Abortion Procedures

First Trimester Abortion Procedures
A woman may have a choice between medical or surgical abortion procedures during the first trimester. The types of abortion procedures performed during the first trimester are:

Methotrexate & Misoprostol (MTX): A medical abortion procedure used up to the first seven weeks of pregnancy. Methotrexate is a drug invented to fight cancer. It attacks rapidly growing cells and will terminate the developing embryo. About a week after taking Methotrexate a woman inserts vaginal suppositories of Misoprostol which cause contractions. This drug has not been approved by the Food and Drug Administration for abortions. It is important to know that this procedure can cause severe cramping and bleeding. A woman may require a surgical procedure if this method does not complete the abortion.

Mifepristone and Misoprostol: A medical abortion procedure used up to the first seven to nine weeks of pregnancy. It is also referred to as RU-486, the abortion pill, and Mifeprex. The medication is taken orally or as an injection. The drug stops the natural function of the body, causing the uterus to soften and breakdown. Two days after taking the drug the woman returns for a check-up. If the fetus hasn’t been expelled from her body she will be given another drug (Cytotec or Misoprostol) to cause the uterus to dilate and contract. Like labor, the contractions will attempt to push the fetus out of the womb. Like the MTX medical abortion, there is no guarantee this procedure will be successful. If it fails, the doctor will schedule a surgical abortion.

Suction Aspiration: A surgical abortion procedure used to terminate pregnancy between 6 to 12 weeks gestation. It is also referred to as suction curettage or vacuum aspiration. This procedure may vary somewhat but generally the woman will lie on her back, feet in the stirrups, similar to when having a pap smear. The doctor will give a general or local anesthetic to numb the cervix then insert rods into the cervix, stretching it open so the abortion instruments can pass through. When the cervix has been stretched sufficiently, the doctor guides a suction device into the uterus which separates the placenta and fetus into smaller parts and extracts it all from the body. The doctor may also use a curette, a loop-shaped knife, to scrape the uterine wall to assure that everything has been removed.

Second Trimester Abortion Procedures
Medication-based abortion procedures are not an option during the second trimester. The most commonly performed second trimester abortion is known as the D&E.

Dilation and Evacuation (D&E): A surgical abortion procedure used to terminate a pregnancy between 15 to 21 weeks gestation. After 14 weeks the fetus is much larger and stronger. The doctor will need to stretch and dilate the cervix, as in a first trimester surgical abortion. Because the pregnancy is further along, dilation will begin a day or two before the procedure. After this, the provider must compress the skull of the fetus, using an instrument to separate the placenta and fetus into smaller parts, and then remove everything from the uterus. A curette will be used to scrape the uterine wall so nothing remains that could cause infection.

Aftercare: Usually an antibiotic will be prescribed to prevent infection. It is important to a woman’s health to take any medications as instructed. Click here for other possible side effects.