Abortion Information

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TYPES OF ABORTIONS

 

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If you’re curious about the difference between abortion by pills versus surgery, you’ve come to the right place.  Expand the sections below to read more.

 

The types of abortion that may be available depend on factors such as how far along a woman is in her pregnancy and what kinds of procedures the abortion provider offers.

 

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TWO TYPES OF ABORTION PROCEDURES:

Medication Abortion

Medication abortions use drugs, instead of surgical instruments, to end a pregnancy.

1.) Early Medication Abortion

Up to 10 weeks from the last menstrual period (LMP) “The Abortion Pill” (mifepristone plus misoprostol) is the most common form of medication abortion. It was approved by the Food & Drug Administration (FDA) for use in women up to 10 weeks after LMP. 1 It is even used beyond 10 weeks LMP, despite an increasing failure rate. 2, 3, 4 It is done by taking a series of pills that disrupt the embryo’s attachment to the uterus, and cause uterine cramps which push the embryo out. 5 The abortion pill is not available over the counter. Things to consider: 6

  • Bleeding can be heavy and lasts an average of 9-16 days.
  • One woman in 100 need a surgical scraping to stop the bleeding.
  • Pregnancies sometimes fail to abort, and this risk increases as pregnancy advances.
  • For pregnancies 8 weeks LMP and beyond, identifiable parts may be seen. 7
  • By 10 weeks LMP, the developing baby is over one inch in length with clearly recognizable arms, legs, hands, and feet. 8

2.) Methotrexate is FDA-approved for treating certain cancers and rheumatoid arthritis, but is used off-label to treat ectopic pregnancies and to induce abortion. 9, 10 Given by mouth or injection, it works by stopping cell growth, resulting in the embryo’s death.

3.) Medication Methods for Induced Abortion — 2nd and 3rd Trimester.11, 12 This procedure induces abortion by using drugs to cause labor and delivery of the fetus and placenta. Drugs may be injected into the fetus or the amniotic fluid to stop the baby’s heart before starting the procedure to avoid a live birth. There is a risk of heavy bleeding, and the placenta may need to be surgically removed. Call us to learn more about these procedures and potential risks.

Surgical Abortion

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

Aspiration/Suction 13, 14 – Up to 13 weeks LMP Most early surgical abortions are performed using this method. Local anesthesia is typically offered to reduce pain. The abortion involves opening the cervix, passing a tube inside the uterus, and attaching it to a suction device which pulls the embryo out.

1.) Dilation and Evacuation 15, 16 (D&E) – 13 weeks LMP and up

Most second trimester abortions are performed using this method. Local anesthesia, oral, or intravenous pain medications and sedation are commonly used. Besides the need to open 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 baby in pieces. D&E is associated with a much higher risk of complications compared to a first trimester surgical abortion.

2.) D&E After Viability 17, 18, 19 – 24 weeks LMP 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 baby’s heart before starting the procedure. The cervix is opened 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 crushes the skull in order to remove the fetus in one piece. Call us to learn more about your pregnancy options.

If you would like to talk more about abortion, types of procedures and risks, call us or find a pregnancy care center near you.

NOTE: We offer accurate information about all your pregnancy options; however, we do not offer or refer for abortion services or emergency contraception. 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.

References
References
  1. U.S. Food & Drug Administration. (2016, March 30). Mifeprex (mifepristone) Information. Retrieved April 8, 2016, from http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111323.htm.
  2. Raymond, E. G., Shannon, C., Weaver, M. A., & Winikoff, B. (2013). First-trimester medical abortion with mifepristone 200 mg and misoprostol: a systematic review.Contraception, 2637. Retrieved from http://dx.doi.org/10.1016/j.contraception.2012.06.011.
  3. Chen, Q. (2011). Mifepristone in combination with prostaglandins for termination of 10–16 weeks’ gestation: a systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology, 159, 247–254.85.
  4. Chen, M. J., & Creinin, M. D. (2015). Mifepristone With Buccal Misoprostol for Medical Abortion. Obstetrics & Gynecology, 126(1), 1221. doi:10.1097/aog.0000000000000897.
  5. U.S. Food & Drug Administration. (2016, March 30). Mifeprex (mifepristone) Information. Retrieved April 8, 2016, from http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111323.htm.
  6. U.S. Food & Drug Administration. (2016, March). Mifeprex label information. Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf.
  7. The Endowment for Human Development. (2006). The Rapidly Growing Brain. Retrieved from http://www.ehd.org/movies.php?mov_id=28.
  8. The Endowment for Human Development. (2006). Right and Left Handedness. Retrieved from http://www.ehd.org/movies.php?mov_id=44.
  9. Physician’s Desk Reference (2014). Drug Summary: Methotrexate. Retrieved October 28, 2015, from http://www.pdr.net/drugsummary/methotrexatetablets?druglabelid=1797&id=2398.
  10. Creinin, M. , Danielsson, KG.(2009). Medical Abortion in Early Pregnancy. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp.114, 12029). Chichester, UK: Wiley-Blackwell.
  11. Kapp, N., von Hertzen, H. (2009). Medical Methods to Induce Abortion in the Second Trimester. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp. 17888). Chichester, UK: Wiley-Blackwell.
  12. American College of Obstetricians and Gynecologists (2013). Practice Bulletin: Second-trimester abortion (135).
  13. 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. 135156).
  14. Chichester, UK: Wiley-Blackwell. Planned Parenthood Federation of America Inc. (2014). In-Clinic Abortion Procedures : Planned Parenthood. Retrieved July 19, 2014, from http://www.plannedparenthood.org/healthinfo/abortion/inclinicabortionprocedures.
  15. Planned Parenthood Federation of America Inc. (2014). In-Clinic Abortion Procedures : Planned Parenthood. Retrieved October 28, 2015, from https://www.plannedparenthood.org/learn/abortion/inclinicabortionprocedures.
  16. 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. 15774). Chichester, UK: Wiley-Blackwell.
  17. 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. 15774). Chichester, UK: Wiley-Blackwell.
  18. American College of Obstetrics and Gynecology. (2013). Practice Bulletin: Second-Trimester Abortion (135).
  19. 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.