abortion procedures and risks

Vacuum Aspiration
Until about 7 weeks after Last Menstrual Period
This surgical abortion is done early in the pregnancy, up to about 7 weeks after the woman’s last menstrual period. A long, thin tube is inserted into the uterus. A large syringe attached to the tube and the embryo is suctioned out, either by a manual pump or an electric pump.

Suction Curettage (or Mechanical Vacuum Aspiration)
About 6 to 14 weeks after Last Menstrual Period
This is the most common type of abortion procedure. Because the fetus is larger, the doctor must first stretch open the cervix. Opening the cervix may be painful, so local or general anesthesia is typically needed. After the cervix is stretched open, the doctor inserts a hard plastic tube into the uterus, then connects this tube to a suction machine. The suction pulls apart the fetus’s body and suctions it out of the uterus. The doctor may also use a loop-shaped tool called a curette to scrape the fetus and fetal parts out of the uterus. (The doctor may refer to the fetus and fetal parts as “products of conception.”)

Dilation and Evacuation (D & E)
within 13-24 weeks after Last Menstrual Period
This surgical abortion is done during the second trimester of pregnancy. At this point in pregnancy, the fetus is too large to be broken up by suction alone and will not pass through the suction tubing. In this procedure, the cervix must be opened wider than in a first trimester abortion. This is done by inserting thin rods made of seaweed (called laminaria) a day or two before the abortion. Once the cervix is stretched open, the doctor pulls out the fetal parts with forceps. The fetal skull is often crushed to ease removal. A loop-shaped tool called a curette is also used to scrape out the contents of the uterus, removing any remaining tissue.

Late Term Abortions
From 20 weeks after Last Menstrual Period to full-term
These procedures typically take place over three days, use local anesthesia, and are associated with increased risk to life and health of the mother. On the first day, under ultrasound guidance, the fetal heart is injected with a medication that stops the heart and causes the fetus to die. Also over the first two days, the cervix is gradually stretched open using laminaria. On the third day, the amniotic sac is burst and drained. The remainder of the procedure is similar to the D&E procedure described above.

Medical Abortion
Abortion pill and Mifepristone
Usually within 7 weeks after Last Menstrual Period
This drug is only approved for use in women up to the 49th day after their last menstrual period. The procedure usually requires three office visits. On the first visit, the woman is given three pills, which cause the supply of blood and nourishment to the developing embryo to be cut off. Two days later, the woman returns to the doctor to take another drug. (It’s been reported that some doctors give their patients these pills to take at home, by that’s not what the FDA recommends.) This causes cramping and contractions of the uterus and expels the embryo. A third visit to the doctor is to confirm that the abortion is complete. A small percentage of women will still require a surgical abortion to complete the process.

Source: Before You Decide: An Abortion Education Resource, © CareNet 2008. To view original sources, click here.

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