Timing is of the Essence: Dating the Pregnancy

Medical Abortion (abortion pills) are best to be used for pregnancies at 12 weeks or less. It is not recommended to take abortion pills after 12 weeks on your own without assistance from a midwife or medical professional. The further in gestation you are when having a medical abortion, the more risk there is. The earlier you can get pills the better, as an abortion at 4-7 weeks can be less intense than an abortion between 8-12 weeks.

If you are planning to take abortion pills at home, the first step is to date the pregnancy to better inform your choices around how you plan your abortion.

• The first step is to date the pregnancy yourself using your Last Missed Period (LMP) combined with the dates you had sex, which could have caused the pregnancy.
• Since many women don’t remember their LMP or exact dates they had sex, it’s good practice to also get an ultrasound to date the pregnancy with accuracy.
• An ultrasound also lets you know where in your uterus the pregnancy has attached and rules out ectopic pregnancy. Abortion with mifepristone and/or misoprostol will NOT end an ectopic pregnancy.

NOTE: For pregnancies between 12 and 22 weeks, it is preferable to seek a surgical abortion at a clinic, or seek guidance from an experienced midwife or professional.

It is important to know the number of weeks you are pregnant for a few reasons: 

• Medical abortion is the least complicated for gestations of 7 weeks or less.
• If you are exceedingly early, you can have the opportunity to take a few extra weeks to make your decision or access your pills.
• The number of weeks pregnant you are determines the way you can plan your abortion, and the way forward.
• If you have an ectopic pregnancy or other complication, this can be better identified the earlier you are in a pregnancy.

Dating Pregnancy using LMP

Pregnancies are dated from the first day of your last period. You will see this called “LMP” or “Last Menstrual Period.” Technically, you did not get pregnant for about two weeks AFTER the first day of your last period, but since most people are not 100% certain when they ovulated last, the gestational date ends up being a little misleading. There are many free LMP calculators online. Here is a good one: HERE

Dating the Pregnancy by Ultrasound

If you cannot remember when the first day of your last period was, or you do not have very regular bleeds, a common and effective way to determine the length of your pregnancy is with a sonogram or ultrasound. 

It is not necessary to get an ultrasound to have a self-managed abortion, but here are a few benefits: 

• Ruling out ectopic pregnancy–this can only be done by ultrasound.
• Confirming that your pregnancy is viable (especially if you live in a country where abortion is illegal, they will give you a D&C to remove the pregnancy).
• Dating the gestation of your pregnancy (how many weeks pregnant you are).

There are a few options for obtaining a dating ultrasound:

NOTE: If you are planning to abort, it is advisable to seek a provider that is known to be pro-choice or will be open to your needs. If you live in a country where abortion is restricted or illegal, be incredibly careful what you share with the doctor, and do not give any indication that you plan to abort. Be vague and perhaps make it seem as though it is a wanted pregnancy. As many pregnancies end in miscarriage in the first trimester, there will be nothing odd to a physician when you “miscarry” several weeks later.

• Your family doctor or regular health care practitioner. Nearly every doctor knows how to handle a pregnancy, so if you like and trust your family doctor, this is a great place to start. 
• The public health department, urgent care, and other free and easy-access clinics usually have a way to help people find out how far along they are in a pregnancy. It might end up being a referral, but they will get you where you need to go.
• Planned Parenthood, Marie Stopes, IPPF, or other reproductive health care clinics are really great places to find support and resources. Even if they are too far away for you to visit–you can call! They can help. They want to help. They are by nature pro-choice and may be more supportive of your choices if you are planning to abort.

Once you have confirmed how many weeks pregnant you are, you can start to plan. When will you next have a few days to relax and bleed? You will want to have a few days to build a cozy nest in which to best self-care. Start planning for when this could be.