I hope this helps,

Dr. Joan

Question:
Dear Doctor Joan,
I need an abortion and my school nurse is saying the best place to go to is the Planned Parenthood.  I go to college in NYC.  I thought they had a great reputations, but one of my friends didn’t have a good experience there.  She said it was very crowded and she said the staff were rude.  Do you recommend Planned Parenthood?  Are all abortion clinics crowded?  I’ve never had an abortion before, and I don’t know what to expect.

Dear Laura,

Planned Parenthood is generally a highly reputable clinic, but the offices vary, so they can differ in their size and style of care.  Overall, I recommend Planned Parenthood. I am familiar with the Planned Parenthood in NYC.  They have excellent doctors.  However, like any high volume abortion clinic on some days they can be crowded and staff can be impatient. You can look at some of the reviews of the NYC Planned Parenthood .   As you can see, some of the reviews are similar to what your friend described.

Of course I am going to recommend that you come to Early Options in New York City!  At Early Options, we have scheduled private appointments, we have a small waiting area and you are taken directly to a private room, you meet your doctor to discuss your options, you have a dedicated clinical assistant who makes sure you have a positive medical experience, all care is conducted in a private examination room, and companions are welcome.  We offer the nonsurgical, noninvasive Aspiration Procedure as the best way to complete an early abortion. With this procedure there is no scraping, no electric suction, no general sedation, no operating room.  This is the most safe way to complete an early abortion.  

In making your decision about where to go, you can ask questions about privacy when you call to make your appointment.  
1) How many women are scheduled to come in at the same time?
2) What is the size of the waiting room?
3) How long will I be in the office?
4) Can I bring a companion to be with me during the visit?
5) Will I meet my doctor before I decide about which early abortion method to choose?
6) Can I schedule a Manual Aspiration procedure?
7) Does the doctor scrape the uterus?

Take a few minutes to read the reviews of Early Options:

Good luck with your decision.  

I hope this is helpful,
Doctor Joan
New York City

Question:
Dear Doctor Joan,
Where do I find a private doctor that offers confidential abortion services?  I do not want to go to an abortion clinic.  I don’t want to be in a crowded waiting room with other women who are getting abortions.  Are all abortion services provided at abortion clinics? Why is it so hard to find private abortion services?  I am early in my pregnancy, so if you can answer soon, that would be great.
Thank you!
Lisa

Answer:
Dear Lisa,
Click here for the best resource for finding a doctor who provides private early abortion services.  This website lists private family doctors who offer nonsurgical early abortion services: the Aspiration Procedure and the Abortion Pill.  These are the safest, most natural abortion methods, and are completely safe for future wanted pregnancies.

There are other resources for finding doctors who offer private abortion services.  These resources include: gynpages.com, prochoice.org, and fwhc.org.  However, some of the clinics listed on these sites may say they are private, but they do not really provide private abortion services.  If you are concerned about high volume clinics, ask these questions regarding private abortion services when you make your appointment:

Will I have a scheduled appointment or do you have many women arrive at the same time?
Will my care be in a private examination room?
Can I bring a companion to be with me the entire time?
How many hours should I expect to be in the office?
Will I meet my doctor to discuss my options?

Another option is to find a doctor who provides the Abortion Pill.  Appointments for the Abortion Pill tend to be more private compared to surgical abortion services.
I hope this is helpful,
Doctor Joan
New York City

Question:
Dear Doctor Joan,
I am pregnant and need to get an abortion.  I am early in my pregnancy.  I missed my period 2 weeks ago, and I’m pretty sure of the date I got pregnant – about 6 weeks ago.  I heard about the abortion pill.  Do you think the abortion pill is the best early abortion method?  Is the abortion pill the same as RU486? I had a friend who took it, and she bled for a long time, but it went fine and she was ok.  I don’t want to have a surgical abortion.  I am afraid of getting surgery.
What do you think?
Erica

Answer:
Dear Erica,
There are two nonsurgical early abortion methods that are safe and noninvasive: the Abortion Pill, and the Aspiration Abortion Procedure.  I recommend both of these methods over a surgical abortion.  The Aspiration Abortion procedure is different from a surgical abortion because 1) there is no scraping; 2) there is no electric suction; 3) there is minimal discomfort so there is no need to be put to sleep; 4) there is immediate recovery; 5) it can me done in a private examination room, not an operaing room; 6) it is nonsurgical so you can eat and drink before your visit; and 7) you can resume your normal activities when you leave the office.  You can click here to compare your early abortion options.

I also recommend the Abortion Pill as another nonsurgical early abortion method.  The abortion pill is actually two pills: you take one pill in the office, and the second one at home 24-72 hours later.  Most women who choose the abortion pill like it because it feels more natural.

At our office, over 90% of women choose the Aspiration Procedure over the Abortion Pill because there is much less bleeding, it can be completed in one visit, and there is minimal discomfort.  Most women who take the Abortion pill can have bleeding for weeks to months, and usually experience hours of discomfort when they go through the miscarriage.

At our office, we do not offer surgical abortion as an early abortion method.  It is much too invasive, like getting stitches when you only need a bandaid.  Medically, early abortion is simple to complete.  The Aspiration Procedure has no major complications and does not interfere with future pregnancies.

I hope this is helpful,

Doctor Joan
Early Abortion Specialist

Question:
Dear Doctor Joan,
I live in New York City.  I missed my period one week ago, and my pregnancy test is positive.  I need to have an abortion, and want to know the best abortion clinic in New York City.  I have had an abortion before.  I went to an abortion clinic and I do not want to go to a clinic like this again.  They had protesters outside, and when I went in to the clinic, there must have been 50 people in the waiting room.  I had a surgical abortion, but it was like an assembly line.  It took 7 hours to actually have the abortion done!  Here are my questions:
What is the best abortion clinic in New York City?
What is the best and safest abortion method when you are early in your pregnancy?
What is the Aspiration Abortion procedure?
Do you recommend the Abortion Pill?
Thank you so much for your time and answers!
Kelly

Answer:
Dear Kelly,
Your questions are excellent and you came to the right place!  I am a doctor who specializes in private early abortion services in New York City.  Unfortunately, most abortions in New York City are performed in high volume abortion clinics, like the one you describe. Many women do not know their early abortion options, and are only familiar with surgical abortions, or D&C’s. They do not know that they can get an early abortion at a private office, instead of an abortion clinic.  Make sure to look at the reviews from our patients.

The best early abortion methods are the Aspiration Abortion Procedure, and the Abortion Pill.  Both of these abortion methods are nonsurgical, and noninvasive.  Most women at Early Options choose the Aspiration abortion method because it only takes a few minutes to complete, there is minimal discomfort, you recover immediately, and there is very little bleeding.  The Aspiration Procedure is different from a surgical abortion because there is no scraping, no electric suction, and no need to be put to sleep. The Abortion Pill is also a good early abortion method, however most women don’t choose it because of lengthy bleeding, its lower success rate, and because it requires two office visits, instead of one.  However, most women who choose the Abortion Pill method are very happy with it.  The advantage of the Abortion Pill is that it can be completed at home, and the experience can be like having a natural miscarriage.

Early Options is not an abortion clinic.  We are a private doctor’s office with two offices located in New York City.  One office is in Manhattan, near Grand Central Station.  The other office is in Brooklyn Heights, just one stop over the bridge from Manhattan.  At Early Options you will not have the experience that you had at a high volume abortion clinic.  At our office you have a private appointment.  You meet your doctor as soon as you come in, and she will discuss your early abortion options.  Your can bring your partner, friend of family member to be with you the entire office visit.  There is no assembly line, like at an abortion clinic.  At our office you will be taken to a private examination room, and all of your care will be conducted in that room.  You will have one dedicated clinical assistant with you the entire time.
I hope this is helpful,
Doctor Joan, Early Abortion specialist

Question:
I see you are a specalist in early abortions in New York City.  I
missed my period about 3 weeks ago, so am I too early?  What methods work best
for early abortions?  Do you know an early abortion specalist in New
Jersey?
Thank you for helping me,

Natalie

Answer:
Dear Natalie,
Thank you for your question about early abortions in New York City and New Jersey.  Many women are not aware that they have more options in terminating a pregnancy if they are less than 10 weeks pregnant.

My preferred method for early abortion is the Aspiration Procedure.  This nonsurgical, noninvasive procedure only takes a few minutes to complete.  It is a natural procedure and does not involve electric suction, scraping of the uterus, or general sedation.  Most women describe the procedure as similar to getting a pap smear.  You recover immediately, and can resume your normal activities when you leave the office.  The Aspiration procedure is completed in a regular doctor’s office (not an operating room).  You are able to bring a companion to be with you during the procedure if that makes you more comfortable.

The other method for early abortion is the abortion pill.  If you missed your period three weeks ago, you are still eligible to take the abortion pill.  I am an expert on the abortion pill, and recommend it.  However, I must add that many women find the Abortion Pill process to be more difficult than they expect.  There can be lengthy bleeding, and severe cramping.  It also requires 2 visits to the doctor, and has a higher failure rate compared to the Aspiration Procedure.

It would be worth your time and effort to come to New York City to our Early Options offices.  We have many patients travel from New Jersey, as well as other parts of the country, and even other countries.  Our medical services for early abortion is unique.  You will have a very positive medical experience in our office. Take the time to look at the patient reviews of our Brooklyn and Manhattan offices.

There are no abortion centers besides Early Options in New Jersey or New York City that offer the Aspiration procedure.  Some abortion clinics claim they provide the Aspiration procedure, but they provide it in the same way as a surgical abortion – in an operating room, recovery room, and sometimes even with scraping.  This is not the proper way to provide the Aspiration Abortion method.

I would not personally recommend any of the abortion clinics in New Jersey.  This is only based on reports from my patients who have told me about their experiences.  Unfortunately the abortion clinics in New Jersey and New York City tend to be high volume, with crowded waiting rooms, and an “assembly line” impersonal approach to medical care.  If you decide to go to an abortion clinic in New Jersey and have a positive medical experience, let me know.
I hope this is helpful,
Doctor Joan

Early Abortion Specialist
New York City

Imagine if abortion were offered as part of your regular family medical care.  If you needed an abortion, it would be available at your regular family doctor’s office, in a regular examination room.  The doctor would offer you early nonsurgical methods, the Abortion Pill, or the Aspiration Procedure.  The Aspiration Procedure would be completed on a regular examination room, like a pap smear, in less than 5 minutes. 

Is this too easy?  Some people think that if abortion were normalized, and less punitive, more women would choose to get abortions.  As a doctor who has completed abortions for over a decade, I don’t think so.  Unlike the perceptions created by people with extreme views, women do not take their decision to end a pregnancy lightly.  In fact, the same rate of abortion exists for countries that have legal and illegal abortion.  If a woman needs an abortion, she will find a way to get one.   But even in the United States, where abortion is a legal medical procedure, women often still feel like they completed a criminal act. 

It’s important for women to talk with each other about their abortions, and normalize the experience.  Otherwise, we are overdetermined by people who want to advocate a particular agenda and by a divisive political system.  It is important to learn from ordinary women who have had to make the decision to have an abortion as one of the many difficult decisions we have to make in our complex but ordinary lives.  Talking about abortion will help women get the kind of  high quality medical care that they need in the situation of an unwanted pregnancy.

Family doctors believe:

• A patient must be an active participant in their medical care. 
• The relationship between a doctor and their patient is a critical component of good medical care
• Emotional health is not separable from physical health
• A patient’s family and community are important participants in their health care
• Noninvasive approaches are always the preferred option

I saw my first abortion during my third year of residency training in Family Practice in NYC.  I had the opportunity to get trained in abortion procedures at Planned Parenthood.  There were many excellent and caring staff and doctors, but I felt that the model of abortion services was not consistent with family practice principles of medical care. I observed what I would call a ”family planning” approach to abortion care, and I thought there should be a better way.  I realized that the field of family practice had an important contribution to make in the area of abortion services. 

What is a “family planning” approach to abortion services?  Medical care is focused on the procedure, not the patient.  Everything is organized toward an efficient model of care.  Patients are seen by multiple staff members for vital signs and lab testing, ultrasound, counseling and consent.  The patient never gets to talk with the doctor about their options.  They meet the doctor in the operating room, right before their abortion procedure.  Companions or family members are not able to participate in any of the medical care.  A patient must see a counselor to talk about their decision, whether or not she wants to be counseled. 

This “family planning” model of abortion care was inconsistent with my training in family practice.  I felt that the principles of family practice were especially relevant to abortion care.  It was important for a woman to meet her doctor and have the opportunity to talk about her decision, her abortion options, and expectations.  It was important to have a dedicated staff member, rather than multiple people involved in the abortion care.  It was important to be able to include a friend or family member in the medical visit.  It was important to use the most noninvasive methods available.  It was important that the emotional aspects of having an abortion were part of the medical care and not dealt with separately.  It  was most important that women have a positive medical experience while going through a difficult situation of an unwanted pregnancy. 

In the next years, I developed the Early Options model of abortion care. Early Options is a pioneering family practice or primary care based approach to early abortion. 

The Early Options model is consistent with principles of family medicine:

• You meet your doctor to discuss your options and to feel comfortable with your medical care;
• You have a dedicated clinical assistant to support you during your entire visit;
• You are able to include your husband, family member, or companion in any part of your medical visit;
• You are offered noninvasive,  nonsurgical early abortion methods: the Aspiration Procedure, and the Abortion Pill;
• The entire visit is organized to support a positive physical and emotional medical experience;
• Early abortion care is part of medical care, and not a “segregated” medical service.

What is it? The Aspiration Procedure is handheld device that applies gentle pressure to “bring down” the early pregnancy tissue. The doctor inserts a speculum (like a pap smear). She numbs the cervix with lidocaine. She inserts a thin cannula (like a straw) through the natural opening of the cervix. She attaches the Aspiration device which provides gentle suction. The menstrual lining and early pregnancy tissue naturally detaches from the uterine wall, and into the device. The uterus contracts in response to the procedure, so there is some natural healthy period-like cramping that resolves within a few minutes. There are no major complications because there is no scraping, no electric suction, and no general anesthesia. Within 10 minutes of starting the procedure, you feel completely better and are able to resume your normal activities.

Ideally, this procedure should be offered in a private, discreet doctor’s office. You should have a scheduled, one hour appointment. You should be able to eat and drink normally before and after your visit. You should be in a dedicated examination room. You should be able to bring a companion to be with you the entire visit. You should be able to meet with your doctor and discuss your options.

Sound too easy? Perhaps that’s the issue. This simple procedure has the potential to take all of the punishment and politics out of ending early pregnancy.

Where do you get it? The Aspiration Procedure is endorsed by the World Health Organization as the safest early abortion method, yet it is extremely difficult to find a doctor who offers it. If you can get to New York City to an Early Options™ medical office it is certainly worth your trip. At Early Options™ you are guaranteed to have a woman doctor, a scheduled appointment, a private examination room, and your companion is welcome to stay with you the entire visit. There are a few other family doctors that offer the Aspiration Procedure in the United States (http://www.earlyabortion.com).

Beware of large abortion clinics that say they offer the Aspiration Procedure. Make sure to ask:

• Does the doctor scrape the uterus? (they should not).
• Is the procedure offered in a private examination room? (it should not be in an operating room)
• Am I taken to a recovery area? (this should not be necessary)
• Do I have an individual appointment or are other women scheduled at the same time?
• Can I eat and drink before my visit? (you should be able to)
• Can my companion accompany me for the entire visit? (they should be able to)
• How long will I be in the clinic? (should be less than 2 hours).

The Aspiration Procedure has the potential to transform early abortion into mainstream medical care. Doctors could learn to provide these services as part of their residency training. Women could access early abortion services at their family doctor’s or gynecologist’s office. Women and doctors who access or provide abortion services could no longer be targeted. More women need to know and advocate for the development of this procedure.