Your options The effects of your choices Changing your mind

The decision to give birth and raise the child, give birth and have the child adopted, or have an abortion may be very hard for you to make. The sooner you seek advice and get help, the better.

Making A Decision

Being pregnant means you have some decisions to make. First, you need to be sure that you are pregnant. If the results of a pregnancy test are positive, you should see a doctor or go to a clinic to confirm that you are pregnant. Then the doctor will find out how far along you are in your pregnancy and talk to you about your options. You will need to think about many factors as you decide. Your health, values, beliefs, and situation will play a role in your decision. You may want to think about:

• Medical problems you may have—there may be a risk to the fetus or signs that something might go wrong with the pregnancy
• How far along you are in your pregnancy
• How much it costs to pay for prenatal care, to raise a child, or to have an abortion
• What your choice will mean for you

Decide as early as possible what you want to do. If you choose either to raise the baby or to have him or her adopted, it is best to begin prenatal care as soon as you can. If you choose to have an abortion, it is simpler and safer for you to have it done as soon as possible. Explore your feelings to make sure that what you decide is right for you.

Raising a Child

Caring for a baby can make your life better. It is also a lot of work and responsibility and takes a lot of time and money. The more support you have from the people around you, the easier it will be for you to raise a child. You may want to think about

:
• Who can help you with child care?
• Is your partner or are other family members available to help you?
• Will you have to change your living arrangements? If so, can you afford to do this?

Prenatal care is important. Good prenatal care makes it more likely that you will have a healthy baby. Be sure to talk to your doctor about labor, delivery, and the postpartum period (after the baby is born). Knowing what to expect will help you get the most out of childbirth and being a new mother.

Adoption

If you cannot raise a child and do not want to have an abortion, adoption may be a good option. In an adoption, a child legally gets new parents. The baby will get a new birth certificate with the new parents' names on it.

If you choose adoption, prenatal care is as important as if you were going to raise the child yourself. Be sure to start care early and see your doctor regularly. After the baby is born, you should talk to your doctor about birth control options. You may have a mixture of feelings when the baby is adopted by new parents—anger, grief, a sense of loss, or a sense of relief and certainty that this was the best decision for you. These feelings can last for a long time and may return to you on the child's birthday, even years after the baby has been adopted.

Counseling can help you feel more comfortable with this decision. The agency that provides the adoption service or a local family services agency may offer counseling.

The Process

Shortly after the baby is born, the birth mother (the woman who gives birth to the baby) signs consent papers that end her right to make decisions for the child and gives her permission for the baby to be adopted. If the baby's birth father is known and he admits to being the father, he also must sign the consent forms. He may sign the papers before the baby is born. After the adopting parents agree to accept the baby and have taken him or her home, they file legal papers asking to adopt the baby. A judge approves the adoption. After a waiting period (from 1 month to 6 months, but sometimes longer), the adoption is final.

Types of Adoption

There are three types of adoptions—open, closed, and semi-open. In open adoption, the birth mother and the people who adopt the baby (adoptive parents) may meet and share names and addresses. The birth father also may be included. In a closed adoption, the birth mother and the adoptive parents do not meet or know each others' names. In a semi-open adoption, the adoption agency will provide the birth mother with information about the baby from the adoptive parents and vice versa, but there is no direct contact between the birth mother and the baby.

An adoption can be arranged by an agency or, in some states, independently. In an agency adoption, most agencies choose the adoptive parents after carefully screening and studying people who apply to adopt a baby. Some agencies let birth mothers participate in this process. Sometimes the baby leaves the hospital with the adopting parents. Sometimes the baby is first placed in foster care.

In independent adoptions, babies are placed in the adoptive parents' home without an agency. This may be done through lawyers, doctors, counselors, or independent organizations. Before the adoption is final, the new parents and the home setting must be approved by the state agency that handles adoptions and by the court.

One benefit of agency adoption is that the agency often provides counseling, support services, and follow-up after the adoption. There also may be fewer legal problems with agency adoptions. But agencies may not allow adoption by single parents, parents over a certain age, or gay and lesbian parents. Independent adoptions often have fewer rules and may have shorter waiting periods.

Financial Help

If you arrange an adoption through an agency, ask the agency what kind of financial help—both medical and legal—is offered. If you cannot afford a private lawyer to help you with the adoption, you may be able to find legal aid. Most, if not all, states allow the adopting parents to pay the birth mother's legal and medical fees. While these and certain other fees, such as counseling, often can be paid for the birth mother, it is not legal for anyone to make money from an adoption.

Abortion

Abortion occurs when the developing pregnancy (the fetus) is removed from a woman's uterus. When a procedure is done to end a pregnancy, it is called "induced abortion." Most abortions are done in the first 12 weeks of pregnancy. The decision to have an abortion should be made as early as possible. The type of procedure used and some of the risks involved depend on how long a woman has been pregnant. A doctor can explain the stage of your pregnancy to help you decide. Your health also may play a role in your decision because some health conditions involve additional risks to a woman during pregnancy and birth.

Abortion is a personal decision. However, some states require that girls younger than 18 years notify their parents or guardian or get permission from a court of law in order to have an abortion.

The Procedure

Induced abortion can be done in several ways. Some abortion procedures are done by surgery. Some are done with medication. The type of abortion you have depends on your choice, your health, and how long you have been pregnant. After the abortion, follow-up care often is provided where the abortion is performed. Most clinics also provide counseling. Early surgical and medical abortions can be done safely in a doctor's office or clinic. In some cases, you can take the medications on your own at home. Later abortions usually are done in a hospital or clinic. This is because the procedure is more complicated, takes longer, and carries more risk.

Risks and Complications

Risks and complications of abortions relate to how long a woman has been pregnant. The earlier a woman has an abortion, the safer it is. Although an abortion is a low risk procedure, some abortions are a form of surgery. As with any surgery, problems, even death, may occur.

However, in most cases, the risks from an abortion, especially early in pregnancy, are less than the risks of giving birth to a baby. Most women who have an abortion can get pregnant in the future. Having an abortion does not increase a woman's risk of cancer.

Follow-up Care

You should have a follow-up visit with your doctor about 2 weeks after the abortion to make sure that you are healing properly. You also should discuss birth control options at this visit.

You may have feelings of guilt, regret, loss, or anger. You may feel relieved. All of these feelings are normal. This decision is easier for some women than others. A doctor's office or clinic can direct you to counseling to help you feel more comfortable with this decision.

Changing Your Mind

If you were going to have and raise the child and then decide against it, you still can think about adoption. You can begin adoption procedures after the baby is born. This is true even if you did not make this choice before the baby was born.

If you decide to have the baby adopted and then change your mind after signing the consent papers, check your state's laws and talk to your lawyer or the adoption agency. In some states, the consent or permission cannot be changed. In other states, the birth mother can change her mind up to 30 days or, in some cases, even longer after she signs the consent forms.

If you decided to have the baby and later want to have an abortion, you need to discuss it with your doctor. After a certain point, it may be too late to have an abortion. The longer a woman waits to have an abortion, the more risk it carries for her.

You can change your mind about having a surgical abortion up until the time the procedure is done. With medical abortion, you should be willing to continue the abortion once the medication has been taken. The baby may be at risk for problems if a woman decides to have the baby after beginning to take the medication.

Finally...

The decision to give birth and raise the child, give birth and have the child adopted, or have an abortion may be very hard for you to make. The sooner you seek advice and get help, the better. Make sure that you have all the facts and all your questions are answered before you decide.

Glossary

Birth Control: Methods to prevent pregnancy.

Prenatal Care: A program of health care for a pregnant woman before the birth of her baby.
Uterus: A muscular organ in the female pelvis that contains and nourishes the developing fetus during pregnancy. Also called a "womb."

This Patient Education Pamphlet was developed by the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women's health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as "superior." To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice may be appropriate.

Copyright © September 2007 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

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