Medical Abortion
Medical abortion uses medication to end a pregnancy during the first trimester. The procedure typically takes a few days and starts with a visit to a participating doctor’s office or clinic.
Having a medical abortion is a major decision with emotional and psychological consequences. If you’re considering this procedure, make sure you understand what it entails, side effects, possible risks, complications and alternatives.1
If you are thinking about abortion, please contact us before you make a final choice. We are here to help you sort through all of your questions and concerns. It is essential that you have all the information you need to help you make an informed and educated decision.
The “Abortion Pill” (mifepristone plus misoprostol) is the most common form of medical abortion. It was approved by the Food & Drug Administration (FDA) for use in women up to 10 weeks after the last menstrual period (LMP). On the first office visit, the first pill (mifepristone) is swallowed, which blocks a hormone essential to keep blood flowing to the baby through the placenta. Eventually, this causes the death of the baby over the next few days. One to two days later, misoprostol tablets are taken, which cause cramping that expels the embryo.2
After a medical abortion, it is very important that you follow up with the provider to make sure you are healing and to check for complications. The abortion provider will decide if the follow-up should include a phone call, a blood test, an office visit, and/or and ultrasound.3
If the doctor thinks that the abortion failed, or was not complete, you will need to decide if you will take more pills to induce abortion, undergo a surgical abortion, or continue your pregnancy.4
Outreach Clinic neither performs nor refers for abortions.
- Mayo Clinic, “Medical Abortion”: https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687?p=1 (Accessed October 5, 2018)
- S. Food & Drug Administration. (2016, March 30). Mifeprex (mifepristone) Information. Retrieved November 7, 2018, from http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111323.htm.
- U,S. Food & Drug Administration. (2016, March). Mifeprex Full Prescribing Information: Post-treatment assessment: Day 7 to 14. Retrieved November 7, 2018, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf
- Food & Drug Administration. (2016, March). Mifeprex Full Prescribing Information. Retrieved November 7, 2018, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf
Surgical Abortion
Surgical abortions are done by opening the cervix and passing instruments into the uterus to remove the developing fetus and placenta. The exact procedure is determined by the gestational age or size of the baby.
Aspiration
Aspiration is a surgical abortion procedure performed during the first 6 to 14 weeks gestation. It is also referred to as suction aspiration, suction curettage, or vacuum aspiration. Medication for pain and possibly sedation will be provided. While lying on an exam table with feet in stirrups, a speculum is inserted in to open the vagina.
A local anesthetic is administered to the cervix to numb it. Then a 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 another instrument. 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.
This procedure usually lasts 10-15 minutes, but recovery can require staying at the clinic for a few hours. Antibiotics are also given 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 prolonged 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 and Evacuation
The dilation and extraction procedure is usually used beginning at about 14 weeks gestation. After 14 weeks gestation the fetal skull begins to calcify making it more difficult, or impossible, to remove through the cervix intact. This procedure is also commonly known as Partial Birth Abortion.
Up to two days before the procedure, something will be inserted vaginally by your doctor to dilate the cervix. On the day of the procedure the fetus is rotated and forceps are used to grasp and pull the legs, shoulders and arms through the birth canal. The skull is collapsed and 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.
Informed consent and counseling are essential when considering your plan for pregnancy. Women should be counseled about the full range of pregnancy options: parenting, abortion, and adoption. Counseling should be a patient-centered shared decision-making process to ensure that a patient’s decision is informed, voluntary, and free of coercion.1 Patients should be made aware of risks and benefits of the procedure and alternatives, and this should be documented in the medical record and on the consent form.
Before you make a final decision regarding your pregnancy, call us today to schedule an appointment to discuss all your options with our trained and compassionate nurses.
- Perucci A. Decision Assessment and Counseling in Abortion Care: Philosophy and Practice, 1st ed, Rowman & Littlefield Publishers, Lanham, Maryland 2012.