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We treat patients from 5-31+6 weeks. Appointments are encouraged after 5 weeks so an intrauterine pregnancy can be confirmed. If it is too early to see the pregnancy inside the uterus on an ultrasound, the failure rate is up to 15% instead of 1-2%. For local patients, an ultrasound is repeated at 1 week and the medicine is given at that time without any additional charge.
Patients arrive and must complete an intake form which will require a complete medical history, information regarding the procedure, and consent forms. Lab will be done to check for anemia, and RH factor to determine if they need Rhogam. Vital signs will be taken, and an ultrasound performed. The patient will also be counseled by a trained medical staff as well as the physician.
If the patient is doing a pill procedure, it is a 2-day process (one appointment). The patient takes one pill on Day 1 (mifepristone/RU 486) which stops the pregnancy. After 24-48 hours of the initial dose of mifeprex, a second medication (misoprostol) will be taken to assist in passing the pregnancy. Nothing usually happens until they take the second medication at home (misoprostol).
Bleeding and cramping will usually start between 1-4 hours after this medicine is taken at home. The time the medication is taken at home is flexible and can be taken at a time that is convenient for the patient. They should not have to miss work due to this.
– If they choose the surgical procedure, the procedure takes about 10 minutes for the procedure but they patient may need to recover for up to an hour. They must be able to drink and walk prior to discharge. The recovery is usually about 15 minutes if the patient chooses to use only local anesthesia.
The patient can expect to be at the office 1 hours for a pill procedure, 2 hours for a surgical procedure. If a two-day procedure is required, it’ll be approximately 1 hours on day 1 and a full day in the office on day 2. Intake takes about 20 minutes, the procedure takes about 10 minutes, and the recovery can take up to an hour.
The doctor will review the case and may need to administer a medication to soften the cervix prior to the surgical procedure which takes an additional hour. Usually this is recommended with minors, obese, multiple surgeries on the uterus, and those not receiving IV sedation to reduce the pain of the procedure.
The pill procedure appointments are quicker. There appointment should be 1-2 hours.
We realize that some patients do not have the time to wait and are willing to pay for expedited service. For an additional $500, these patients move to the top of this list and are allowed to move quickly through the process. This is available for scheduled appointments as well as walk-ins.
We offer appointments everyday but Sunday. Appointments are offered in the evening as late at 9 pm as well as weekends. We can accept walk-ins and next day appointments. Scheduled appointments are required for weekends and evenings.
Surgical procedures in the first trimester should be able to return to work the next day. They will feel drowsy the day of the procedure and the pain is minimal. If they are greater than 17 weeks, they may require a 2-day procedure. They can return to work the day after the procedure is complete. We do supply excuses for work and school upon request.
Patients should not bring their children into the building.
No purses or book bags are allowed into the building due to fear of concealed weapons
Patients must have a government issued ID.
Drivers for surgical patients must check in with the patient and present a copy of their driver’s license. If an Uber is providing local transportation, uber information must be provided. Patients cannot driver for 24 hours after procedure, if IV sedation is used.
If the patient is using a visa that is not their own to pay for services, the person who is named on the visa card must be present with a valid ID
After checking in, it may be neccessary to have patients family memebrs wait on the first floor waiting room. However, all attempts are made to allow family to stay with the patient throughout the visit.
Its imperative that a pregnancy test be preformed at this time and follow ups be scheduled before 6 weeks from their precedure date. No additional charges for follow ups scheduled in this time window. If the procedure under 6 weeks fail, there is no additional charges for this as well.
They will be provided with a list of symptoms that should alert them to come in sooner. They will also be provided with a phone number for after hour emergencies. Pt can schedule a follow up in a month for their own peace of mind as well.
We follow the Colorado state laws regarding proper disposal of pregnancy tissue. Patients cannot take the pregnancy tissue home with them. If they desire a funeral or cremation services, they can contact a funeral home and they will pick up the pregnancy tissue directly from the office. They need to notify the staff prior to the procedure of this preference.
Approximately 10% of patients are Rh negative. This means they lack the Rh factor. There is an 80-90% chance the pregnancy is Rh positive which means the Rh factor is present.
After 12 weeks the exposure to Rh is substantial enough that it can cause issues with future pregnancies if Rhogam is not given. This can result in future pregnancy complications such as recurrent miscarriages or complicated, high-risk pregnancies.
If the patient is Rh negative, we offer RhoGAM in the office for an additional charge. It is required that Rhogam be given to patients that are 12 weeks and greater. We follow the NAF and WHO guidelines to abortion care which does not require Rhogam prior to 12 weeks. Patients can still elect to receive Rhogam under 12 weeks if they prefer.
There is an additional charge for this medication.
The surgical procedure is very well tolerated. We offer IV medication, Fentanyl and Versed. We give a “twilight” anesthesia which means patients can still breath on their own. Fentanyl reduces pain and versed will affect the patient’s memory. These medications relax the patient, and some patients may sleep as a result. Not all patients will sleep, however.
Medication will also be used to numb the cervix (mouth of the uterus) and the lower 2/3 of the uterus. Patients can elect not to have IV sedation and proceed with only local which numbs the area.
There is no distinct difference in pain between the pill or surgical procedures. Ultimately, it depends on the patient’s individual pain tolerance.
Patients who decide to have a pill abortion will be provided with all the necessary medication to complete the abortion procedure. you will also be given a script for ibuprofen, as well as birth control/nausea meds per patient request.
Surgical patients that are requesting IV medication during the procedure MUST have a driver. The driver needs to check in with the patient and must present us with their driver’s license. They must stay at the office (in their vehicle) until the patient is discharged.
The pill procedure is 96-99% successful. The failure rate increases after 10 weeks. We recommend surgery after 10 weeks. We recommend that a patient return to the office after 2 weeks if the pregnancy symptoms persist or if they have a positive pregnancy test after 1 month.
We encourage any concerned patients to return for peace of mind if needed. If the pill is unsuccessful, a surgical procedure to remove the remaining tissue may need to be performed. If the patient follows up within 6 weeks of the initial visit, there is no additional charge. Patients will need a driver at this visit if they desire IV sedation.
The surgery is 99% successful. On rare occasions, there can be some retained tissue. The surgical procedure is a blind procedure and is performed by feel so this is a known but uncommon outcome. Patients are instructed to return if a pregnancy test is positive after 4 weeks.
Birth control prescriptions will be offered to every patient. Each patient’s medical history as well as preferences will be used to decide which is the best option. Birth control pills should be initiated 2 weeks after the surgical treatment. In the pill procedure, it is recommended that the pill be initiated at the time of a negative pregnancy test.
Patients that are under 18 can still have an abortion procedure. Colorado does not require the parental consent, but the parents must be notified. There are 4 avenues these patients can pursue.
1. They can be accompanied by a parent. They must bring their birth certificate and the parent must have a government issued ID
2. According to the “Colorado Parental Notification Act”, the healthcare provider must notify the parent or legal guardian of the minor’s scheduled abortion. This notification letter is certified mail sent to the parent or guardian at least 48 hours in advance of the scheduled abortion. The patient will need to present their birth certificate or documentation identifying their legal guardian more than 48 hours prior to their appointment.
3. The patient can present documentation of legal emancipation
4. The judicial bypass program is a process that the minor can pursue that avoids the need for parental notification. The patient can present their case to a judge who can determine if the minor can proceed without this requirement.
Both pill and surgical procedures are safe. The complications to either procedure is 1%. Neither will affect the ability to have children in the future.
Patients can resume normal activity after the procedure is complete in both the pill and procedure. The main concern at this point is infection given the mouth of the uterus has been opened and an infection could potentially occur. Pelvic rest (no sexual activity, tampons, or baths) for a period of 2 weeks after the procedure is completed.
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