FAQ's

Abortion in Memphis
How early can I get an abortion?
What are medical reasons someone could not have an abortion?
Is surgical abortion my only option?
What is the medication/medical abortion?
What happens during your surgical abortion appointment at Choices?
What happens during the surgical abortion procedure?
How effective is the surgical abortion? How safe is the surgical abortion?
What happens during your medication abortion appointment?
What happens during the medication abortion process?
How effective is the medication abortion?
How safe is the medication abortion?
I’m under 18. How can I get an abortion?
How much does first trimester abortion cost?
Does Choices have any assistance available to help women pay for abortions?
Will my insurance cover my abortion procedure?
Do I need to make an appointment?
What is an abortion follow-up?
I'm worried about pain during the abortion. Does it hurt?
Can Choices put me to sleep during my abortion procedure?
What happens to you immediately after an abortion?
I still haven't had a period since my abortion. When should my period start?
Is it possible to still be pregnant after abortion?
Will multiple abortions affect my ability to get pregnant in the future?
Is there support available after my abortion?

Assisted Reproductive Technologies - Coming Soon!

IUDs

Implanon®

Emergency Contraception
What is emergency contraception or emergency birth control?
How does emergency contraception work?
Are emergency contraceptive pills (ECPs) the same thing as the “morning after pill”?
How do I get emergency contraception?
Can I get emergency contraception (EC) before I need it?
Will EC protect me from sexually transmitted diseases (STDs)?
Is emergency contraception the same thing as the “abortion pill?”

Gay, Lesbian, Bisexual, and Transgender Health
Why is it important to tell my doctor I'm gay or transgender?
Are lesbians at risk for sexually transmitted diseases/infections?
I'm transgender, and I want to use hormones. Are there any risks?

PAP Smears
What is a PAP smear?
What causes cervical cancer?
How often do I need a PAP smear?

Pregnancy
Can a woman be pregnant and still have a period?
What if I have a positive pregnancy test and then start bleeding?
Can the exact date of conception be determined accurately?
If I have a negative pregnancy test after I have missed my period, does that mean I am not pregnant?

Sexually Transmitted Diseases/Infections
What are common signs or symptoms of sexually transmitted diseases/infections?
Which sexually transmitted diseases/infections are curable?
Which sexually transmitted diseases/infections are treatable?
How many people have STDs?
How do you get an STD?
How do you get tested for STDs?
Can STDs cause health problems?
How are STDs treated?

Teens
Can a teen get a surgical abortion?
Can a teen get a medication abortion?
Can a teen get birth control and STD testing?

Abortion in Memphis

How early can I get an abortion?
At Choices, you need to be at least 6 weeks since your last normal menstrual cycle to have an abortion.

What are the medical reasons someone could not have a surgical abortion?

• Uncontrolled high blood pressure
• Uncontrolled seizure disorders
• Bleeding disorders

Is surgical abortion my only option?
At Choices, we offer both the surgical abortion and the medication abortion. Click here for more information on both types of abortions at Choices.

What is the medication/medical abortion?
The medication/medical abortion uses medications to cause an abortion. Click here for more information on medication abortion at Choices.

What happens during your surgical abortion appointment at Choices?

• You will complete a medical history form, including information about your past and current health.
• You will have lab tests done, including a measure of your hematocrit and Rh typing. We will also check your vital signs to make sure you are in good health for the procedure.
• You will have an ultrasound.
• You will spend time with a patient educator discussing your pregnancy options, medical history, risks of the procedure, future plans for birth control, and any other questions you may have about your procedure.
• You will be given pre-operative medications to help alleviate the pain and discomfort of the operation.
• In some cases additional pre-operative medications are administered (Misoprostol) to prepare your cervix for the procedure.
• You will see the nurse again to receive your aftercare instructions and be discharged to go home.

What happens during the surgical abortion procedure?

• You will meet the doctor.
• The doctor will perform an examination prior to the procedure.
• A speculum will be inserted into your vagina.
• You will be given an injection of numbing medicine in and around your cervix.
• The opening of your cervix will be gradually opened with dilators.
• A hollow, plastic tube is inserted into your uterus.
• Either a hand held suction device or machine suction device will empty out your uterus.
• The doctor will remove the plastic tube and the speculum.

How effective is the surgical abortion?
The surgical abortion is very effective. It works 98 out of every 100 times. You will follow up with a health care provider to be sure it worked, and you are well.

How safe is the surgical abortion?
Surgical abortion procedures are very safe, and there are risks with any medical procedure. The risks increase the longer you are pregnant. Possible risks include:

• an allergic reaction
• blood clots in the uterus
• incomplete abortion — part of the pregnancy is left inside the uterus
  
• infection
• injury to the cervix or other organs
• undetected pregnancy outside of the uterus
• very heavy bleeding

What happens during your medication abortion appointment?

• You will complete a medical history, including information about your past and current health.
• You will have an anemia and Rh test done.
• We will check your vital signs to make sure you are in good health for the procedure.
• You will have an ultrasound.
• You will spend time with a patient educator discussing your pregnancy options, medical history, risks of the procedure, future plans for birth control, and any other questions you may have about your procedure.
• You will schedule a follow-up appointment for 10 to 14 days after your abortion.
• You will meet with the doctor and discuss how to use the abortion pill and how the medication abortion process works.
• The doctor will give you the abortion pill to take at the clinic.
• You will also be given some cramping and anti-nausea medications, as well as antibiotics.

What happens during the medication abortion process?

• You will meet with the doctor discuss how to use the abortion pill.
• The doctor will give you the abortion pill to take at the clinic.
• The doctor will give you a second medication, misoprostol, to take at home, when it is convenient for you, anytime between 24 and 48 hours from the time you took the abortion pill in the clinic.
• You will also be given some pain and anti-nausea medications.

How effective is the medication abortion?
The abortion pill is very effective. It works about 92 out of every 100 times. You'll follow up with a health care provider after your abortion, so you can be sure that it worked, and that you are well.

How safe is the medication abortion?
Most women can have a medication abortion safely. But all medical procedures have some risks, so safety is a concern.

Rare, but possible risks include:

• an allergic reaction to either of the pills
• incomplete abortion — part of the pregnancy is left inside the uterus
• infection
• undetected ectopic pregnancy
• very heavy bleeding

I’m under 18. Can I get an abortion?
Yes. However, in the state of Tennessee you are required to have the permission of one of your parents or guardian. If you are unable to get permission from your parent or guardian or you do not have a legal guardian you can petition juvenile court to grant you a judicial bypass. Choices can refer you an attorney that will work with you free of charge through this process. A minor from a surrounding state may also use this process. Please call us at 901-274-3550 for more information.

How much does first trimester abortion cost?
For pricing information, click here.

Does Choices have any assistance available to help women pay for abortions?
Yes. We have financial assistance available for women who qualify based on household size and monthly income. Please call us at 901-274-3550 for more information.

Will my insurance cover my abortion procedure?
Some insurance plans cover abortion, and many cover family planning services. Choices can help you find out if your insurance will cover your abortion and even file the necessary claims for you.

Do I need to make an appointment?
Yes. Abortions are provided by appointment only.

What is an abortion follow-up?
It is important that you receive a follow-up 2 to 3 weeks after your surgical abortion procedure, and 10 days after your medication abortion procedure. This follow-up appointment will not cost you anything extra at Choices.

I'm worried about pain during the abortion. Does it hurt?
The discomfort a woman feels during abortion comes from muscle cramps, similar but stronger than menstrual cramps. Women may experience mild to heavy cramps during the procedure. To help with pain management, we recommend taking 800 mg of Ibuprofen every 6 hours starting the day before your appointment and including at least 1 dose the day of your appointment before you come to the clinic. You should also plan to take 600-800 mg of Ibuprofen every 6 hours for 3-5 days after your procedure.

Can Choices put me to sleep during my abortion procedure?
Choices uses a local anesthetic to block sensation in the cervix. The procedure itself is very quick (2-5 minutes) and patients are not sedated (put to sleep). Our patients typically do very well with this protocol. If you would like to be sedated during your abortion procedure, Choices can refer you to other clinics who may offer this service.

What happens to you immediately after an abortion?
If you have the ability to take the next day off work, it's great to be able to "take it easy" that day. Avoid aspirin because it can increase bleeding. We recommend not lifting heavy objects for the same reason.

You may have cramping as the uterus returns to its pre-pregnant size. Other than cramps, you are not really "sore." You can certainly go out that day, but if you can "take it easy" and stay home relaxing, you will probably feel better. You don't have to stay in bed.

More information is available on the aftercare handout you will receive at the clinic. For two weeks after an abortion, avoid sex or putting anything in your vagina because it increases the risk of infection.

At our clinic, we give women a 24 hour hotline number they can call to reach the clinic if they have any questions, concerns, or problems after the abortion.

I still haven't had a period since my abortion. When should my period start?
A normal period should begin in 4 to 8 weeks after your abortion procedure. It varies depending on the individual. The body may or may not need some time to re-establish its cycles.

Is it possible to still be pregnant after abortion?
It is possible that the pregnancy could be "missed" during an early (5-7 weeks) suction aspiration procedure BUT, the doctor carefully evaluates the tissue that was removed from your uterus right after the procedure to make sure all the fetal tissue is there. If they don't find it, they will tell you and re-aspirate that same day.

Having a follow-up appointment at Choices or at your own doctor will determine whether the abortion procedure was complete.

Will multiple abortions affect my ability to get pregnant in the future?
The possibility of fertility problems is the about the same as if you had never had any abortions -- abortion does not affect fertility. Because you have gotten pregnant in the past indicates you are fertile and you can most likely get pregnant again. Statistically, women become less fertile as they get older, but statistics cannot predict fertility in any one individual.

Post-abortion complications are rare - they occur in less than 1% of abortions. Only some abortion complications lead to inability to become pregnant, due to scar tissue, if the uterus or cervix was perforated or became infected post-abortion.

Is there support available after my abortion?
Yes. Check out the resources below and on our resource page.

Assisted Reproductive Technologies

Coming Soon!

Birth Control

What is the best method of birth control or contraception?
All women and men should have control over if and when they become parents. Making decisions about birth control, or contraception, is not easy – there are many things to think about. Learning about birth control methods you or your partner can use to prevent pregnancy and talking with your doctor are good ways to get started.

There is no “best” method of birth control. Each method has its own pros and cons. Some methods work better than others do at preventing pregnancy. The birth control method you choose should take into account your overall health, how often you have sex, the number of sexual partners you have, if you want to have children, how well each method works (or is effective) in preventing pregnancy, any potential side effects, and your comfort level with using the method.

What are the different birth control methods that I can use?
There are many methods of birth control that a woman can use. Talk with your doctor or nurse to help you figure out what method is best for you. You can always try one method and if you do not like it, you can try another one.

Don’t forget that all of the methods below work best if used correctly. Be sure you know the correct way to use them. Talk with your doctor or nurse and don’t feel embarrassed about talking with her or him again if you forget or don’t understand.

Here is a list of birth control methods with estimates of effectiveness, or how well they work in preventing pregnancy when used correctly, for each method:

• Continuous Abstinence – This means not having sexual intercourse (vaginal, anal, or oral intercourse) at any time. It is the only sure way to prevent pregnancy and protect against HIV and other STDs. This method is 100% effective at preventing pregnancy and STDs.
• Periodic Abstinence or Fertility Awareness Methods – Periodic abstinence means you do not have sex on the days that you may be fertile. Fertility awareness means that you can be abstinent or have sex but you use a “barrier” method of birth control to keep sperm from getting to the egg.
• The Male Condom – Condoms are called barrier methods of birth control because they put up a block, or barrier, which keeps the sperm from reaching the egg. Only latex or polyurethane (because some people are allergic to latex) condoms are proven to help protect against STDs, including HIV. "Natural” or “lambskin” condoms made from animal products also are available, but lambskin condoms are not recommended for STD prevention because they have tiny pores that may allow for the passage of viruses like HIV, hepatitis B and herpes
• Oral Contraceptives– Also called “the pill,” contains hormone and is available in different dosages. It does not protect against STDs or HIV.
• Copper IUD (Intrauterine Device)– An IUD is a small device that is shaped in the form of a “T.” Your health care provider places it inside the uterus. The Copper IUD can stay in your uterus for up to 12 years. It does not protect against STDs or HIV.
• Intrauterine System or IUS (Mirena)– The IUS is a small T-shaped device like the IUD and is placed inside the uterus by a doctor. Each day, it releases a small amount of a hormone similar to progesterone called levonorgestrel that causes the cervical mucus to thicken so sperm cannot reach the egg. The IUS stays in your uterus for up to five years. It does not protect against STDs or HIV.
• The Female Condom– Worn by the woman, this barrier method keeps sperm from getting into her body. It is made of polyurethane, is packaged with a lubricant, and may protect against STDs, including HIV. It can be inserted up to 8 hours prior to sexual intercourse. Female condoms are 79 to 95% effective at preventing pregnancy.
• Depo-Provera– With this method women get injections, or shots, of the hormone progestin in the buttocks or arm every 3 months. It does not protect against STDs or HIV. It is 97% effective at preventing pregnancy.
• Diaphragm, Cervical Cap or Shield– These are barrier methods of birth control, where the sperm are blocked from entering the cervix and reaching the egg. The diaphragm is shaped like a shallow latex cup. The cervical cap is a thimble-shaped latex cup. The cervical shield is a silicone cup that has a one-way valve that creates suction and helps it fit against the cervix. The diaphragm is 84 to 94% effective at preventing pregnancy. The cervical cap is 84 to 91% effective at preventing pregnancy for women who have not had a child and 68 to 74% for women who have had a child. The cervical shield is 85% effective at preventing pregnancy. Barrier methods must be left in place for 6 to 8 hours after intercourse to prevent pregnancy and removed by 24 hours for the diaphragm and 48 for cap and shield.
• Contraceptive Sponge - This is a barrier method of birth control that was re-approved by the Food and Drug Administration in 2005. It is a soft, disk shaped device, with a loop for removal. It is made out of polyurethane foam and contains the spermicide nonoxynol-9. Before intercourse, you wet the sponge and place it, loop side down, up inside your vagina to cover the cervix. The sponge is 84 to 91% effective at preventing pregnancy in women who have not had a child and 68 to 80% for women who have had a child.
• The Patch (Ortho Evra) – This is a skin patch worn on the lower abdomen, buttocks, or upper body. It releases the hormones progestin and estrogen into the bloodstream. You put on a new patch once a week for three weeks, and then do not wear a patch during the fourth week in order to have a menstrual period. The patch is 98 to 99% effective at preventing pregnancy, but appears to be less effective in women who weigh more than 198 pounds. It does not protect against STDs or HIV.
• The Hormonal Vaginal Contraceptive Ring (NuvaRing) – The NuvaRing is a ring that releases the hormones progestin and estrogen. You squeeze the ring between your thumb and index finger and insert it into your vagina. You wear the ring for three weeks, take it out for the week that you have your period, and then put in a new ring. The ring is 98 to 99% effective at preventing pregnancy.
• Surgical Sterilization (Tubal Ligation or Vasectomy) – These surgical methods are meant for people who want a permanent method of birth control. Tubal ligation or “tying tubes” is done on the woman to stop eggs from going down to her uterus where they can be fertilized. The man has a vasectomy to keep sperm from going to his penis, so his ejaculate never has any sperm in it. They are 99.9% effective at preventing pregnancy.
• Emergency Contraception – This is NOT a regular method of birth control and should not be used as one. Emergency contraception, or emergency birth control, is used to keep a woman from getting pregnant when she has had unprotected vaginal intercourse. “Unprotected” can mean that no method of birth control was used. It can also mean that a birth control method was used but did not work – like a condom breaking. Or, a woman may have forgotten to take her birth control pills, or may have been abused or forced to have sex when she did not want to. Emergency contraception does not protects against STDs or HIV.

How effective is withdrawal as a birth control method?
Withdrawal is not the most effective birth control method. Withdrawal is when a man takes his penis out of a woman’s vagina (or “pulls out”) before he ejaculates, or has an orgasm. This stops the sperm from going to the egg. “Pulling out” can be hard for a man to do and it takes a lot of self-control. Withdrawal does not protect you from STDs or HIV.

Everyone I know is on the pill. Is it safe?
Today’s pills have lower doses of hormones than earlier birth control pills. This has greatly lowered the risk of side effects; however, there are both benefits and risks with taking birth control pills. Benefits include having more regular and lighter periods, fewer menstrual cramps; and a lower risk for ovarian and endometrial cancer, and pelvic inflammatory disease (PID). Serious side effects include an increased chance, for some women, of developing heart disease, high blood pressure, and blood clots. Minor side effects include nausea, headaches, sore breasts, weight gain, irregular bleeding and depression. Many of these side effects go away after taking the pill for a few months. Women who smoke, are over age 35, or have a history of blood clots or breast or endometrial cancer are more at risk for dangerous side effects and may not be able to take the pill. Talk with your doctor or nurse about whether the pill is right for you.

Will birth control pills protect me from HIV, the virus that causes AIDS, and other STDs?
No. Birth control pills or other types of birth control, such as intrauterine devices (IUDs), Depo-Provera, or tubal ligation will NOT protect you from HIV and other STDs.

The male and female condoms are the only birth control methods that are proven to help protect you from HIV and other STDs. If you are allergic to latex, there are condoms made of polyurethane that you can use. Condoms come lubricated (which can make sexual intercourse more comfortable and pleasurable) and non-lubricated (which can be used for oral sex).

IUDs (Intrauterine Devices)

What is an IUD?
The letters IUD stand for "intrauterine device." IUDs are small, "T-shaped" devices made of flexible plastic. A health care provider inserts an IUD into a woman's uterus to prevent pregnancy.

There are two brands of IUD available in the United States — ParaGard and Mirena, and both are available at Choices. The ParaGard® IUD contains copper. It is effective for 12 years. The Mirena IUD releases a small amount of progestin, a hormone. It is effective for five years.

How does an IUD work?
Both the ParaGard® and the Mirena® IUDs affect the way sperm move, preventing them from joining with an egg. If sperm cannot join with an egg, pregnancy cannot happen. Both types also alter the lining of the uterus. Some people say that this keeps a fertilized egg from attaching to the lining of the uterus. But there is no proof that this actually happens. The progestin in the Mirena® IUD helps prevent pregnancy. Progestin works by keeping a woman's ovaries from releasing eggs — ovulation. Pregnancy cannot happen if there is no egg to join with sperm. Progestin also prevents pregnancy by thickening a woman's cervical mucus. The mucus blocks sperm and keeps it from joining with an egg.

How effective is the IUD?
Effectiveness is an important and common concern when choosing a birth control method. IUDs are one of the most effective forms of birth control available. Less than 1 out of 100 women will get pregnant each year if they use the ParaGard® or the Mirena® IUD. Keep in mind that the IUD doesn't protect against sexually transmitted infections. Use a latex or female condom along with the IUD to reduce the risk of infection.

How safe is the IUD?
Most women can use either the ParaGard® or the Mirena® IUD safely. But all medications have some risks, so safety is a common concern when choosing a birth control method. Certain conditions increase the risk of side effects. Talk with your health care provider about your health and whether an IUD is likely to be safe for you. There are many other methods of birth control that may be safe for you if you cannot use an IUD. A health care provider may find that the unique size, shape, or condition of a woman’s uterus does not allow correct placement of an IUD. This is not common.

What are the benefits of an IUD?
The ParaGard® and the Mirena® IUDs are two of the least expensive, longest lasting forms of birth control available to women today. There are many other benefits.

• IUDs may improve your sex life. There is nothing to put in place before intercourse to prevent pregnancy. Some women say that they feel free to be more spontaneous because they do not have to worry about becoming pregnant.
• The ParaGard® IUD does not change a woman's hormone levels.
• The Mirena® IUD may reduce period cramps and make your period lighter. On average, menstrual flow is reduced by 90 percent. For some women, periods stop altogether.
• IUDs can be used during breastfeeding.
• The ability to become pregnant returns quickly once the IUD is removed.

Some women may worry that they are pregnant if they do not have a regular period. But the IUD is very effective. If you are concerned about a possible pregnancy, you can always take a pregnancy test. Overall, most women who get an IUD are satisfied with their choice. Ninety-nine percent of IUD users are pleased with them.

What are the disadvantages of an IUD?
It's important to think about the possible side effects of using an IUD. You may have

• mild to moderate pain when the IUD is put in
• cramping or backache for a few days
• spotting between periods in the first 3–6 months
• irregular periods in the first 3–6 months — with Mirena®
• heavier periods and worse menstrual cramps — with ParaGard®

Simple pain relievers can usually reduce bleeding, cramping, and other discomforts. If they are severe and do not seem to lessen, tell your health care provider.

How soon after getting an IUD can I have sex?
You can have sex as soon as you like after the IUD is inserted.

• The ParaGard® IUD is effective immediately.
• The Mirena® IUD is effective immediately if inserted within seven days after the start of your period. If you have Mirena® inserted at any other time during your menstrual cycle, use another method of birth control like a condom, female condom, or spermicide if you have vaginal intercourse during the first week after insertion. Protection will begin after seven days.

How is an IUD removed?
Having an IUD removed or replaced is usually simple. Your health care provider will do it for you. Women should never try to remove IUDs themselves or ask nonprofessionals to do it for them. Serious damage could result. In rare cases, IUDs cannot be easily pulled free. In these cases, the cervix may have to be dilated and a surgical tool may be used to free the IUD. In very rare cases, surgery becomes necessary.

How much does an IUD cost?
The IUD is the most inexpensive long-term and reversible form of birth control you can get. Unlike other forms of birth control, the IUD only costs money in the beginning.  You can find specific information about the cost of IUDs at Choices here.

Is there any financial assistance to help pay for IUDs?
Yes. Choices's medical practitioner will be glad to discuss assistance programs with you and help you complete and file the necessary paperwork.

The ParaGard Patient Assistance Program will assist qualified patients with the payment for the copper IUD. The patient can have no public or private prescription insurance and have an income at or below 200% of the Federal Poverty Level. The patient must also be a US resident. The patient must also be 18 years of age or older. Those with Medicare or Medicaid are not eligible.

Arch Foundation Patient Assistance Program for Mirena will assist qualified patients with the payment for the Mirena IUS. The patient must have no prescription coverage for the requested medication and meet income guidelines. The patient must also be a US resident. 

Implanon®

What is IMPLANON®?
IMPLANON® is a type of birth control for women. It is a small flexible plastic rod the length of a matchstick that is placed under the skin of your arm. IMPLANON® contains a hormone called etonogestrel. The IMPLANON® rod can prevent pregnancy for up to three years.

What are side effects with IMPLANON®?
The most common side effect of IMPLANON® is a change in your menstrual periods. In studies, about 1 in 10 women stopped using IMPLANON® because of bleeding problems. Expect your bleeding to be irregular and unpredictable throughout the time you are using IMPLANON®. You may have more bleeding, less bleeding, or no bleeding. The time between bleeding may vary, and you may have spotting throughout the month. Other common side effects reported in women using IMPLANON® during clinical trials include: headache; vaginitis; weight gain; acne; breast pain; viral infections such as colds, sore throats, sinus infections, or flu-like symptoms; stomach pain; cramping during bleeding; mood swings; nervousness or depression; back pain; nausea; dizziness; pain; and pain at the site of insertion.

How does IMPLANON® work?
IMPLANON® prevents pregnancy in several ways. The most important way is by stopping release of an egg from your ovary. IMPLANON® also changes the mucus in your cervix and this change may keep sperm from reaching the egg. Also, IMPLANON® changes the lining of your uterus.

How effective is IMPLANON®?
If IMPLANON® is inserted correctly, your chance of getting pregnant is very low (less than one pregnancy per 100 women who use IMPLANON® for one year). IMPLANON® must be removed by the end of the third year and may be replaced with a new IMPLANON®. It is not known if IMPLANON® is as effective in very overweight women because clinical studies did not include many overweight women. Certain medicines may make IMPLANON® less effective, and you may also need to use a barrier method of contraception while you are using these medicines.

What if I change my mind about birth control?
Your healthcare provider can remove IMPLANON® at any time. If you want to become pregnant after IMPLANON® removal, your ability to get pregnant may return quickly. If you don’t want to get pregnant, you should start another birth control method right away.

What if I want to become pregnant?
Once IMPLANON® is successfully removed, your ability to get pregnant usually returns quickly. Some women have become pregnant within days after removal of IMPLANON®.

What if I become pregnant while using IMPLANON®?
You should see your healthcare provider right away. It is important to remove IMPLANON® and make sure that the pregnancy is not ectopic (occurring outside the womb). Based on experience with birth control pills, IMPLANON® is not likely to cause birth defects.

How is IMPLANON® inserted?
IMPLANON® insertion is a minor procedure that can be performed in at Choices. IMPLANON® is inserted just under the skin on the inner side of your upper arm. The entire procedure is done using a local anesthetic and generally takes a few minutes.

How much does IMPLANON® cost?
You can find specific information about the cost of IMPLANON® at Choices here

Emergency Contraception

What is emergency contraception (or emergency birth control)?
Emergency contraception, or emergency birth control, is used to help keep a woman from getting pregnant after she has had unprotected sex (sex without using birth control).

You can use emergency contraception if you didn’t use birth control, you were forced to have sex, the condom broke or came off, he didn’t pull out in time, you missed two or more birth control pills in a row, or you were late getting your shot.

Emergency contraception should not be used as regular birth control. Other birth control methods are much better at keeping women from becoming pregnant.

How does emergency contraception work?
Emergency contraception can keep you from becoming pregnant by keeping the egg from leaving the ovary, or keeping the sperm from meeting the egg, or keeping the fertilized egg from attaching to the uterus (womb). If you are already pregnant, emergency contraception will NOT work.

Are emergency contraceptive pills (ECPs) the same thing as the “morning after pill”?
Yes. Emergency contraceptive is also known as the “morning after pill”, Plan B, or next day contraception.

How do I get emergency contraception?
Anyone, 17 years old or older, can stop by Choices, Monday - Thursday from 9:00am to 2:00pm, and purchase EC with a valid state issued photo ID. If you are younger than 17, you will need to make an appointment to get a prescription.

Can I get emergency contraception before I need them?
Yes. Visit Choices to purchase EC, so you’ll have it when you do need. EC is most effective the sooner it is taken after unprotected sex.

Will ECPs protect me from sexually transmitted diseases (STDs)?
No. Only a latex or polyurethane condom will protect you from most STDs .

Is emergency contraception the same thing as the “abortion pill?”
No. Emergency contraception can keep a woman from becoming pregnant. The abortion pill (Mifeprex, also called RU-486) works after a woman becomes pregnant (after a fertilized egg has attached to the uterus). The abortion pill makes the uterus force out the egg, ending the pregnancy.

Gay, Lesbian, Bisexual, and Transgender Health

Why is it important to tell my doctor I'm gay, lesbian, or transgender?
When your doctor knows about your sexual orientation and gender identity he or she can give you even better health care. However, it is understandable that you may be afraid to come out to your doctor, especially if you've had bad experiences coming out as gay and/or transgender to other folks in the past.

Why would you get better care?

Because your doctor can then ask you more specific questions about your sexual practices and know what kinds of tests he or she should run. In other words, if a woman is regularly having sex with women, then the doctor can talk to her about safer sex methods between women. If a guy is regularly having anal sex with men, then the doctor can offer him an anal pap smear. If you are trans, then your doctor can understand why you may be taking hormones and be sure to not prescribe something that will react badly with testosterone or estrogen.

Are lesbians at risk for sexually transmitted diseases/infections?
Lesbian women are at risk for many of the same STDs as heterosexual women. Lesbian women can transmit STDs to each other through skin-to-skin contact, mucosa contact, vaginal fluids, and menstrual blood. Sharing sex toys is another method of transmitting STDs.

I'm transgender, and I want to use hormones. Are there any risks?
Yes, there are some risks. If you work with a physician, then you can minimize the risks. Do not believe everything you read on Web sites about hormones. The most accurate information can be gathered by talking to a trans-friendly health professional.

PAP Smears/Well Woman Care

What is a PAP smear?
A PAP smear is a test used to screen women for signs of cervical cancer.

What causes cervical cancer?
Exposure to Human Papillomavirus (HPV) usually during intercourse can lead to the development of cervical cancer. See the Centers for Disease Control for more information.

How often do I need a PAP smear?
Over 21 years old?

• Most women who have ever been sexually active need a PAP smear every year starting by age 21.
• Some women with an abnormal PAP smear result will need to repeat a PAP smear every 6 months.

• If you have been sexually active for 3 years or more, you should have a PAP smear.
• All sexually active women should have a PAP smear by the time they are 21 regardless of how many years you have been sexually active.

Can I get my PAP smear every 3 years?
If you are over 30 years old, the American Society for Colposcopy and Cervical Pathology has recommended that you may get a PAP smear every 3 years based on certain health criteria. Come in and talk to our nurse practitioner about whether you meet these guidelines.

Pregnancy

Can a woman be pregnant and still have a period?
Pregnant women can have some light irregular bleeding during pregnancy, but it should not be like a “normal” period. Some women can confuse this for their period because often it can come right around the time she was expecting her normal period. The irregular bleeding or spotting that can occur during pregnancy is often a dark brown color or a light pinkish.

What if I have a positive pregnancy test and then start bleeding?
About 25-30% of pregnant women experience some type of spotting or bleeding in early pregnancy. This can be a result of many different factors. Many women who have this light bleeding go on to have normal pregnancies and healthy babies. About half of the women who experience some light bleeding will go on to have heavier bleeding that will ultimately result in miscarriage. Unfortunately there is no way to predict whether or not vaginal bleeding will progress to miscarriage. If you experience light bleeding that continues to get heavier, accompanied by painful cramping, back pain or stabbing pains, then you would want to seek medical attention right away.

Can the exact date of conception be determined accurately?
Many women have questions about the date of possible conception, and unfortunately figuring this out is not always so easy. The assumption is that if a woman has pretty regular menstrual cycles, then she will be ovulating during a certain time of the month. Ovulation is the time when conception can take place because that is when an egg is made available. The problem is that most women do not ovulate on an exact date each month, and many women have a different ovulation day from month to month. If you also take into account that sperm can live in the body 3-5 days after intercourse has taken place, this can make figuring out conception very difficult. Most doctors use the first day of the last period (LMP) and ultrasound measurements to gauge the gestational age of a pregnancy and determine when the conception occured. These are just tools used to estimate the dates—it is very hard for anything to tell the exact date of conception. Most people do not realize that ultrasounds can be off up to 5-7 days in early pregnancy and up to a couple weeks off if the first ultrasounds are done farther into the second trimester or beyond. Due dates are not an accurate tool for determining conception since they also are only an estimation date (only 5% of women give birth on their due dates).

If I have a negative pregnancy test after I have missed my period, does that mean I am not pregnant?
A negative result can mean that you are not pregnant, you took the test too early, or you took the test incorrectly. Pregnancy tests vary in their sensitivity (how soon they can detect the hormone hCG), and you may not have given your body enough time to produce enough hCG hormones that will show up on the test. Also, if you let a test sit for too long (after the instructions on the box tell you), the test is invalid. It is best to follow the instructions and wait until you have missed a period before taking the test. Some women show up accurately on a test the day they miss a period, while others may not show up positive until 3-4 weeks after a missed period. We encourage women to test after a missed period; if the result is negative they should wait a week and test again if a normal period has not started.

Sexually Transmitted Diseases/Infections

What are common signs or symptoms of sexually transmitted diseases/infections?

• Itching around the vagina
• Discharge from the vagina for woman
• Discharge from the penis for men
• Pain during sex
• Pain during urination
• Pain in the pelvic area
• Sore throats in people who have oral sex
• Pain in or around the anus
• Chancre soars – painless red sores – on the vagina, penis, anus, tongue or throat
• Small blisters or scabs on the vagina, penis, or anus
• Soft, flesh-colored warts around the vagina, penis, or anus

Which sexually transmitted diseases/infections are curable?

• Gonorrhea
• Chlamydia
• Trichomoniasis
• Syphilis

Which sexually transmitted diseases/infections are treatable?

• Herpes, Types 1 and 2
• HIV/AIDS

How many people have STDs?
The United States has the highest rates of STDs in the industrialized world. In the United States alone, about 19 million new infections are estimated to occur each year. Women suffer more frequent and more serious complications from STDs than men.

How do you get an STD?
You can get and pass STDs through vaginal, anal, or oral sex. Trichomoniasis can also picked up from contact with damp or moist objects such as towels, wet clothing, or a toilet seat, if the genital area gets in contact with these damp objects. Some STDs cause no symptoms, but can still be passed from person to person even if there are no symptoms.

How do you get tested for STDs?
Depending on the STD, your practitioner may do a pelvic exam for women and a genital exam for men, cultures may be collected of discharge or sores for the precise diagnosis of the illness. Urine test for Chlamydia and Gonorrhea is available, and a blood sample may be drawn to test for Syphilis and HIV.

Can STDs cause health problems?
Yes. While each STD causes different health problems, overall, they can cause cervical cancer and other cancers, liver disease, pelvic inflammatory disease, infertility, pregnancy problems, and other complications. Some STDs increase your risk of getting HIV/AIDS. HIV/AIDS can cause a number of health problems and raise the risk of getting life-threatening diseases and certain forms of cancer.

How are STDs treated?
The treatment depends on the type of STD. For some STDs, treatment may involve taking medicine or getting a shot. For other STDs that can’t be cured, like herpes, there is treatment to relieve the symptoms.

Teens
Can a teen get a surgical abortion?
Yes, but the requirements vary state by state. In the state of Tennessee, a minor under the age of 18 must have permission from one parent or guardian. If you are unable to obtain permission from your parent or guardian, you may petition juvenile court for a judicial bypass. The staff at Choices can provide you with the name of an attorney who will help you through the judicial bypass process free of charge.

Can a teen get a medication abortion?
Yes, but the requirements vary state by state. In the state of Tennessee, a minor under the age of 18 must have permission from one parent or guardian. If you are unable to obtain permission from your parent or guardian, you may petition juvenile court for a judicial bypass. The staff at Choices can provide you with the name of an attorney who will help you through the judicial bypass process free of charge.

Can a teen get birth control and STD testing?
Yes. In the state of Tennessee, minors between ages of 13 and 17 can request and receive family planning and STD testing services with out the permission of their parents or guardians.