COVID-19 Update: Appointments will take place virtually*
*Except for IUD and Nexplanon Insertions and Removals
Before you get started, use this calculator to determine approximately how many weeks and days pregnant you are.
In response to COVID-19 SHORE Centre has updated some of our processes to follow current public health recommendations and guidelines. At this time our appointments will take place virtually by phone, and video conferencing.
SHORE Centre offers the abortion pill up to 9 weeks of pregnancy. To learn more about the abortion pill before you make an appointment click here.
If you are looking for more information about your abortion options, click here to read more about the differences.
We strive to provide abortion care that meets our client’s unique needs and circumstances. Our abortion services are trans-inclusive, barrier-free, and free interpretation services are available for all appointments.
If you have decided to have a medication abortion, please read through the following information to start the process with us.
Medical Screening and Intake Telephone Call - Booking and What to Expect
This appointment is virtual and will take place by telephone. Please do not come into SHORE Centre’s office for this appointment.
Once you have selected your virtual appointment time you will receive a few emails automatically from us, please complete the Medical History and Consent forms before your Medical Screening and Intake Telephone Call. During this telephone call you will speak with a patient intake worker to discuss abortion options available to you, review your medical history and eligibility, and determine what testing is needed prior to your appointment.
If you are eligible to have a medication abortion at SHORE Centre you will then be sent the necessary requisitions for any testing needed before your appointment with the clinician (blood work, urine test, ultrasound). These can be emailed to you or faxed directly to the clinic.
The Medical Screening and Intake Telephone Call must take place with the person who the appointment is for. Family members, friends, and support people cannot book the appointment for someone else. Please let us know if you need the assistance of an interpreter, we are happy to arrange one at no cost to you to assist at your appointments.
Between now and the time of your appointment you begin to experience abdominal pain or bleeding or any unusual vaginal discharge, please seek immediate medical attention.
Making Appointments for Blood Work and Ultrasound
After you complete your Eligibility Screening Call you will be sent a confirmation email. Please review the confirmation email and the details of your upcoming appointment. Be sure to print your requisition(s) for blood work and ultrasound.
Please remember to drink 1 Litre of water an hour before your ultrasound appointment.
Please arrange appointments for your blood work and ultrasound during the time frame recommended in the email. If you are having difficulty scheduling your ultrasound or blood work appointment please call us at 519-743-9360.
Although Health Canada no longer requires an ultrasound for the provision of Mifegymiso, although SHORE Centre clinicians may still require them based on your health hisotry.
Your Appointment for Blood Work
Print off your requisition to take with you to your appointment. If you would prefer we fax your requisition please let us know at least 1 business day before your appointment for blood work.
In preparing for your appointment, you will have blood work completed. The requisition you received for blood work has the following items checked off on it: CBC, ABO, Chlamydia (CT), Gonorrhea (GC) and bHCG.
CBC, ABO, and bHCG are tested using blood. Chlamydia and Gonorrhea are tested using urine. To prepare for the urine test, please be sure you have not urinated for at least 2 hours prior to providing the sample.
Below is more information about the testing that is done.
The complete blood count, or CBC, lists a number of many important values. This information provides the clinician a better understanding of your overall health.
ABO grouping is a test performed to determine an individual’s blood type (eg. A, B, O, or AB).
Beta hCG, also known as quantitative serum beta-HCG, refers to the testing of the amount of hCG hormone present in the blood.
Chlamydia (CT) and Gonorrhea (GC)
During an abortion cells infected with Chlamydia or Gonorrhea can travel from your vaginal opening up into your uterus. When the cells travel and are not treated, you are at greater risk for developing a secondary infection called Pelvic Inflammatory Disease. This test is offered to all SHORE Centre clients who will be having a medical abortion.
Your Ultrasound Appointment
If you require an ultrasound, print off your requisition to take with you to your appointment. If you would prefer we fax your requisition please let us know at least 1 business day before your appointment.
An ultrasound may needed before your appointment with the clinician. Ultrasound is an important step in the process of having an abortion as it will help determine how many weeks you have been pregnant and where the pregnancy is located.
An ultrasound exam uses high-frequency sound waves to scan the abdomen and pelvic cavity. In early pregnancy, a transvaginal ultrasound, using a specially designed probe is used inside the vagina to generate images. This ultrasound will help determine if the pregnancy is inside of the uterus or if it is ectopic.
Ectopic pregnancies (sometimes called “tubal pregnancies”) are when the pregnancy implants and grows in a fallopian tube rather than in the uterus. An ectopic pregnancy can be life-threatening if it is not detected.
To prepare for your ultrasound you will be asked to drink one litre of water one hour before your appointment and not urinate until after the time of your ultrasound.
24 Hours Before Your Appointment
Make sure you have completed your appointments for blood work and ultrasound. Results of your blood work and ultrasound are necessary in order to receive a prescription for Mifegymiso. It often takes 24 hours for the results of your blood work and ultrasound to be processed and made available to SHORE Centre.
If you are having difficulty arranging these appointments, please contact SHORE Centre immediately.
If your blood work and ultrasound are not received before your scheduled appointment with SHORE Centre there may be a delay in getting your prescription and/or we may suggest rescheduling your appointment.
The Day of Your Appointment with SHORE Centre
All appointments will be conducted remotely using Zoom, Jane or Doxy video conferencing platforms.
On your appointment day, you will receive an email from SHORE Centre’s Options Team that includes a link to attend your appointment virtually.
When you open the email, you will be invited to either download the app (click yes and then open) or to join the meeting (agree). The app will prompt you to enable your microphone and cameray. Follow the prompts on your screen and you will be connected to your counsellor and clinician.
If you are unable to use or access this technology, please contact us as soon as possible so we can discuss telemedicine alternatives.
Meeting with your Counsellor
Your first video call will be with a SHORE Centre counsellor whose role is to help answer your questions about using the medication and ensure you are ready to proceed with seeing the clinician to receive your prescription for Mifegymiso. On average, this takes between 20 and 30 minutes based on your individual needs. If you think you may need more time than this, please let us know and we can arrange a longer appointment with you.
Our practice is to meet with the person who will be using the medication on their own before inviting a support person to join us. This allows the person who is going to be using the medication to speak about their feelings, questions, and concerns confidentially.
We are here to support you. If someone has pressured you to have an abortion, please let us know so that we can support you in your decision and help you connect with any community services you need.
You are welcome to share any information you would like with the counsellor, but you will never be asked why you have chosen to have an abortion. We understand that there are many reasons why people decide abortion is the right decision for them. We are here to listen without judgement and support you.
If you are feeling conflicted about your decision or uncertain and decide during your time with the counsellor that you do not want to have an abortion we will support you to arrange for prenatal care and support.
If you need more time to consider your options, let us know. You set the pace of the appointment, let us know what you need.
What if I change my mind?
If you decide that you would not like to proceed with medication abortion we can assist you with the next steps of booking an appointment for aspiration abortion.
If you decide that you would not like to have an abortion and would prefer to talk about adoption or parenting we can assist you with the next steps of arranging prenatal care and any other referrals you may need.
If you would like to make an appointment to speak with one of our counsellors about all your options, we can help you book that appointment too!
Meeting with your Clinician
After you meet with the counsellor you will meet with a clinician. You may have to click another link from your email to join this session. Your counsellor will let you know what the next step is when it is time to connect with your clinician.
Your support person is welcome to be with you during your meeting with the clinician if you want them there. The clinician will ensure you are confident that using medication to end your pregnancy is the right decision for you. On average, this takes between 30 and 45 minutes based on individual needs. If you think you may need more time than this, please let us know and we can arrange a longer appointment with you.
You will be asked questions about your medical history including:
– allergies, medications you use, medical diagnoses, past surgeries, previous pregnancies (births, miscarriages, and abortion)
If you would prefer to meet with the clinician without your support person present, please be sure to let us know. We can be discreet about why the meeting is just with you.
The clinician will also go through information about birth control options, they are able to prescribe the birth control method of your choice and we can book you in for appointments for IUD and Nexplanon insertion at SHORE Centre.
Finally, the clinician will prepare your prescriptions for Mifegymiso and pain relief medication.
Filling Your Prescription
Your prescription will be faxed to the pharmacy of your choice and you can usually pick it up the same day. It is usually a good idea to call the phamacy before you go to ensure they have your prescription in-stock and ready to pick up.
Mifegymiso is free with your Ontario Health Card. If you do not have have an Ontario Health Card, please let us know so that we can explore coverage options with you. If you have OHIP and the pharmacy says you need to pay for your presciption please call us immediately so we can help or show the pharmacist this webpage.
Taking the medication at home
You will take the medication at home (see Mifegymiso instruction guide).
There is one pill of mifepristone in the green box inside the Mifegymiso packaging. Swallow the pill with a glass of water. Most people don’t feel any different after take mifepristone, although some people may feel nauseous. A small number start bleeding and cramping because the pregnancy tissue has started to empty from the uterus. Once you take mifepristone, your abortion cannot be reversed.
Between 24 hours and 48 hours after taking Mifepristone (Step 1), you will take a second medication called Misoprostol (Step 2). There are 4 pills of misoprostol in the orange box inside the Mifegymiso packaging.
Where to place the misoprostol tablets inside the mouth.
To take Misoprostol (Step 2):
– First take a sip of water to moisten your mouth.
– Then place all 4 pills in your mouth with 2 pills on the left side and 2 pills on the right side in between your gum and cheek (see diagram).
– Set a timer for 30 minutes and let medication begin to dissolve.
– After 30 minutes take a sip of water and swallow everything left in your mouth. It is normal for the medication to not fully dissolve.
After using Misoprostol: Within 30 minutes to an hour you can expect to have very heavy bleeding and pass clots that may be quite strong and painful, but will get better over time – generally the most painful time is the first 4 to 6 hours. Make sure to take the pain relief medication you clinician recommends to help manage the pain and nausea and feel more comfortable. Bleeding can last up to 3 weeks and may range from light to heavy during this time.
Side effects include: Nausea, vomiting, diarrhea, dizziness, abdominal discomfort/pain, cramps, fever and chills. These side effects usually last a short time and go away on their own.
While you can return to your normal activities, you may be more tired than usual for a few days. Avoid strenuous activities or exercise until your follow-up visit. If you choose, the clinician will advise you how and when to begin the contraception method of your choice.
Follow up blood work
You will need to complete a follow up blood test to confirm that the pregnancy has ended. This is the only way to confirm that the medication was effective. Your clinician will let you know what day to go for your blood work on.
Follow up appointment
You will get a questionnaire by email a few days after your appointment, your answers to the questions will help your clinician have a full picture of your experience of taking Mifegymiso when they review your file to determine if the medication worked as expected.
Once we have your answers to this questionnaire and your follow-up blood work results we will be in touch. This usually takes place within 7 days of you completing your follow-up blood work.
In the rare case that Mifegymiso did not end the pregnancy as expected, you will discuss next steps with your clinician. These steps may include waiting longer, taking additional medication, or having a surgical procedure to complete the abortion.
In preparation for your follow-up you can ask for a prescription for the birth control method of your choice and we can also book an appointment to have an IUD inserted at SHORE Centre.
Healthcard and Payment Information
You must bring your Ontario health card (OHIP), with it the cost of the clinic visits and medication is covered.
Out of province health cards may be accepted for clinic visits only. The cost of Mifegymiso is separate and ranges from $337.25 – $375.97 based on pharmacy. Other insurance that may be accepted for for the cost of clinic visits (only) includes: University Health Insurance Program (UHIP), Guard Me Insurance, Interim Federal Health Program (IFH), Department of National Defence (DND). With private insurance, you may need to pay upfront and submit claims to your insurance company for reimbursement.
Limited financial assistance may be available for people who do not have any health insurance and are unable to afford the costs related to their appointment at SHORE Centre. During your Medical Screening and Intake Telephone Call our Patient Intake Worker will discuss options and next steps for receiving financial assistance.
Support Available to You
If you have questions, concerns, or would just like to talk to someone at SHORE Centre you can book a session with one of our counsellors by calling 519-743-9360 Monday to Friday between 9:00 AM and 4:00 PM or you can request an appointment here: https://clinic.shorecentre.ca/contact-us/.
Please note that our office is closed on Saturday, Sunday, and all statutory holidays. We will do our best to reply to all emails and phone messages in two business days or less.