If you think you might be pregnant, and you’re looking for information on your
options, abortion may be something you’re considering.
Some women feel like now isn’t a good time to have a baby, or they worry that they won’t be able to continue on in school. Because abortion is a permanent decision, it can be a good idea to take a couple of days to get as much information as you can about all your options to make the best choice for you. Whatever your choice may be The Pregnancy Center is here to help you.
Here is some information on abortion procedures and risks:
The type of procedure is based on how far along you are in pregnancy. It is extremely important that you confirm your pregnancy with a “Limited Obstetrical” ultrasound and make sure it is a viable pregnancy (non-ectopic) before making the decision to terminate your pregnancy.
Methotrexate & Misoprostol (MTX)
MTX is a medical abortion procedure used up to the first 7 weeks (49 days of pregnancy). This procedure is not as commonly used as in the past because of the availability of mifepristone.
- Methotrexate is given orally or by injection during the first office visit.
- Antibiotics are also given in order to prevent infection.
- Misoprostol tablets are given orally or inserted vaginally about 3 to 7 days later. This can be done at home.
- This procedure will usually trigger contractions and expel the fetus. The process may take a few hours or as long as a few days.
- A physical exam is given a week later to ensure that the abortion procedure is complete and to check for complications.
- Methotrexate is primarily used in the treatment of cancer and rheumatoid arthritis because it attacks the most rapidly growing cells in the body. In the case of abortion, it causes the fetus and placenta to separate from the lining of the uterus. Using the drug for this purpose is not approved by the FDA.
The side effects and risks of Methotrexate & Misoprostol include the following:
- Cramping, nausea, diarrhea, heavy bleeding, fever
- The procedure is unsuccessful approximately 5% of the time with the potential of requiring an additional surgical abortion procedure to complete the termination.
- It is not advised for women who have anemia, bleeding disorders, liver or kidney disease, seizure disorder, acute inflammatory bowel disease, or who use an intrauterine device (IUD).
Mifepristone (Mifeprex) and Misoprostol
Mifepristone (mifeprex) and misoprostol is a medical abortion procedure used up to the first 7 to 9 weeks of pregnancy. It is also referred to as RU-486 or the abortion pill.
- A physical exam is first given in order to determine eligibility for this type of medical abortion procedure. You are not eligible if you have any of the following: ectopic pregnancy, ovarian mass, IUD, corticosteroid use, adrenal failure, anemia, bleeding disorders or use of blood thinners, asthma, liver or kidney problems, heart disease, or high blood pressure. You will be given antibiotics to prevent infection.
- Mifepristone is given orally during your first office visit. Mifepristone blocks progesterone from the uterine lining, causing the lining to break down, preventing the ability to continue a pregnancy.
- Misoprostol tablets are taken orally or inserted vaginally about 36 to 72 hours after taking the mifepristone. The tablets will cause contractions and expel the fetus. This process may take a few hours or as long as a few days.
- A physical exam is given two weeks later to ensure the abortion was complete and to check for complications.
The side effects and risks of Mifepristone & Misoprostol include the following:
- Cramping, nausea, vomiting diarrhea, heavy bleeding, infection
- The procedure is unsuccessful approximately 8-10% of the time with the potential of requiring an additional surgical abortion procedure to complete the termination.
- It is not advised for women who have anemia, bleeding disorders, liver or kidney disease, seizure disorder, acute inflammatory bowel disease or use an intrauterine device (IUD).
How is aspiration performed?
Aspiration is a surgical abortion procedure performed during the first 6 to 16 weeks gestation. It is also referred to as suction aspiration, suction curettage, or vacuum aspiration. Your abortion provider will give you medication for pain and possibly sedation. You will lie on your back with your feet in stirrups, and a speculum is inserted to open the vagina.
A local anesthetic is administered to your cervix to numb it. Then a tenaculum (surgical instrument with long handles and a clamp at the end) is used to hold the cervix in place for the cervix to be dilated by absorbent rods that vary in size.
The rods may also be put in a few days prior to the procedure. When the cervix is wide enough, a cannula, which is a long plastic tube connected to a suction device, is inserted into the uterus to suction out the fetus and placenta.
The procedure usually lasts 10-15 minutes, but recovery can require staying at the clinic for a few hours. Your doctor will also give you antibiotics to help prevent infection.
What are the side effects and risks of suction aspiration?
Common side effects of the procedure include cramping, nausea, sweating, and feeling faint. Less frequent side effects include possible heavy or prolong bleeding, blood clots, damage to the cervix and perforation of the uterus.
Infection due to remaining tissue or infection caused by an STD or bacteria being introduced to the uterus can cause fever, pain, abdominal tenderness and possibly scar tissue. Contact your healthcare provider immediately if your side effects persist or worsen.
Dilation & Evacuation (D&E)
How is dilation & evacuation performed?
Dilation and evacuation is a surgical abortion procedure performed after 16 weeks gestation. In most cases, 24 hours prior to the actual procedure, your abortion provider will insert laminaria or a synthetic dilator inside your cervix. When the procedure begins the next day, your abortion provider will use a tenaculum to keep the cervix and uterus in place and cone-shaped rods of increasing size are used to continue the dilation process.
A numbing medication will be used on the cervix. A shot may be given before the procedure begins to ensure fetal death has occurred. A cannula (long tube) will then be inserted to begin removing tissue away from the lining.
Then, using a curette (surgical instrument shaped like a scoop or spoon), the lining is scraped to remove any residuals. If needed, forceps may be used to remove larger parts. The last step is usually a final suctioning to make sure the contents are completely removed.
The procedure normally takes between 15-30 minutes. The fetal remains are usually examined to ensure everything was removed and that the abortion was complete. An antibiotic will be given to help prevent infection.
What are the side effects and risks of dilation & evacuation?
Common side effects include nausea, bleeding, and cramping which may last for two weeks following the procedure.
Although rare, the following are additional risks related to dilation and evacuation: damage to uterine lining or cervix, perforation of the uterus, infection, and blood clots. Contact your healthcare provider immediately if your symptoms persist or worsen.
Dilation and Extraction
How are dilation and extraction performed?
The dilation and extraction procedure is used after 21 weeks gestation. The procedure is also known as D & X, Intact D & X, Intrauterine Cranial Decompression, and Partial Birth Abortion.
Two days before the procedure, laminaria is inserted vaginally to dilate the cervix. Your water should break on the third day and you should return to the clinic. The fetus is rotated and forceps are used to grasp and pull the legs, shoulders, and arms through the birth canal.
A small incision is made at the base of the skull to allow a suction catheter inside. The catheter removes the cerebral material until the skull collapses. The fetus is then completely removed.
The availability of any procedure used in the third trimester is based on the laws of that state.
What are the side effects and risks related to dilation and extraction?
The side effects are the same as dilation and evacuation. However, there is an increased chance of emotional problems from the reality of more advanced fetal development. Contact your healthcare provider immediately if your symptoms persist or worsen.
Information taken from the American Pregnancy Association: