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Abortion Methods

The first step to making an informed decision concerning the outcome of your pregnancy is to make sure you are pregnant. See a health care provider for a pregnancy test, a physical examination, and possibly an ultrasound procedure to accurately determine how far along you are. The stage of pregnancy will affect pregnancy decisions. If you decide on abortion, the stage of pregnancy will affect the method your doctor uses to terminate your pregnancy.

A careful assessment of your health history may also reveal information important to your decision-making about abortion. For example, are you in good health now? What is your blood type? Do you have an illness or condition, such as diabetes or high blood pressure, which would complicate a pregnancy? Is there a genetic family trait that could affect your fetus? Has the fetus been exposed to toxic substances like alcohol or "street drugs" that can cause damage? Is this pregnancy the result of rape or incest? And, it is vitally important to know what your options are for this pregnancy: adoption, abortion, or continuing the pregnancy and parenting a child.

Early Medical Abortion

Medical abortion is achieved by the action of drugs that interfere with the growth and continued development of the fetus.

Over 22% (22.6%) of abortions done in Alaska in 2004 were done by medical (non-surgical) means.

The first drugs given will:

  • cause the placenta to separate from the uterine wall
  • stop the fetal cells from growing and dividing

A second drug is given within a few days to cause the uterus to contract and expel the uterine contents of pregnancy.

This method takes longer than surgical abortion procedures. The entire procedure generally takes place over the space of a week or less but could take longer. A follow up visit is needed to be certain the uterus is completely empty.

Possible complications and side effects:

Vacuum Aspiration

A visit to the doctor's office will be required before the procedure for a preliminary examination, ultrasound, laboratory testing, and to obtain informed consent.

This procedure can sometimes be accomplished during one long office visit or may require a second visit to complete the procedure. The actual vacuum aspiration procedure generally takes 10-30 minutes plus one to two hours for recovery.

There are several steps involved:

  • A local anesthetic is used to block pain at the cervix (opening to the uterus).
  • The cervix is gently opened to about the diameter of a fountain pen. This may be accompanied by menstrual-like cramps
  • A cannula (a small, hollow tube) is inserted into the uterus
  • A vacuum is applied and the uterine contents are extracted by this suction. This may cause some cramping.
  • A follow-up appointment should be made for two to three weeks later

Possible complications:

Dilation and Curettage (D&C)

Although D&C was traditionally used for abortions, most surgical abortions are now done by vacuum aspiration. This procedure can be accomplished within 24 hours, including recovery time at the clinic.

These are the steps involved:

  • A local anesthetic is used to block pain at the cervix (opening to the uterus)
  • The cervix is gently opened to about the diameter of a fountain pen. This may be accompanied by menstrual-like cramps.
  • A curette, a tiny metal loop, is used to gently scrape the walls of the uterus to remove the uterine contents of pregnancy. This may cause some cramping.
  • A follow-up appointment should be made for about two to three weeks later.

Possible complications:

METHODS USED AFTER TWELVE WEEKS
(FOURTEEN WEEKS FROM THE LAST MENSTRUAL PERIOD)

Dilation and Evacuation (D&E)

The steps involved are:

  • The cervix must be opened up (dilated) a bit wider for procedures in the second trimester. This takes a little longer. Often an absorbent material is placed in the cervix. As the material absorbs moisture, it slowly dilates the cervix. This may take several hours; sometimes overnight. This may cause some cramping.
  • After the cervix is dilated, anesthesia is given. This is often a combination of local anesthesia at the cervix as well as intravenous medication to reduce cramping and promote relaxation. This procedure can also be done under general anesthesia, that is the woman will be "sleeping".
  • The uterine contents of pregnancy are then removed by vacuum aspiration.
  • After 14 weeks gestation, medical instruments such as forceps, curette (a scraping tool), or suction are often used to grasp and remove the uterine contents of pregnancy. It is not always possible to remove an intact fetus using this procedure.

     

Possible complications:

Dilation and extraction (D&X)

These procedures are performed later in the second trimester and into the third trimester. They are rare, and done to preserve the life or health of the woman. They also might be done when the fetus has already died in the uterus or has a fatal defect.

The steps are:

  • The cervix must be opened up (dilated) and will take up to 24 to 48 hours. An absorbent material is placed in the cervix. As the material absorbs moisture, it slowly dilates the cervix. It may take more than one application of the material.
  • After the cervix is dilated, anesthesia is given. This is often a combination of local anesthesia at the cervix as well as intravenous medication to help with pain control and relaxation. This procedure may also be done under general anesthesia.
  • The uterine contents of pregnancy are then removed by the use of medical instruments such as forceps, curette, and suction. It is not always possible to remove an intact fetus using this procedure.
  •  

Possible complications:

Labor Induction

Abortion by labor induction is a procedure generally used after 16 weeks' gestation. It also might be done when the fetus has already died in the uterus or has a fatal defect. Labor is started early and a fetus is delivered in much the same way as a full term pregnancy and delivery occur. The process generally takes 1-2 days. Hospitalization is almost always required. These procedures are rare.

The steps involved in starting early labor are:

  • The cervix is prepared by "softening" so it will open easily as labor progresses. To do this, a medicated suppository, a gel, absorbent material, or a combination of these, is placed in the vagina or cervix.
  • Labor (uterine contractions) is then started by giving additional medications. This can be done in several ways:
    • Vaginal suppository (most often used method)
    • By intravenous administration, that is, through an "IV" into an arm vein (often used method)
    • By intramuscular injection, that is, a "shot" (sometimes used method)
    • By administration directly into the uterus (almost never used method; a last resort)
  • The duration of labor depends on the size of the fetus and the strength of uterine contractions.
  • The fetus will be pushed out of the uterus and delivered vaginally as a result of the contractions.

Possible complications:




 
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