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 in place for 3 years 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.

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

Medical Abortion at Clinique médicale Fémina

At our clinic, the word “choice” is about deciding to have an abortion, as well as the abortion method. In addition to surgical abortion, medical abortion has been available since February 2018.

You may choose this method if you meet the following criteria:

  • Your pregnancy is under 9 weeks, starting from the first day of your last period;
  • You live less than an hour away from a clinic or hospital;
  • You don’t have anemia;
  • A caregiver (close friend or family member) is available to be present during the critical phase.

The decision to proceed using the medical method will be taken during your first appointment.

Here is an overview of the steps to follow:

  • Once the pregnancy has been confirmed by the ultrasound and your hemoglobin level has been checked (Note: If you have anemia, a medical abortion is not a good choice as it causes more bleeding than a surgical abortion), if you have no other contraindications, we will give you the abortive medication.
  • The mifepristone medication will be taken orally, at the clinic, in the presence of one of our staff members, noting the time when it is taken. In the vast majority of cases, this medication will not cause any side effects or bleeding, except in rare instances. This medication only stops the pregnancy process and at this stage, you cannot reverse your decision. It will soften and open your cervix to prepare your uterus for the next stage, expulsion.
  • This second step will take place using a medication called misoprostol that must be taken 24 to 48 hours after taking the mifepristone (not before 24 hours and no later than 48), even if you have experienced some bleeding after taking the first medication. Four (4) tablets must be allowed to melt in the mouth, between the cheek and the gum line 30 minutes before swallowing them. This is when the presence of a supportive person is important. Misoprostol side effects are severe menstrual cramps (contractions) and sometimes, heavy bleeding. It is exactly like having a miscarriage, consequently, you will need to accept these painful side effects when choosing this method. The majority of women expel the pregnancy within 4 hours but it might take several hours, sometimes several days and very rarely several weeks. There is a 5% chance of needing a surgical abortion. Experience confirms that if you are patient, most of the time, your uterus will eventually expel all of the tissue.

A follow-up exam at our clinic, 2 to 3 weeks later is essential to confirm that your abortion is complete. As you might notice, this is a slightly more complex method than the surgical abortion, but with a 95% success rate, this means you are avoiding surgery. However, you need to be ready and available to go through all of these steps.

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

Can an abortion decrease my future fertility?

Women who consult abortion clinics are, with few exceptions, very fertile and will remain fertile after their abortion.

Medication abortion, also called medical abortion, does not require any surgical handling in more than 95% of cases, so the risk of complications that may affect your fertility is extremely low.
Surgical abortion is also very safe and the rate of major complications that could affect your fertility is very low, around 0.1% (1 per 1000). The rate of complications increases with the number of weeks of pregnancy. Therefore, the ideal scenario is to consult us early, while making sure you do it when YOU are ready.

The main factor that may compromise your fertility is not abortion but your age, because fertility decreases exponentially after age 35. Complications from STDs such as chlamydia or gonorrhea and certain diseases such as endometriosis are next on the list of causes of infertility.

Is abortion painful?

It all depends on the type of abortion chosen.

Thanks to the sedative drugs used, surgical abortion is often painless. Some women will experience mild abdominal pain, similar to menstrual cramps. The medical staff will make sure to give you the optimal dose of medication so that your abortion experience is as smooth as possible.

Medication abortion often causes a higher level of pain, as the uterus has to expel the pregnancy. The process may take up to several hours. You will be offered oral medication to reduce discomfort during more difficult times.

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