Descriptions of abortion methods commonly used for each trimester of pregnancy are provided below. A list of references for the information is also included. The methods are listed in alphabetical order. Any of the below mentioned risks or complications can be lessened with good medical care.
First Trimester Abortion Methods (0-14 weeks of pregnancy)
Second Trimester Abortion Methods (14-26 weeks of pregnancy)
Third Trimester Abortion Methods (26-40 weeks of pregnancy)
Glossary
Explanations of Risks
Expectations after Surgery
Fetal Pain
Sources
Dilation and Sharp Curettage (D & C)
In this type of procedure, the cervix is slowly opened and the fetus, placenta and membranes are scraped from inside the uterus with a sharp instrument.
| Possible Complications | |
Incomplete abortion requiring vacuum aspiration Infection of the uterus Excessive bleeding Torn cervix Infection of fallopian tubes Punctured uterus Blood clots in the uterus Reaction to anesthesia |
|
Methotrexate/Misoprostol (Methotrexate/Misoprostol information from WebMD)
This is a type of medical abortion with the first medication, Methotrexate, being given by injection into the muscle, followed by vaginal placement of misoprostol.
The fetus, placenta and membranes are generally expelled the next day. If not, the dosage of misoprostol is repeated.
| Possible Complications | |
Incomplete abortion which may necessitate a surgical abortion Allergic reaction to medications Prolonged bleeding Nausea and vomiting Diarrhea Abdominal pain and cramping |
|
Mifepristone/Misoprostol (RU-486) (Mifeprex [mifepristone] Information from the FDA)
This medication can be taken up to 5 weeks after conception or approximately 7 weeks after the first day of your last normal menstrual period.
The woman is given Mifepristone to be taken by mouth. After a period of time in the doctor's office, she may return home. At 36 - 48 hours after this dose, the woman returns to receive the proper amount of misoprostol.
The client should then be watched closely by doctors and nurses for a few hours. The fetus, placenta and membranes are usually expelled during this time. (For further information from the FDA see www.fda.gov)
The woman should return to the doctor's office on 14th day after taking the medication to assure that there are no problems and that the fetus, placenta and membranes have been fully expelled.
| Possible Complications | |
Incomplete abortion which may necessitate a surgical abortion Allergic reaction to medications Prolonged bleeding Nausea and vomiting Diarrhea Abdominal pain and cramping |
|
Vacuum Aspiration
This is the most common abortion procedure in the first trimester, with 97% of all abortions during that time period being performed in this manner.
The cervix is opened enough to allow the insertion of a suction catheter (tube).
The fetus, placenta and membranes are then removed by the use of the specially designed suction catheter or vacuum device.
This method generally takes approximately 5 minutes after the cervix has been opened. The procedure used for cervical dilatation can take several hours.
| Possible Complications | |
Incomplete abortion which may necessitate a surgical abortion Infection of the uterus Excessive bleeding Torn cervix Infection of fallopian tubes Punctured uterus Blood clots in the uterus Reaction to anesthesia Infertility |
|
Similar to a caesarean birth, an incision is made in the uterus and the fetus is removed.
It is usually performed in cases of failed prostaglandin or intra-amniotic instillations.
Anesthesia is given to the woman so she will not feel the surgery.
| Possible Complications | |
Infection of incision Severe systemic infection (sepsis) Blood clots to the heart, lungs and brain (emboli) Stomach contents breathed into the lungs (aspiration pneumonia) Injury to the urinary tract Blood clots in the uterus Heavy bleeding Pelvic infection Retention of pieces of the placenta Reaction to the anesthesia Infertility |
|
Dilation and Evacuation
This procedure is performed under local anesthetic between 13 and 20 weeks of pregnancy.
It involves the gradual opening of the cervix and removal of the fetus, placenta and membranes by alternating suction and sharp curettage.
This is currently the most common method used in the second trimester.
| Possible Complications | |
Blood clots in the uterus Heavy bleeding Cut or torn cervix Perforation (puncture) of the wall of the uterus Pelvic infection Incomplete abortion Reaction to the anesthesia Infertility |
|
Intra-Amniotic Instillations
Solutions of hypertonic urea and a prostaglandin may be instilled into the amniotic sac after partial removal of the amniotic fluid.
Urea kills the fetus, and prostaglandin helps ensure expulsion.
Contractions begin within 8 to 12 hours and may last 48 hours before the fetus, placenta and membranes are expelled.
| Possible Complications | |
Retention of pieces of the placenta Pelvic infection Heavy bleeding Ruptured uterus Blood clots Incomplete abortion Reaction to anesthesia Infertility |
|
Vaginal Prostaglandin
Prostaglandin E2 causes the uterus to contract and the cervix to soften and open.
These actions result in the eventual expulsion of the fetus, placenta and membranes.
The prostaglandin is supplied in the form of vaginal suppositories or gels applied to the cervical canal.
Oxytocin may be given after the administration of the prostaglandin if labor contractions are not strong enough.
| Possible Complications | |
Retention of pieces of the placenta Pelvic infection Heavy bleeding Ruptured uterus Blood clots Incomplete abortion Reaction to anesthesia |
|
See above
In this procedure, the physician pulls the fetus feet-first out of the uterus into the birth canal, except for the head which is kept lodged just inside the uterus.
The base of the fetus's skull is punctured with a sharp instrument such as a long scissors or pointed metal tube.
A catheter is inserted into the wound and removes the fetus's brain with a powerful suction machine. This causes the skull to collapse, and allows for the expulsion of the fetus.
| Possible Complications | |
Risks are similar to childbirth Uterine infection Blood clots to heart, lungs and brain Heavy bleeding High blood pressure Reaction to anesthesia Infertility |
|
Amniotic sac: Membrane bag that contains the fetus and fluid before birth.
Cervix: Lowest and narrow end of the uterus; the neck, which extends into the vagina.
Conception: Union of the sperm and egg resulting in fertilization.
Curettage: Scraping of the lining of the uterus with a sharp instrument to remove fetus, placenta and membranes.
Dilatation: Stretching of the mouth of the uterus (cervix) to open wide enough to allow passage of the baby.
Fetus: SDCL 34-23A-1 (2) and SDCL 34-25-1.1 (4) define fetus as "the biological offspring, including the implanted embryo or unborn child, of human parents."
Hypertonic Urea: A solution containing a large amount of salts.
Intra-Amniotic Instillation: Putting liquids that contain large amounts of salts into the amniotic sac.
Local Anesthetic: The use of medication to numb a small area of the body.
Membranes: Thin layer of tissue that surrounds the fetus.
Oxytocin: Drugs that cause the uterus to contract.
Placenta: Flattened, round mass of spongy tissue that contains a lot of blood vessels. It attaches to the inside of the wall of the uterus and carries food and oxygen to the fetus, and carries wastes away from the fetus.
Prostaglandin: Substance present in many body tissues. Used to induce abortions or labor.
Suction Catheter: A tube that sucks the fetus, placenta and membranes from the uterus.
Suppositories: A cone-shaped semi-solid substance used to put medication in the vagina.
Systemic: Pertains to the whole body. Involves many organ systems.
Trimester: One of three periods of about 3 months each into which pregnancy is divided.
Vacuum Device: A machine that uses suction to remove the fetus, placenta and membranes.
Any of the below mentioned risks may be lessened with good medical care.
Anesthesia is generally given for surgical abortions (D & C, Vacuum Aspiration, Dilation and Evacuation, Abdominal Hysterotomy, Intra-amniotic instillations, and Intact Dilation and Extraction)
Shortness of breath has many different causes.
Most women who undergo surgical abortions done in appropriate medical facilities recover without physical complications.
Any significant emotional and psychological issues should be considered and addressed before and after a chosen abortion.
Findings from some studies suggest that the unborn fetus may feel physical pain.
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