Types of Abortion
An elective abortion is the deliberate termination of a pregnancy. It is not the same thing as a spontaneous abortion, otherwise known as a miscarriage Miscarriage: a naturally occurring event where a pregnancy ends on its own before 20 weeks. (1).
There are two categories of elective abortion procedures: medical and surgical. The type of abortion procedure used is based on how far along your pregnancy is (gestational age).
Medical abortions involve the use of medication to terminate the pregnancy and can be done within 10 weeks from your last menstrual period (LMP). (4, 5)
Surgical abortions, often referred to as “in-clinic abortions,” terminate the pregnancy through a surgical procedure. Surgical abortions can be done throughout all three trimesters, depending on your state’s abortion laws. (8)
To determine how far along your pregnancy is, The American College of Obstetricians and Gynecologists recommends the use of an ultrasound as the most accurate way. (9) While Focus Women’s Center does not provide abortions, we do offer free ultrasounds to qualifying patients as part of our Pregnancy Verification and Consultation appointment.
If you are pregnant and considering abortion, find out why Focus Women’s Center should be your first step.
MEDICAL ABORTION
RU486 – The ABORTION PILL (within 10 weeks after LMP)
The most common regime for a medical abortion is a two-step process involving a combination of mifepristone (RU486)
Generic Name: mifepristone (RU486)
Brand Name: Mifprex
Commonly Called: The Abortion Pill (2 & 3)
and misoprostol. The FDA has approved the use of mifepristone for use up to 70 days (10 weeks) from your last menstrual period (LMP). Please note: The Abortion Pill is NOT the same thing as the Morning-After Pill.
How Does The Abortion Pill Work?
Day 1
Day 2 or 3
What To Expect
Follow-Up
Effectiveness
Please Note: Medical abortions are not effective for terminating ectopic pregnancies Ectopic Pregnancies: When a fertilized egg implants and grows outside of the uterus. This can cause life-threatening bleeding if left untreated. (7) .
Symptoms of a ruptured ectopic pregnancy (which can be life-threatening if not treated) may be confused with some of the common side effects of a medical abortion, such as abdominal pain and bleeding. (2, 7) Therefore, it is important to have an ultrasound to make sure you have an intrauterine pregnancy before having a medical abortion. While Focus Women’s Center does not provide abortions, we do offer free ultrasounds to some of our patients as part of our Pregnancy Verification and Consultation appointment.
SURGICAL ABORTION
These procedures are done in the clinic. The pre-abortion workup for each is the same and usually includes a pregnancy test, medical history, physical exam, and some lab tests. It is important to make sure you are also screened for STDs and that you receive a Rh factor blood test Whether you abort, miscarry, or carry to term - if your blood type is found to be Rh negative, you should receive an injection of RhoGam to prevent severe complications in the fetus in future pregnancies. (10) .
Some clinics may also do an ultrasound to determine gestational age and to rule out an ectopic pregnancy Ectopic Pregnancies: When a fertilized egg implants and grows outside of the uterus. This can cause life-threatening bleeding if left untreated. (7) . (11)
Aspiration Abortion (5, 8, 12, 13, 14)
(First Trimester up to 16 weeks after LMP)
The most common type of first trimester abortion is a vacuum aspiration, also known as a suction abortion. Usually a patient will spend 3-4 hours at the clinic for this procedure, although the procedure itself only takes 5-10 minutes to complete.
What To Expect
Side Effects
Risks
Effectiveness
What To Expect
For a Dilation and Evacuation (D&E) you may need to visit the abortion provider anywhere from a few hours to a day before the abortion to have your cervix dilated. The cervix is dilated either by using a medication, laminaria, or dilators. You also may be given a prostaglandin like misoprostol to soften the cervix. For a D&E, you will be given general or regional anesthesia for pain relief. You may also be offered sedation orally or through an IV. Some patients require a shot through the abdomen to stop the fetal heartbeat before the procedure. The procedure itself is similar to the first trimester abortion. However, besides using a vacuum suction, the abortion provider will also use surgical instruments like forceps to remove larger parts, or a curette to scrape the uterine lining. This procedure normally takes between 15-30 minutes to complete. Afterwards, you will be given an antibiotic to help prevent infection and sent to a recovery area to rest.
Side Effects
For a Dilation and Evacuation (D&E), it is common to experience nausea, bleeding, and cramping which may occur for two weeks after the procedure.
Risks
Although rare, risks of a Dilation and Evacuation (D&E) abortion include damage to the cervix, perforation of the uterus, hemorrhaging, blood clots, and infection due to either retained products of conception, or STDs or bacteria being introduced into the uterus.
Effectiveness
Surgical abortions have a 99% success rate of terminating pregnancies.
If you are pregnant and considering abortion, find out why Focus Women’s Center should be your first step.
Sources
(1) U.S. National Library of Medicine. (2020). Miscarriage. Retrieved from https://medlineplus.gov/ency/article/001488.htm
(2) RxList Inc. (2020) Mifeprex RU486. Retrieved from https://www.rxlist.com/mifeprex-ru486-drug.htm#description
(3) Stacey, D. (2019). The abortion pill- RU486. Retrieved from https://www.verywellhealth.com/ru486-the-abortion-pill-906956
(4) U.S. Food and Drug Administration (FDA). (2016).Medication guide Mifeprex. Retrieved from https://www.fda.gov/media/72923/download
(5) Gynecology and Society of Family Planning Committee on Practice Bulletins, Creinin, M, & Grossman, D. (2014). Medical management of first trimester abortion. The American College of Obstetricians and Gynecologists, 2014(143), 1-18. Retrieved from https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2014/03/medical-management-of-first-trimester-abortion
(6) Guttmacher Institute. (2020). Medication abortion. Retrieved from https://www.guttmacher.org/evidence-you-can-use/medication-abortion#
(7) Mayo Foundation for Medical Education and Research. (2020). Ectopic pregnancy. Retrieved from https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088
(8) Gotter, A. (2016). Surgical abortion. Retrieved from https://www.healthline.com/health/surgical-abortion
(9) American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice, Pettker, C., Goldberg, J., El-Sayed, Y., Copel, J., & Society for Maternal Fetal Medicine. (2017). Committee opinion: Methods for estimating due date. American College of Obstetricians and Gynecologists, 2017(700), 1-5. Retrieved from https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2017/05/methods-for-estimating-the-due-date.pdf
(10) Mayo Foundation for Medical Education and Research. (2020). Rh factor blood test. Retrieved from https://www.mayoclinic.org/tests-procedures/rh-factor/about/pac-20394960
(11) Retrieved from Healthwise Staff. (2019). Surgical abortion care. University of Michigan Health System.
(12) American College of Obstetricians and Gynecologists. (2020). Induced abortion. Retrieved from https://www.acog.org/patient-resources/faqs/special-procedures/induced-abortion
(13) American Pregnancy Association. (2020). Surgical abortion procedures. Retrieved from https://americanpregnancy.org/unplanned-pregnancy/surgical-abortions/
(14) Mayo Foundation for Medical Education and Research. (2020). Dilation and curettage (D&C). Retrieved from https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910