Abortion is the termination of a pregnancy. Natural abortion can occur spontaneously due to complications during pregnancy. This is commonly known as miscarriage. Induced abortion is a surgical or medical procedure that terminates a pregnancy by the removal or expulsion from the uterus of a fetus or embryo, resulting in or caused by its death.
You will need to have an ultrasound to verify your pregnancy and to determine how far along you are in your pregnancy in order to know which abortion procedure is applicable. Ultrasounds are provided at no cost at several of the centers listed on this site. Learn about the difference.
Abortion can have significant physical, emotional, and spiritual consequences. The risks can vary, depending on which abortion procedure is used. Learn more about the Risks of Abortion.
This drug is only approved by the Food & Drug Administration for use in women up to the 49th day after their last menstrual period; however, it is commonly used “off label” up to 63 days. This procedure usually requires three office visits. On the first visit, the woman is given pills to cause the death of the fetus. Two days later, if the fetus has not been expelled from her body, the woman is given a second drug (misoprostol) to accomplish this. One to two weeks later, an evaluation is done to determine if the procedure has been completed. 11, 12
RU486 will not work in the case of an ectopic pregnancy. This is a potentially life-threatening condition in which the embryo lodges outside the uterus, usually in the fallopian tube. 13, 14
If an ectopic pregnancy is not diagnosed early, the tube may burst, causing internal bleeding and in some cases, the death of the woman.
This surgical abortion is done throughout the first trimester. Depending upon the provider and the cost, varying degrees of pain control are offered ranging from local anesthetic to full general anesthesia. For very early pregnancies (4-7 weeks LMP), local anesthesia is usually given. Then a long, thin tube is inserted into the uterus. A large syringe is attached to the tube and the embryo is suctioned out.
Towards the end of the first trimester, the cervix needs to be opened wider to complete the procedure because the fetus is larger. This may require a two day process where medications are placed in the vagina, or a thin rod made of seaweed is inserted into the cervix to gradually soften and open the cervix over night. The day of the procedure, the doctor may need to further stretch open the cervix using metal rods. This is usually painful so local or general anesthesia is typically needed. Next, the doctor inserts a plastic tube into the uterus and then applies suction. Either electric or manual suction machines are commonly used. Manual Vacuum Aspirators (MVA) are becoming more popular in the U.S. The suction pulls the fetus’ body apart and 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 the “products of conception.”) 1, 2, 3, 4
This surgical abortion is done during the second trimester of pregnancy. In this procedure, the cervix must be opened wider than in a first trimester abortion because the fetus is larger. This is done by inserting numerous thin rods made of seaweed into the cervix a day or two before the abortion. Sometimes, other oral or vaginal medications are used to further soften the cervix. The day of the procedure, after anesthesia is given (local or general), the cervix is further stretched open using metal rods. Until about 16 weeks gestation, the procedure starts with a plastic tube inserted through the cervical opening and suction is applied. The suction pulls the fetus’ body apart and out of the uterus any remaining fetal parts are removed with a grasping tool (forceps). A sharp tool (called a curette) may also be used to remove any remaining tissue.
After 16 weeks, much of the procedure is done with forceps to pull fetal parts out through the cervical opening. The doctor keeps track of what fetal parts have been removed so that none are left inside to potentially cause infection. Lastly, a curette, and/or the suction machine is used to remove any remaining tissue or blood clot ensuring the uterus is empty. 5, 6, 7
When the abortion is done at a point when a live birth is possible, injections are given to cause fetal death. This is done in order to comply with the federal law which requires that the fetus be dead before complete removal from the mother’s body. The medications (digoxin and potassium chloride) are either injected into the amniotic fluid, the umbilical cord or directly into the fetus’ heart. The remainder of the procedure is the same as described above.
An alternate technique called “Intact D and E” may also be used. The goal of this procedure is to remove the fetus in one piece thus reducing the risk of leaving parts behind to cause infection, among other things. This procedure requires the cervix to be open even further by inserting the seaweed rods in the cervix two or more days prior to the abortion. Often it is necessary to crush the fetus’ skull for removal as it is difficult to dilate the cervix enough to bring the head out intact. 8, 9, 10
This technique involves the termination of pregnancy by the stimulation of labor-like contractions that cause eventual expulsion of the fetus and placenta from the uterus. Like labor at full term, this procedure typically involves 10-24 hours in the hospital labor and delivery unit. Digoxin or potassium chloride is injected into the amniotic fluid, or umbilical cord or fetal heart prior to the procedure in order to avoid the delivery of a live baby. The cervix may be softened either with the use of seaweed sticks, or medications at the start of the procedure. Various combinations of oral mifepristone and oral or vaginal misoprostol are the medications of choice for midtrimester pregnancy terminations. These medications cause the pregnancy to detach from the uterus and the uterus to contract and expel the fetus and placenta, in most cases. Throughout the procedure, the patient may receive oral or intravenous pain medications. Occasionally, a scraping of the uterus is needed to remove the placenta. Potential complications include hemorrhage and the need for a blood transfusion, retained placenta and uterine rupture. The absolute risk of uterine rupture is not known. 15
(This information provided courtesy of OptionLine)
Whether you choose abortion, or the decision you make about your pregnancy will affect you for the rest of your life. Talk with trusted family members and friends. Also, there are caring, trained counselors who are available 24 hours a day, 7 days a week, to help you through this confusing and difficult time. There is no cost for the counseling and it is completely confidential. Call 1-800-712-4357 to talk with a counselor or contact them online.
Would you like to know what other women who have had an abortion say about how it has affected them and their lives? Here are some from women who have made that choice.
If you have taken the first dose of mifepristone (also known as RU486 or the “abortion pill”) and regret your decision it may not be too late. There is a process for reversing the abortion pill, but time is essential. Call right away to get help.
Option Line provides caring, confidential support to anyone facing an unexpected pregnancy. Their consultants are available 24 hours a day, 7 days a week via a toll-free phone number, email or live chat. They will connect you with a nearby pregnancy resource center that offers pregnancy tests as well as answers to your questions about pregnancy, STIs (Sexually Transmitted Infections), abortion, adoption, parenting, medical referrals and much more.
Every situation is unique. It is important to check with your state’s laws concerning rights and responsibilities in adoption such as marital status and paternal consent.