Abortion is STILL LEGAL in Alabama
and it is your constitutional right to obtain one prior to the state’s gestational limit of 21 weeks 6 days after your last menstrual period
Here is everything you need to know if you want West Alabama Women’s Center to provide you with an abortion:
The state of Alabama requires every person obtaining an abortion to make two clinic visits at least 48 hours apart. During your initial visit you will receive an ultrasound for proof of pregnancy and to determine how advanced the pregnancy is, counseling with a staff member to ensure you are comfortable with your decision, that no one is coercing you into ending a pregnancy, and of any other options for continuing a pregnancy if that is a choice you prefer to make. You will also receive information mandated by the state about potential risks of abortion and potential risks of pregnancy, and resources that are available to you should you choose to continue the pregnancy. That decision belongs completely to you, and there is no judgement from anyone at the clinic whichever path you choose. If your pregnancy is less than 10 weeks gestation, you will also be told that you can choose either a medication abortion (a self-managed miscarriage) or a procedural abortion (a vacuum aspiration). If you have advanced beyond 10 weeks you will only be able to receive a procedural abortion (for more information about abortion types, click here. You will then be scheduled for an appointment at least 48 hours in the future.
Alabama’s Mandatory 48 Hour “Informed Consent” Process
The State of Alabama Mandatory 48 hour counseling session where a qualified person must provide the following information:
- The name of the physician who will perform the abortion in writing or by business card
- Development of the fetus and probable anatomical and physiological characteristics of the embryo or fetus at the time the abortion will be performed that is explained in the state required literature
- The risks and complications associated with the abortion procedure
- Risks and complications associated with full term childbirth
- Alternatives to abortion that include continuation of the pregnancy and keeping the child, or placing the child for adoption
- List of agencies that offer assistance and a brief summary of services offered including adoption agencies. The state of Alabama provides a Resource Directory that lists all this information
- Methods of birth control
- The father’s obligation to assist in the support of the child
- Patient must not be forced or required by anyone to have an abortion. The patient is free to withhold or withdraw consent to the abortion at any time before or during the abortion unless stopping the procedure jeopardizes the patient’s health. Exercising this right will not affect the right to future care or treatment and without loss of state or federal funded benefits which the patient might otherwise be entitled to.
The patient must receive this information at least 48 hours in advance in person or by return receipt certified mail with restricted delivery. Mailing of the printed materials may be arranged by telephone. Patients requesting mail must also receive the materials again in person at their appointment time. The clinic must receive the signed green return receipt card of the certified mail dated 48 hours before the abortion. The process of mailing the required literature takes several days to complete the process to meet state requirements.
In addition to the 48 hour Counseling and Decision Making Counseling, the educational process must include the following:
- The physician who will perform the abortion is required to perform an ultrasound before the abortion.
- The patient has the right to view the ultrasound and must complete a required form to acknowledge that she either saw the ultrasound image or that she was offered the opportunity and rejected it.
- The patient has the right to view a videotape prepared by the Department of Public Health
- Patients are provided with written descriptions of the abortion procedure, and risks and complications for the procedure. Patients must be supplied with materials that accurately pertain to their circumstances and are appropriate to the patient’s gestational age.
This may be accomplished in group sessions if voluntary, however individual counseling must be offered.
The following objectives must be fulfilled with each patient who chooses abortion:
- Ensure informed consent by establishing that the patient is mentally competent and appears to understand the nature and consequences of the procedure.
- Prepare the patient for surgery in a manner that facilitates their safety and comfort.
- Assist the patient in reaching a decision about the method of contraception they will use and then respect the patient’s choice.
- Provide the patient with accurate information, directly applicable to their procedure, about the risks of surgery and benefits as well.
- Provide patients the opportunity to ask questions about the procedure.
- Describe the abortion procedure in terms the patient can readily understand.
- Inform the patient that they are free to withdraw the request for abortion until a certain point in their care.
- Consent form must be obtained for a support person to be present for any part of the abortion process.
- Written documentation signed and dated by the patient and witnessed by a staff person, indicating all of the above steps has taken place.
Counseling notes are a part of the permanent medical record and function as such in both a medical and legal context.
What to Bring to the Clinic
Before arriving for your abortion counseling visit, you should have the following identification:
For a patient 18 years of age or older, some form of identification with a photograph on it such as driver’s license, or state non-driver identification card, high school annual photo with name printed, school ID, or military identification card.
For a patient under 18 years of age, unless you are an emancipated minor or have a judicial waiver specific to abortion: a parent, legal guardian, or adult with durable power of attorney must accompany you. The adult must have a picture identification and proof of parenthood (such as a birth certificate) or the guardianship or power of attorney documents. The clinic is required to keep in their possession the original documents or a certified copy. The patient must bring some form of picture identification or proof of identity, such as a school identification card, military identification card, or a yearbook with photo and name. A birth certificate alone is not a form of identification, but is proof of parenthood (Alabama residents can go to their county health department and get a copy of their birth certificate while they wait).
On your first visit to West Alabama Women’s Center you will receive 48 hour required counseling (including state literature and opportunity to view a video prepared by the state of Alabama) lab tests, an ultrasound to determine how many weeks you are pregnant. You will have the opportunity to view or to not view the ultrasound.
No smoking or food or drinks are allowed in the clinic.
When you arrive at the clinic, go to the receptionist’s window and sign in. Patient sign in sheets are HIPAA compliant protecting your privacy. You will be given a number for your privacy and will always be identified by that same number while you are at the clinic. Our receptionist will give you a packet of papers to fill out in the waiting room. You should fill out these documents fully; they give us your medical history so that we can tailor our services to your individual needs.
After you have completed your paperwork and verified your identity and age to the receptionist, you can relax and watch TV or read until called back for your lab work.
Next, a staff technician will call you back for your lab work. The lab includes vital signs check (pulse, blood pressure, temperature), and two tests which require a few drops of blood from your fingertip. The blood tests check for Rh-factor and hematocrit. These tests give us an understanding of your overall health and take only a few moments.
Your next step is the ultrasound examination. Ultrasound is the safest and surest way to confirm that you are pregnant, rule out ectopic pregnancy, and determine how long you have been pregnant. A small video screen shows a black-and-white image of the inside of your uterus. State law requires that we offer you the opportunity to see the ultrasound but you are not required to look at the picture.
After the ultrasound, you go to the counseling room for a counseling session and paperwork. You will learn more about the abortion options available so that you can make an informed decision about which method is best for you. If you decide not to have an abortion, you will learn about the many resources available to pregnant women for adoption or assistance with pre-natal care. There will be many papers to read and consent forms to sign.
If you are already certain that you want an abortion, we respect your decision and no one will try to talk you out of it. However, state law requires that we give you information about all options available to pregnant women and you will sign forms saying you have been given this information. You are not required to take this information.
You will also receive information about contraception (birth control) to help you decide which method will best help you to prevent future unwanted pregnancies after your abortion. All prescription contraceptives are available through West Alabama Women’s Center; or you may decide which method is best for you and see your own doctor to receive it.
YOU CAN CHANGE YOUR MIND AT ANY TIME DURING THIS VISIT. THE ABORTION HAS NOT BEGUN. IF YOU DECIDE NOT TO HAVE AN ABORTION, YOU DO NOT HAVE TO RETURN TO THE CLINIC.
You may have different abortion options available to you depending on the time you have been pregnant. If you are less than 10 weeks gestation, you can choose between medication and an in-clinic procedure.
A medication abortion is actually two medications. The 1st medication administered is Mifeprex (abortion pill), which will be provided to you to ingest while you are at the clinic. It blocks progesterone, causing the embryo to stop developing in the uterus. The 2nd drug is misoprostol or cytotec, which comes as four pills that you place between your cheek and gum. The misoprostol causes the uterus to contract and empty, ending the pregnancy. The misoprostol can be taken later in the privacy of your own home or another safe space. This process can fall into a range of experiences from a heavy period to something not much different from labor. Many patients who choose medication do so because of the privacy, autonomy and less invasive nature of the process. Others prefer an in clinic procedure because of its simplicity and speed. Only you know what process is the best for you and your situation.
In all in-clinic procedures the process will begin with a gradual dilation of the cervix with a series of small rods in order to allow the doctor to insert the tools necessary to remove the embryo or fetus. Despite the common phrase “surgical abortion,” there is actually no cutting, incisions or stitches involved in a procedural abortion. In most abortions a small tube will be inserted and light vacuum will be used to remove the pregnancy matter including fetus or embryo and uterine lining. A curette (a small metal rod with a loop on one end) will then be inserted to ensure all of the lining has been removed from the uterus to prevent any retained tissue and minimize any risk of infection. Should the pregnancy be more advanced (past the first trimester) a small pair of forceps will be used to remove the fetus prior to curettage.
Frequently patients who experience an unplanned pregnancy and want an abortion are unable to immediately find the additional money for an unexpected medical procedure. We understand that abortion is a time sensitive issue and that as patients advance in gestational age the costs can begin to increase starting at the second trimester. If you need financial assistance for paying for your procedure, or for the additional expenses that can come from needing to travel to an abortion clinic for care (gas, hotel expenses, etc.), know that there are organizations that can help. Let the clinic know and they will be able to assist you in the process.
Alabama law requires that if you are a minor (17 years old or younger) and have never been married, you must have written consent of one of your natural parents or a legal guardian in order to get an abortion in this state, even if you do not live with them. If you cannot or do not want to get consent from a parent or guardian, you can go to court and ask for a judge to approve the abortion.
During the parental consent waiver process, you have the right to file a petition in your county of residence or in the county where the abortion will be performed. Judicial waivers cannot be obtained for patients out of state. You have the right to a speedy process and a lawyer will be provided at no cost to you. You should expect answers to your questions and help filling out your forms. Above all, you should expect complete confidentiality from the court.
The court shall grant your petition for waiver of the parental consent requirement if it determines that you are mature and well informed enough to intelligently decide to have an abortion without the consent of a parent or guardian and that it is in your best interest to have an abortion.
While it is often easier to go to court in your home county, sometimes juvenile judges in large counties with a family court will be more familiar with the process. You may also have personal reasons for wanting to go outside your county for judicial consent. Call the courthouse and find out where to go to file a petition to waive parental consent for an abortion. Your local courthouse should be able to give you the phone number of courthouses in other counties. We recommend you receive your pre-abortion counseling at the clinic prior to filing a judicial waiver. This counseling session will prepare you to answer questions the judge may ask you as well as begin the mandatory waiting period process. Always contact West Alabama Women’s Center immediately after finding out your results.