There are many types of abortion procedures. All of these procedures carry physical risks and potential side effects.
The Abortion Pill: Up to 9 weeks from LMP
A type of medical abortion, known as the “Abortion Pill,” is actually a series of pills usually requiring three office visits. Depending on the clinic’s policies, this procedure is used with women who are within 30 to 63 days after their last menstrual period.
- During the first visit, a woman is given 3 mifepristone pills (also know as Mifeprex or RU-486) and sent home to take the medication. These first pills deplete the lining of the uterus. This cuts off the blood supply (oxygen and nutrients) to the developing fetus, resulting in fetal death.
- During the second visit two days later, a woman is given another drug, misoprostol (also known as Cytotec). The second pill induces labor and causes expulsion of the fetus. Typical side effects may include nausea and vomiting, diarrhea, dizziness, fever, chills, headaches, abdominal pain, and severe cramping. Women are usually at home, not at the doctor’s office or under direct medical supervision while having the abortion. Some women report mental and emotional disturbance at seeing expelled identifiable fetal contents. Bleeding may continue for up to 6 weeks.
- During the third visit two weeks later, the doctor should determine whether the procedure has been completed, meaning that the uterus is void of fetal and pregnancy-related tissues. If not, a surgical abortion as the ones described below may need to be performed. Up to 8% of medical abortions fail and thus necessitate a surgical abortion.
Before attempting a medical abortion, it may be critical to have an ultrasound to determine an intrauterine pregnancy. If the fetus attached outside the uterus, known as an ectopic pregnancy, the medical abortion will not be effective. An ectopic pregnancy is a potentially life-threatening condition for the woman. Undergoing a medical abortion on an ectopic pregnancy may mask ectopic symptoms, delaying medical attention, which could result in maternal death. Contact us to discuss our complimentary limited obstetric ultrasound.
Aspiration/Suction: Up to 13 weeks from LMP
The majority of first trimester surgical abortions use this method. A doctor’s visit may be required prior to the day of the abortion procedure to soften the cervix. On the day of the procedure, dilating rods are used to open the cervix to allow surgical instruments entry into the uterus. A thin plastic tube connected to a vacuum is inserted, which pulls the fetus apart and out of the uterus. Following the suction, a curette may be used to scrape out any remaining fetal tissue. Depending on the clinic, local anesthesia or sedation may be offered to reduce pain.
Serious physical complications with early surgical abortions are not frequent but may include bleeding, infection, allergic reactions to medications, damage to internal organs, and incomplete abortion. Maternal death is rare with this procedure.
Since miscarriage is not uncommon during the first trimester, it may be beneficial have an ultrasound to assess viability prior to pursuing an abortion. Contact us to discuss our complimentary limited obstetric ultrasound.
Dilation and Evacuation (D&E): 13 weeks LMP and up
This surgical method is used for second trimester abortions. The cervix must be softened 2-3 days prior to the abortion. The fetus may be a given lethal injection several days before the procedure as well. The cervix must be opened wider to accommodate removal of the larger, more developed fetus. Forceps are used to pull fetal parts out, which are then accounted for. Any remaining tissue may be removed by curette or suction.
The most common complication of this surgical abortion is incomplete abortion with retained tissue. Other risks include blood clots, heavy bleeding, infection, organ damage, and reactions to anesthesia. Risk of maternal death increases with advancement of pregnancy.
Maternal risks increase with abortion procedures used after 13 weeks LMP. Having an ultrasound to measure gestational age can give valuable information. Contact us to discuss our complimentary limited obstetric ultrasound.
Dilation and Extraction After Viability: 24 weeks LMP and up
This procedure takes 2-3 days, and is similar to a D&E prior to 24 weeks. To avoid the birth of a live fetus, lethal injection may be administered into the amniotic fluid, umbilical cord, or fetal heart prior to the procedure. Forceps are used to remove the fetus in parts. An alternative method is an “intact D&E” with the goal of removing the fetus in one piece. In order to remove the fetal skull, it often must be crushed to pass through the cervix. Any remaining tissue may be removed by curette or suction.
Later-term abortion procedures carry the highest risk of maternal death at a rate of 1 per 11,000 at 21 weeks LMP or later. Other risks include complications with anesthesia, embolism, heavy bleeding, organ damage, and infection.
While abortion is a medical procedure, it also carries additional risks. Learn about other potential effects of abortion.
Avenues for Women offers counseling and accurate information about all pregnancy options; however, we do not offer or refer for abortion services.
The information presented on this website is intended for general education purposes only and should not be relied upon as a substitute for professional and/or medical advice.