Abortion Methods & Medical Risks (2024)

Methods & Medical Risks

There are three ways a pregnancy can end: a woman can give birth, have a miscarriage or she can choose to have an abortion. Different methods of abortion are used depending on how far along the pregnancy is. If you make an informed decision to have an abortion, you and your doctor will need to consider how long you have been pregnant before deciding which abortion method to use.

FIRST TRIMESTER

One -7 Weeks

The abortion pill regimen, also known as RU-486, is a drug combination designed to end pregnancies up to 49 days after the last menstrual period (five weeks since conception).

The Abortion Pill Regimen

• The abortion pill regimen is a combination of drugs that results in a chemical abortion. The pills must be taken in the doctor's office or clinic.
• After the doctor confirms a pregnancy, the woman is given three Mifeprex pills, which block the activity of progesterone, a hormone necessary to sustain pregnancy.
• One to three days later, the woman takes two tablets of another drug, Misoprostol, which causes the lining of the uterus to break down, causing the already implanted human embryo to detach and be expelled through the softened cervix.
• Two weeks later, the woman must return to the doctor to ensure the abortion occurred and that her uterus is empty. At the follow-up appointment, the doctor conducts an exam or ultrasound to make sure that the pregnancy has ended and the woman is well.
• If the abortion pill regimen is unsuccessful, a surgical abortion may be required.

It is important to understand the need for two follow-up visits with your health care provider and that you have access to a medical care facility in case of an emergency.

The abortion pill regimen may cause side effects. Tell your doctor if any of the following symptoms are severe or do not go away: vagin*l bleeding or spotting; cramps; pelvic pain; vagin*l burning, itching, or discharge; headache; tiredness; difficulty falling asleep or staying asleep; anxiety; and/or back or leg pain. It may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

According to the FDA, the abortion pill has not been studied in women who are heavy smokers. Please tell your doctor if you smoke more than 10 cigarettes a day.

13 Weeks

Suction curettage (also referred to as vacuum aspiration) is generally used during the first trimester. Unless there are complications, this procedure is done on an outpatient basis and may be done in a physician’s office or a clinic.

Suction Curettage

• An anti-bacterial solution is used to cleanse the vagin*l area.
• The doctor will spray or inject medicine on the opening of the uterus (cervix) to prevent pain.
• The opening of the cervix is then gradually stretched. This is done by the insertion of a series or rods, each one thicker than the previous one, into the opening of the cervix. The thickest rod used is about the width of a fountain pen.
• After the opening is stretched, a clear plastic tube (catheter) is inserted into the uterus.
• The suction (vacuum) is turned on and fetal tissues and other products of pregnancy are removed through the catheter.
• After the suction tube has been removed, a narrow metal loop (curette) may be used to gently scrape the walls of the uterus to be sure it has been completely emptied.
• The procedure will usually take about 10 to 15 minutes, but recovery may require staying at the clinic for a few hours following the procedure.

Medical Risks of Suction Curettage

Immediate medical risks may include pelvic infection, incomplete abortion, blood clots in the uterus, heavy bleeding, cut or torn cervix, perforation of the wall of the uterus and anesthesia-related complications.

SECOND TRIMESTER

14-23 Weeks

From 14-23 weeks after the first day of the last menstrual period, dilatation and evacuation (D&E) and labor induction are the two methods typically used.

Dilatation and Evacuation (D&E)

• The procedure will generally be done on an outpatient basis, but may require hospitalization.
• An abortion using the D&E method is done in two steps: dilation (opening the cervix) and evacuation (emptying) the uterus.
• An antibacterial solution is used to cleanse the vagin*l area.
• The doctor may insert a sponge-like material into the cervix. As the sponge gets wet, it swells and opens the mouth of the cervix. You may feel pressure or cramping while the dilator is in place.
• The doctor will remove the sponge between two and 16 hours after placement.
• You may be given intravenous medications to ease pain and prevent infection.
• After a local or general anesthesia is given, the fetus and other products of pregnancy are removed from the uterus with medical instruments such as forceps and suction curettage.

Medical Risks of Dilatation and Evacuation (D&E)

Immediate medical risks may include pelvic infection, incomplete abortion, blood clots in the uterus, heavy bleeding, cut or torn cervix, perforation of the wall of the uterus and anesthesia-related complications.

Labor Induction

• The procedure will generally require a hospital stay of one or more days.
• Labor-induction method is used if the doctor determines that the age of the fetus is late in the second trimester. Labor induction usually requires a longer stay and is not performed in a clinic setting.
• The medicine to induce labor will be injected in one of two ways: directly into a vein, or through the belly into the amniotic sac.
• Labor will usually begin in two to four hours.

Medical Risks of Labor Induction

• If the afterbirth is not removed with the fetus during labor induction, the doctor must open the cervix and use suction curettage as described in the first trimester.
• Labor induction abortion carries the highest risk for problems, such as infection, heavy bleeding, stroke and high blood pressure.
• When medicines are used to start labor, the risk of rupture of the womb is greater than during normal childbirth.
• Other immediate medical risks may include pelvic infection, incomplete abortion, blood clots in the uterus, heavy bleeding, cut or torn cervix, perforation of the wall of the uterus and anesthesia-related complications.
• If the labor-induction method is used, there is a small chance that a fetus could live for a short period of time.

THIRD TRIMESTER

24-38 Weeks

An abortion at this stage of your pregnancy may only be done if your doctor reasonably believes it is necessary to prevent your death or to preserve your health.

Labor Induction

• Labor induction usually requires the woman to be admitted to the hospital.
• Labor will be started by injecting medicines into the woman’s
  blood stream.
• Labor and delivery of the fetus during the third trimester are similar
  to childbirth.
• The duration of labor depends on the size of the baby and the readiness of the womb.

Medical Risks of Labor Induction

• Possible complications of third-trimester labor induction include infection, heavy bleeding, stroke and high blood pressure.
• When medicines are used to start labor, the risk of rupture of the womb is greater than during normal childbirth.
• Other immediate medical risks may include pelvic infection, incomplete abortion, blood clots in the uterus, heavy bleeding, cut or torn cervix, perforation of the wall of the uterus and anesthesia-related complications.

Caesarean Section

• This method requires that the woman be admitted into a hospital.
• A caesarean section may be performed if labor cannot be started by inducing labor, or if the woman or her fetus is too sick to undergo labor.
• A caesarean section is removal of the baby by surgically opening the belly and womb. The woman is made numb by medication, either injected into the vein or spine, or inhaled into the lungs.
• Complications are similar to those seen with childbirth caesarean sections and with administration of anesthesia, such as severe infection (sepsis); blood clots to the heart and brain (emboli); stomach contents breathed into the lungs (aspiration pneumonia); severe bleeding (hemorrhage); and injury to the urinary tract. Other possible immediate risks include pelvic infection, incomplete abortion, blood clots in the uterus, heavy bleeding, cut or torn cervix, perforation of the wall of the uterus and anesthesia-related complications

Medical Risks of Caesarean Section

• Complications are similar to those seen with childbirth caesarean sections and with administration of anesthesia, such as severe infection (sepsis); blood clots to the heart and brain (emboli); stomach contents breathed into the lungs (aspiration pneumonia); severe bleeding (hemorrhage); and injury to the urinary tract.
• Other possible immediate risks include pelvic infection, incomplete abortion, blood clots in the uterus, heavy bleeding, cut or torn cervix, perforation of the wall of the uterus and anesthesia-related complications.