Northern Options for Women (NOW)

What to Expect

First Appointment

When we call you to arrange your first appointment, we will give you a date and time, as well as instructions on where to go.
You will meet a doctor who will do an ultrasound to determine the stage of your pregnancy. Do not pee in the hour before your first appointment, as this may interfere with the ultrasound. While you are waiting to see the doctor, you may be asked to fill out a short questionnaire to help us understand how we can help you.

The doctor will discuss your options with you.  If you decide to proceed with an abortion, the doctor will talk about whether a medical abortion  or surgical abortion  is most appropriate for you, and answer any questions that you have. You will also be asked questions about your health, medications, and allergies.

Next, you will meet a nurse practitioner.  The nurse practitioner will provide counseling about your decision. If you choose to continue with the pregnancy she will discuss arranging follow up prenatal care and ultrasound. If you choose adoption, she will connect you with the resources you need for this. If you choose abortion, she will discuss options for birth control for after the abortion.

You may be given antibiotics if you have had a recent infection or if you have not recently been tested for sexually transmitted infections.  If you choose to proceed with a surgical abortion, you will be given an appointment time for the following day and given instructions about when to stop eating.

Contact us to arrange an appointment 

Medical Abortion

Information on Medical Termination of Pregnancy (PDF)

Medical Termination of Pregnancy Instructions (PDF)

 Medical abortion uses a drug instead of a surgical procedure.  It can be performed up to 9 weeks from the first day of the last menstrual period. This may need to be confirmed by ultrasound during your initial appointment
It takes between 1 and 3 weeks to complete. There is a 95% success rate; the other 5% will have to complete the abortion with a surgical procedure.

Women who choose this option must be able to attend multiple doctor visits over a 2-3 week time frame. They must also be willing not to have sexual intercourse or consume alcohol for 14 days.
If you and your doctor determine that this is the right choice for you during your first appointment, you will be given a requisition to have blood work done.

You will be given a prescription for Mifegymiso and pain medication, which you may pick up at the pharmacy.  Mifegymiso is a prescription that contains two medications: Mifepristone and Misoprostol.  Mifepristone is a medication that blocks progesterone which is the hormone that supports the pregnancy. Misoprostol is a medication that, when used after mifepristone, will cause the cervix (neck of the womb) to soften and open, and will cause the uterus to contract and push out the pregnancy.

You and your doctor will discuss the best time to take the mifepristone.

Two days later, you will take the misoprostol either by inserting tablets in your vagina or in your cheek.
One week after the initial visit, you will see the doctor again for blood work and possibly an ultrasound to see if the abortion has been successful. If the abortion is complete, you are done. If the pregnancy is still present, you may wait another week, repeat the misoprostol tablets, or have a surgical abortion. Further follow up will be discussed at that time  

Surgical Abortion

If you choose to have a surgical abortion, you will return to the same place the day after your ultrasound and counseling appointment .
Your entire stay will usually be a few hours, though the procedure itself takes only 10 – 20 minutes. Women often enjoy bringing an ipod with them to listen to their own relaxing music.

If this is your first pregnancy or you are more than 12 weeks from your last period, you may be given a medication called misoprostol to take before your abortion. Misoprostol is a medication that will cause the cervix (neck of the womb) to soften and open. This medication can be either inserted into the vagina or dissolved in the cheek. After you take this, the abortion cannot be reversed

You will be given a medication called Ativan to dissolve under your tongue. This will help you to relax. You will also be given an anti-inflammatory medication to decrease cramping. 

You will go into the same room where you had your ultrasound.  You will be with a nurse practitioner and the doctor. The nurse practitioner will put a small intravenous in a vein in your arm, and through that she will give you medications to help you relax and to decrease pain. You will not be put to sleep, as it is safer for you to be awake during the procedure. You will be able to tell the nurse beside you if you feel anxious or if you feel pain, and she can adjust your medication dose.

The doctor will determine the size and position of your uterus by inserting a gloved finger into your vagina and laying the other hand on your lower belly.  A tool called a speculum will be inserted into your vagina, exactly the same way as when you have a pap test done.  The cervix (neck of the womb) will then be frozen by small injections of local anesthetic (xylocaine). This may feel pinchy or crampy.

The doctor will then gently open (dilate) the cervix to gain access to the uterus.  This may result in slight pressure and cramping.

Once the cervix is open the doctor will empty the pregnancy tissue with a tube connected to a suction pump.  A woman can feel minimal to heavy cramping as the uterus contracts and gets smaller. You may hear a suction-like sound.
The doctor will then clean the walls of the uterus to ensure that all of the tissue is removed and a final suction is done. The entire procedure normally takes approximately 10 minutes.
You will then be led back to the recovery room, where you will be able to eat and drink. You are not allowed to drive for 24 hours after the procedure, so you must arrange to have someone pick you up.

The Night Before the Surgical Abortion

Before your surgical abortion appointment:

  • Do not eat or drink after midnight before your surgical abortion, except you can drink clear fluids (water, apple juice, ginger ale) until 4 hours before your abortion.
  • Do not drink alcohol the day before your abortion.
  • Bring comfortable loose clothes for after your abortion, including comfortable underwear. Thong underwear will not be comfortable, as you will be wearing a pad after the abortion.
  • Arrange to have someone pick you up after the abortion, as you will not be allowed to drive.
  • If you decide after your first appointment not to come for your abortion, please call the NOW Program number at 873-5710 (outside of Yellowknife, 1-888-873-5710).

Contact us to arrange an appointment .