Contraception and Abortion

When working with young people, having a basic understanding of contraception and abortion is important, but always remember that signposting a young person (and supporting them to get there) is even more important.

We have chosen to break apart the two topics just to give you some background knowledge just in case a young person needs some supporting information or reassurance that they are making the right decision.

Contraception

Contraception (sometimes known as birth control) has been around for quite awhile in its current form. But we know from historical texts that reproductive health was something that was thought about thousands of years ago.

Modern contraception comes in several forms such as condoms, pills, an implant in the arm, a small device inserted in the uterus, an injection, and even a small ring that can be inserted into the vagina. Each method works in a range of different ways, but there are some shared features across many of them, such as containing hormones. Some of the ways in which contraception works include:

• acting as a physical barrier to stop sperm from entering the vagina (internal and external condoms).
• changing the way sperm moves so it can’t get to the egg to fertilise it (copper IUD).
• thickening cervical mucus to block and trap sperm so they can’t get to an egg to fertilise it (Depo-Provera injection, hormonal IUD, Progestogen only pill, the implant).
• stopping or delaying an egg being released from the ovary, a process called ovulation (Combined pill, the implant, hormonal ring).
• changing the uteral lining, making it difficult for an egg to implant (hormonal IUD, Progestogen only pill).

Because of these differences, there is no one-size-fits-all when it comes to contraception.

The best thing you can do as a youth worker is to support the young person in having these conversations with their GP or a sexual health specialist.  But if a young person is concerned about recent unprotected sex and talking to a specialist isn't an option, you can support the young person to access emergency contraception from a pharmacy without a presciption.

Abortion (sometimes called termination)

We know that the topic of abortion can be difficult for some to discuss, and it may illicit strong views. We encourage you to speak with a professional if you have any specific questions.

Safe and legal abortion services are an essential part of reproductive and sexual health and rights. Abortion services should be viewed alongside comprehensive relationship and sexuality education, easily available contraception, and high quality maternal and perinatal care as essential parts of healthcare to ensure choice in decision-making about whether or when to have children.

No matter how many weeks pregnant someone is, they can contact a health practitioner such as a general practitioner (GP), midwife, Sexual Health Victoria, or 1800 My Options to find abortion services in their area that will meet their needs. Most services provide non-judgmental and unbiased counselling to support their options and choice.

There are two different types of abortion services available in Australia:

• Medical abortion or Early Medical Abortion (EMA)– this involves taking pills to terminate the pregnancy.
• Surgical abortion – this involves a minor operation.

A medical abortion brings on a miscarriage similar to a natural miscarriage and consists of taking two medications. Once the medication has been taken, patients generally go home to miscarry the pregnancy. This option can be offered up to nine weeks of pregnancy.

There may be some symptoms experienced such as heavy bleeding and cramps at the time the miscarriage happens, which is usually around 4-6 hours after the second medication is taken.

Having a support person during this time can be beneficial and having a phone available if you need to call for advice or information in important.

EMA may require more clinic visits than a surgical abortion and may also require blood tests.

Surgical abortion is usually done up to 12 weeks and six days into the pregnancy.

This method of abortion requires a procedure which is completed in a clinic or hospital setting. The abortion itself takes 3-5 minutes, but the person will spend 1-3 hours at the clinic. Bleeding after the procedure generally stops within two weeks and may often be lighter than with EMA.

Pain medication may be given to assist the process. Some people report not feeling any side effects while others find the procedure causes cramps and discomfort.

While we provided this information to give you a brief overview of abortions, it is important to remember that when working with young people, it is a good idea to encourage them to talk to a parent or another trusted adult. This may be you!

The reason for this is that if a young person does decide to have an abortion, it is good to have adult support. They would also be offered counselling which they can decide whether it would be helpful for them. It is important to highlight that this counselling is available to everyone seeking an abortion.