Understanding the Abortion Option

Chemical Abortion

A chemical abortion uses drugs (as opposed to surgery) to terminate your pregnancy. RU-486 (mifepristone) and misoprostol are the two drugs commonly used for chemical abortions. This procedure usually requires 2 or 3 office visits. On the first visit, pills are given to block the effects of progesterone, a pregnancy-sustaining hormone. This drug cuts off the supply of blood and nutrients to the developing embryo. On the second visit, another drug is given to cause the uterus to contract and expel the embryo. A third visit is done to confirm that the abortion is complete. Approximately 1% - 4% of chemical abortions are incomplete, requiring a surgical abortion to terminate the pregnancy.

The side effects of a chemical abortion include hemorrhage (heavy bleeding) and infections. Abortion pills are only used in early pregnancies.

D&C Surgical Abortion (Dilation and Curettage with Vacuum Aspiration)

This type of surgical abortion is typically used during the first trimester of pregnancy. The doctor dilates (opens) the cervix and empties the uterus using suction. After suctioning, the doctor may also scrape the walls of the uterus to ensure the embryo and placenta have been completely removed. The day before the procedure, thin absorbent rods may be placed in the cervix to cause it to dilate. Further dilating many be necessary depending on the size of the growing fetus. If this is the case, metal rods may be inserted into the cervix to cause additional dilation.

D&C abortion can be painful, and local anesthesia or IV sedation may be used to manage pain.

The side effects of a D&C abortion include hemorrhage (heavy bleeding), infection, and damage to organs by abortion instruments. In extreme cases, complications can lead to death.

D&E Surgical Abortion (Dilation and Evacuation)

This type of abortion is usually performed in the second trimester of pregnancy. Because the fetus is larger, the cervix is dilated one to two days prior to the procedure with thin absorbent rods (Laminaria) inserted into the cervix. Oral or vaginal medication may also be used to dilate the cervix.

After the cervix is stretched open, the fetus is removed using a grasping tool (forceps). Due to the size of the fetus, it is usually necessary to take it out in parts in order for it to fit through the cervix. The uterus is then scraped out with a curette, and suctioned to remove any remaining fetal tissue.

D&E abortions are painful, and IV conscious sedation is commonly used to manage the pain. The doctor keeps track of the removed fetal parts to insure that none are left inside the uterus, as this could cause infection.

The side effects of a D&E abortion include hemorrhage (heavy bleeding), infection, and damage to organs by abortion instruments. The further along the pregnancy, the greater the risk of these complications due to the increased work required to empty the uterus. In extreme cases, complications can lead to death.