Did you know ? “Contraception”

  • It is possible to install an IUD (hormonal or copper) even if you have never been pregnant and at any time in the menstrual cycle.
  • Combined hormonal contraception reduces the risk of endometrial, ovarian and colon cancer.
  • The contraceptive implant, Nexplanon, has been available in Quebec since August 2020, but has existed for more than 30 years in other countries and constitutes one of the most effective forms of long-acting contraception.

Did you know ? “Domestic violence”

  • Around 40% of women consulting for reproductive health have experienced or are experiencing violence from their partner. ¹
  • Women victims of domestic violence have 2.5 times more termination of pregnancy (IG) than women who do not experience it, and they use less method of contraception.²
  • Contraceptive coercion, which represents a “series of behaviors that interfere with contraception and birth planning, while reducing women’s autonomy over their reproductive choices” is sometimes the only form of violence within the intimate relationship It can take different forms:
    • Contraceptive sabotage, e.g. hiding or destroying contraception, piercing condoms, etc.
    • Contraceptive control, e.g.: continuous and invasive monitoring of contraception by the intimate partner.
    • Contraceptive interference, e.g. stealthing (practice meaning removing the condom without the consent of the other person).³

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Did you know ? “Abortion”

  • Abortion has always existed, everywhere and in all cultures.
  • 1 in 3 women have an abortion in their lifetime.
  • A little over a third of women who terminate a pregnancy already have one or more children.

How to check IUD strings ?

When installing the IUD, we recommended that you check the strings from time to time to ensure position.

The IUD is installed in the uterus, but strings come out into the vagina so that it can eventually be removed. If the strings are cut too short or not visible, it may be more difficult to remove the IUD. We will then have to use some specialized instruments.

These threads should not bother you or your partner on a daily basis, but if you put a finger in the vagina, you should be able to feel them. Over time, they will soften and become surrounded around the cervix.

Suggested technique:

  • You can place yourself in a squat position, lying on your back or with one foot on the edge of the bathtub.
  • Insert one or two fingers into the vagina and try to reach all the way down to touch the cervix (a donut-shaped structure similar to the tip of the nose).
  • As you work your way around the cervix, you should be able to feel the threads.

If you no longer feel the strings or if they become longer than before, do not hesitate to contact us so that we can confirm the position of the IUD.

Can I breastfeed after a procedure ?

  • For the surgical intervention (abortion or curettage for stopped pregnancy), where midazolam (Versed) and fentanyl (Sublimaze) are administered, women can resume breastfeeding as soon as they are awake and stable ( source: Clinical protocol n°15 Analgesia and anesthesia in breastfeeding mothers (Clinical protocols of the Academy of Breastfeeding Medicine – 2017).


  • For the abortion by medication, there is no contraindication to breastfeeding either. Concerning the taking of mifepristone, limited data suggest that it would not be necessary to stop breastfeeding after a single dose of mifepristone (source: Lactmed) and for misoprostol, it can be taken during breastfeeding and no precautions special care is not required due to the low passage into breast milk (source: Pregnancy and breastfeeding – Therapeutic guide, 2nd edition, 2013).

Is the insertion of an IUD painful?

Every person is different and the level of discomfort or pain that is experienced may vary depending on your anatomy, your level of stress or your past experiences. Our clinic specializes in this field, which is why we can offer whatever you need for your IUD insertion to take place in the best possible conditions.

To choose the most suitable IUD, please refer to the IUD comparison table on our website. You may also call us at 514 843-7904 and ask to speak to our nurse who can help you make an informed choice and obtain a prescription if you have not already received it from your doctor, nurse practitioner or midwife.

Here is an overview of what will take place during your visit to our clinic:

  • As recommended when making the appointment, you will have taken a pain relief medication one hour prior to your arrival at the clinic (example: one pill of Naproxen 500mg or two pills of Aleeve 220mg or three 200 mg ibuprofen pills).
  • The procedure for inserting an IUD is the same no matter which IUD you choose.
  • We will then proceed with the anesthesia of the cervix to reduce discomfort.

The IUD can be installed at any time during your cycle. You will be asked not to have unprotected sexual intercourse for a period of three (3) weeks prior to your appointment to ensure that the routine pregnancy test is accurate.

What is the NEXPLANON® contraceptive implant?

NEXPLANON® is a contraceptive implant consisting of a small flexible, latex-free plastic stick, 4 cm long and 2 mm in diameter. It is inserted under the skin of the inner side of the arm, by a doctor or a health professional who has received the necessary training. The insertion is done using an applicator specially designed for this purpose. The skin is previously anesthetized to minimize discomfort. The hormone etonogestrel (a progestin) it contains will be released in relatively stable daily doses and absorbed into the bloodstream. It will then blocks ovulation and thicken the mucus in the cervix, preventing conception.

NEXPLANON® is 99.4% effective. It can be left up to 5 years¹ and to have it removed it is also necessary to consult a health professional who has taken the training.

About 20% of women with the implant will stop menstruating completely (compared to 50% for the MIRENA IUD). In 80% of women there will be menstrual changes in the form of unpredictable and sometimes persistent spotting. This is probably the most common side effect that you will need to accept. This method does not contain estrogen, so it can be used by the majority of women, even smokers 35 years and older and those suffering from migraines.


1 – https://www.inspq.qc.ca/sites/default/files/2024-05/3466-protocole-contraception-quebec-2024.pdf

Medical or Surgical Abortion? Know the Pros and Cons to choose the method that suits you.

Medical Abortion

  1. Pro: Most women who choose medical abortion are surprised by the easy process and would opt for this method again if necessary. 95% of women who choose medical abortion will avoid the possible risks of surgery.
  2. Pro: It respects your privacy since the abortion will take place at home and you will be surrounded by those you have selected to support you during that time.
  3. Con: A medical abortion is exactly like a natural miscarriage, which means that abdominal cramps and possible heavy bleeding are to be expected. You might have to go to the clinic or the emergency room if the bleeding and cramps become too intense.
  4. Con: If absenteeism from work or school is a problem for you, a medical abortion is not a good choice as a minimum of 2 visits is necessary and sometimes more in 5 to 10% of cases.
  5. Con: If no one knows about your abortion, a medical abortion is not a good option as someone must be present with you at home while the pregnancy is being expelled. The same applies if you are caring for young children on your own or if you are planning on taking a trip in the month following the abortion.
  6. Con: If you are suffering from an anxiety disorder that is not fully controlled, this method comes with less certainty, therefore more anxiety.

Surgical Abortion

  1. Pro: If you have a busy schedule, if surgery does not worry you and you want a quick procedure (surgery takes approximately 10 minutes, with a total visit time of approximately 3 hours) this method is for you. One visit only and a very low complication rate (1 to 2%).
  2. Pro: If you are worried about pain and bleeding, this method is often painless and post-operative bleeding is usually light.
  3. Con: Even though it is a minor one, it still is technically a surgery which comes with the risks inherent to it. In about 1% of cases, there is the possibility that a second procedure might be necessary in the following weeks due to tissue retention. There is a very low risk of uterine perforation, hemorrhage, reaction to anesthesia, infection or intrauterine adhesions (scar tissue in the uterus).
  4. Con: You cannot drive a motor vehicle for 24 hours following the procedure.

For more information, please read the Comparison Table in the Abortion section on our website or call the clinic at 514-843-7904.


Surgical Abortion at Clinique médicale Fémina

We have been offering this service since the clinic was founded in 1988. Should you choose our clinic, you can be absolutely confident that we will be able to adapt to your needs. Our expertise in this field has allowed us to develop a very effective pain management strategy.

Here is the process to receive this service:

  • When giving you an appointment, our reception staff will verify the following information to ensure that we are able to proceed with your abortion with minimal risk:
    • First day of your last regular period to determine the number of weeks of pregnancy. If you are over 12 weeks, we will have to refer you to another clinic which specializes in second trimester abortions;
    • Height and weight: if your BMI is over 40, we might have to refer you to a hospital;
    • If you are diabetic taking insulin, you will need to advise us so that we may give you the proper directions regarding your appointment.
  • During your appointment, we recommend that you be accompanied by someone who cares and supports your choice. You will not be allowed to drive for 24 hours following the procedure. We also ask you to fast 3 hours before the time of your appointment.
  • After filling out the medical questionnaire, you will meet our counselor alone. She will answer your questions and will check your medical record. If your choice is clear, she will have you sign a form consenting to the procedure and the anesthesia. During this interview, you will discuss the contraceptive method you plan to use after your abortion. If you are interested in a hormonal or copper IUD, it can be inserted by the doctor at the end of the procedure.
  • In the operating room, the doctor and nurse will perform an ultrasound to determine the stage of your pregnancy and to rule out an ectopic pregnancy. The nurse will then insert an intravenous catheter to administer a combination of painkillers and relaxing medications (conscious sedation) that can sometimes be combined with the inhalation of a very short-acting relaxing gas, depending on your needs. The doctor will then perform the abortion using the aspiration-dilation and curettage method. Thanks to medications used during the procedure, pain is often non-existent and conscious sedation causes amnesia which is much appreciated by patients.
  • Once you’re back in the recovery room, you will be asked to rest for a minimum of one hour to ensure that you leave the clinic in good condition. We will offer you a light snack and provide you with all of the necessary prescriptions.
  • After the abortion, once you’re home, we recommend that you rest for 24 hours before resuming your regular activities.

For more information, please visit the Surgical Abortion section of our website or call us at 514-843-7904