Surgical Abortion
The method used depends on how long you have been pregnant - the number of days since the first day of your last period.
First Trimester (7-13 weeks)
Dilation & Aspiration (D&A)
With few exceptions, surgically induced abortions are performed by a procedure known as Dilation and Aspiration. During the procedure the cervix or neck of the uterus (womb) must be opened to remove the fetus. In the first 12 weeks of pregnancy this is generally accomplished by sequentially inserting tapered rods of increasing width called "dilators." Usually, the cervix needs to be opened no more than 1/4"-1/2" in the first trimester. This can be done with anywhere between 1 to 8 dilator insertions, depending on the stage of the pregnancy and the resistance of the individual cervix, and will cause cramping (much like menstrual cramps). Once the cervix has been adequately dilated, the fetus is removed by inserting a hollow plastic tube called a "vacurette" and applying suction. Generally, the plastic tube is moved in and out or is rotated to enhance the suction force at the tip of the vacurette. This is sometimes followed by curetting (scraping) the walls of the uterus to ensure that no fetal tissue or parts are left behind that might cause subsequent problems. It is important to note that beyond physical complications, often the most prominent side effects of this procedure are psychological and emotional.
"Every woman - whatever her age, background or sexuality - has a trauma at destroying a pregnancy" -Dr. Julius Fogel, psychiatrist and obstetrician (who has personally performed over 20,000 abortions)
Second Trimester (13-26 weeks)
Dilation & Evacuation (D&E)
Abortion performed in the middle months of pregnancy is a significantly different procedure from the first trimester. The procedures used require greater time and skill and entail somewhat greater risk. The essential difference is that the cervix must be dilated to increasing diameters as the fetus grows. The extent to which the cervix can be safely dilated with dilators varies, dependent upon the woman's cervix. Most experienced physicians will avoid the use of mechanical dilators beyond the 14th week of pregnancy; some will avoid them after the 10th week. As a general rule, the method of choice for dilating the cervix beyond the 12th week involves the use of osmotic dilators. Osmotic dilators are stalks of material which absorb water and expand once placed inside the cervix, they are inserted and left overnight (this will cause cramping). The next morning, the cervix will have dilated and softened. The fetus and placenta are removed in parts with forceps. Suction is then used to scrape the uterus to ensure that no fetal parts remain. Sharp curettage may or may not be performed as a final step. This type of abortion is performed under sedation combined with local anesthesia. Physical risks are greater than a first trimester abortion and psychological and emotional impact can be greater as well.
* After 24 weeks of pregnancy, abortions are usually performed only for serious health reasons.
"One cannot hurt a child without hurting the child's mother" - David Reardon, author
Possible Complications Following Surgical Abortions:
- Infection
- Incomplete abortion
- Heavy bleeding
- Damage to the uterus or nearby internal structures
- Cervical tears
- Continued pregnancy
- Psychological problems
- Nightmares
