Abortion: Procedures
Procedure |
When is it Used? |
How is it Performed? |
| Manual Vacuum Aspiration |
7 weeks |
The cervical muscle is stretched with dilators (metal rods) until the opening is wide enough to allow the abortion instruments to pass into the uterus. A hand-held syringe is attached to tubing that is inserted into the uterus and the fetus is suctioned out. |
| Suction Curettage |
6-14 weeks |
The doctor opens the cervix with a dilator ( a metal rod) or laminaia (thin sticks dericed from plants and inserted hours before the procedure). The doctor inserts tubing into the uterus and connects the tubing to a suction machine. The suction pulls the fetus apart and out of the uterus. One variation of this procedure involves a a Curette ( a loop-shaped knife) to scrape the fetal parts out of the uterus. |
| Dilation and Evacuation (D&E) |
13 - 24 weeks |
Because the developing fetus doubles in size between weeks 11 and 12, it is now too large to pass through the suction tubing. Therefore, the cervix must be opened wider than in the first trimester abortion, by inserting laminaria a day or two before the abortion. After opening the cervix, the doctor pulls out the fetal parts with forceps. The fetus' skull is crushed to ease removal. |
| Dilation and Extraction (D&X) |
From 20 weeks to Full Term |
This procedure takes 3 days. During the first 2 days, the cervix is dilated and medication is given for cramping. On the 3rd day, you receive medication to start labor, after which the doctor uses ultrasound to locate the fetus' legs. Grasping a leg with forceps, the doctor delivers the baby up to the baby's head. Next, scissors are inserted into the base of the skull to create an opening, where a suction catheter is used to remove the skull contents. The skull collapses and the baby is removed completely. |
| RU486, Mifepristone |
4-7 weeks |
Also called "medical abortion," this procedure is used for women who are within 30 - 49 days after their last menstrual period. this procedure usually requires 3 different office visits. The RU-486 or Mifepristone pills are given 2 days prior to a second medication, called Misprostol. The combination of these medications causes the uterus to expel the fetus. |
What are the immediate risks?Some side effects may occur with induced abortion, as with any major medical surgery. These include abdominal pain and cramping, nausea, vomiting, and diarrhea. In most abortions, no serious complications occur. However, complications may happen in as many as 1 out of every 100 early abortions and in about 1 out of every 50 later abortions. Such complications may include:
- Heavy Bleeding - Some bleeding after abortion is normal. There is, however, a risk of hemorrhage, especially if the uterine artery is torn. When this happens, a blood transfusion may be required.
- Infection - Bacteria may get into the uterus from an incomplete abortion resulting in infection. A serious infection may lead to persistent fever over several days and extended hospitalization.
- Incomplete Abortion - Some fetal parts may not be removed by the abortion. Bleeding and infection may occur. RU486 may fail in up to 1 out of every 20 cases.
- Allergic Reaction to Drugs - An allergic reaction to anesthesia used during abortion surgery may result in convulsions, heart attack, and (in extreme cases) death.
- Tearing of the Cervix - The cervix may be cut or torn by abortion instruments.
- Scarring of the Uterine Lining - Suction tubing, curettes, and other abortion instruments may cause permanent scarring of the uterine lining.
- Perforation of the Uterus - The uterus may be punctured or torn by abortion instruments. The risk of this complication increases with the length of the pregnancy. If this occurs, major surgery, including a hysterectomy, may be required.
- Damage to Internal Organs - When the uterus is punctured or torn, there is also a risk that damage will occur to nearby organs, such as the bowel and bladder.
- Death - In extreme cases, other physical complications from abortion including excessive bleeding, infection, organ damage from a perforated uterus, and adverse reactions to anesthesia may lead to death. This complication is very rare and occurs, on average, in less than 20 cases per year.
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