message you can give