Abortion Procedures

Abortion Procedures

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MEDICAL ABORTION

Medication abortion (also called the abortion pill) can be taken up to 70 days (10 weeks pregnant) after the start of your last menstrual period.

  • It’s called RU-486 and was approved by the FDA in 2000; it is also called a medical or chemical termination.
  • The pill is actually two drugs, mifepristone and misoprostol, taken in two separate doses.
  • It can be taken up to 11 weeks in most cases.
  • It is not an option for people with certain medical conditions.
  • The abortion pill is not the same as the emergency contraceptive, The Morning After Pill or Plan B One Step.
  • Abortion pill reversal is possible if action is taken after the first dose.

Action – The first medication, Mifeprex blocks progesterone. Progesterone is a hormone that is necessary for the pregnancy to survive. Without progesterone, the embryo dies. The second medication, Mifepristone, causes cramping, expelling the embryo and uterine contents.

Side effects – Cramping and bleeding are expected. Bleeding may be like a heavy period. Bleeding can last 9 to 16 days and possibly up to 30 days. Other possible side effects include nausea, vomiting, diarrhea, fever, chills, weakness, dizziness and headache.

Complications – Possible complications include heavy bleeding requiring surgery to stop the bleeding, and serious infection. Before taking any medication, you should discuss the risks with your doctor and know what do to if complications arise.

Follow-up – It is important to follow-up with your doctor after taking this medication regime to see if an abortion has occurred and to assess for complications.

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SURGICAL ABORTION

Surgical abortions are done by dilating the cervix and passing instruments into the uterus to suction, grasp, pull, and scrape the pregnancy out. The exact procedure is determined by the fetus’ level of growth.

Aspiration/Suction23,24 – Up to 13 weeks estimated gestational age. Most early surgical terminations are performed using this method. Local anesthesia is typically offered to reduce pain. The abortion involves dilating the cervix, passing a tube inside the uterus, and attaching it to suction device which pulls the embryo out.

Dilation and Evacuation25,26 (D&E) – 13 weeks estimated gestational age and up. Most second trimester terminations are performed using this method. Local anesthesia, oral, or intravenous pain medications and sedation are commonly used. Besides the need to dilate the cervix much wider, the main difference between this procedure and a first trimester abortion is the use of forceps to grasp fetal parts and remove the fetus in pieces. D&E is associated with a much higher risk of complications compared to a first trimester surgical abortion.

D&E After Viability27-29 – 21 weeks estimated gestational age and up. This procedure typically takes 2–3 days and is associated with increased risk to the life and health of the mother. General anesthesia is usually recommended, if available. Drugs may be injected into the fetus or the amniotic fluid to stop the fetus’ heart before starting the procedure. The cervix is dilated wide, the amniotic sac is broken, and forceps are used to dismember the fetus. The “Intact D&E” pulls the fetus out legs first, then compresses the skull in order to remove the fetus in one piece.

REFERENCES

MEDICAL ABORTION

Information taken from U.S. Food and Drug Administration (2016). “Mifeprex Medication Guide.” U.S. Department of Health. Retrieved from http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088643.pdf

SURGICAL ABORTIONS
23. Paul, M., Lichtenberg, E. S., Borgatta, L., Grimes, D. A., Stubblefield, P. G., & Creinin, M. D. (2009). First Trimester Aspiration Abortion. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp. 135-156).

24. Chichester, UK: Wiley-Blackwell. Planned Parenthood Federation of America Inc. (2014). In-Clinic Abortion Procedures : Planned Parenthood. Retrieved July 19, 2014.

25. Planned Parenthood Federation of America Inc. (2014). In-Clinic Abortion Procedures : Planned Parenthood. Retrieved October 28, 2015.

26. Paul, M., Lichtenberg, E. S., Borgatta, L., Grimes, D. A., Stubblefield, P. G., & Creinin, M. D. (2009). Dilation and Evacuation. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp. 157-74). Chichester, UK: Wiley-Blackwell.

27. Paul, M., Lichtenberg, E. S., Borgatta, L., Grimes, D. A., Stubblefield, P. G., & Creinin, M. D. (2009). Dilation and Evacuation. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp. 157-74). Chichester, UK: Wiley-Blackwell.

28. American College of Obstetrics and Gynecology. (2013). Practice Bulletin: Second-Trimester Abortion (135).

29. Pasquini, L., et al. Intracardiac injection of potassium chloride as method for feticide: Experience from a single U.K. tertiary centre. Br J Obstet Gynaecol. 2008;115(4):528–31.

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