Methods of abortion procedures can vary depending on how many weeks pregnant a woman is and existing medical conditions that the patient might have. Typically, abortion treatment will be recommended upon a medical assessment made by a doctor where different types of abortion procedures are discussed.
In the United States, there are two kinds of abortion procedures available to women – in-clinic abortions and the abortion pill. Deciding what type of abortion procedure is best in the situation will most likely be based on access, availability, and the trimester of pregnancy. Most women who opt to have an abortion due to unplanned pregnancy will do so early on.
Medical Abortion
Medical abortions are non-surgical and non-invasive methods of pregnancy termination. Instead, they most commonly rely on certain kinds of medications for termination. This is known most widely as the abortion pill. The medical name for the drug used as the abortion pill is mifepristone, its generic name RU-486 and its brand name Mifeprex. Mifepristone works to terminate a pregnancy by blocking the hormone progesterone, which is needed to prevent the lining of the uterus from breaking down and disrupting the pregnancy.
For pregnancies under nine weeks, you may be able to take misoprostol at the same time after mifepristone is taken at the clinic. Women who are more than nine weeks will leave the clinic and return 1-3 days later to take it. During this second appointment, you will be required to take misoprostol by placing it in the vagina in order for the fetus and placenta to pass.
Mifepristone is not available as an over-the-counter drug and must be provided by your healthcare professional. Two or more visits will often be required in the process of medical abortion to terminate the pregnancy effectively. This drug is typically prescribed within the first trimester of pregnancy and is approved for use by the FDA for up to 7 weeks after your last period. After 7 weeks, the effectiveness of this treatment diminishes.
Another medical combination sometimes used for medical abortion procedures is Methotrexate and Misoprostol, which can be used for the first seven weeks of a pregnancy. Mifepristone is more commonly used in the U.S. because of its effectiveness.
Some of the side effects of medical abortions include similar symptoms to a miscarriage. It is normal for the woman to experience bleeding and cramping, as well as dizziness, nausea, headaches, diarrhea, and flushes or sweats.
Surgical Abortions
Surgical abortions are medical abortion procedures done in a healthcare provider’s office or clinic. For surgical procedures, there are many different options to choose from, although how many weeks into the pregnancy the woman is often determines the treatment method.
The most common surgical abortion method is called aspiration, also known as vacuum aspiration. This procedure is typically performed up to 16 weeks after the woman’s last period. Aspiration consists of the insertion of a tub through the dilated cervix and into the uterus, where a gentle suction removes fetal tissues and empties the uterus. This method is usually done with a local anaesthetic, sedation, or general anaeasthetic. The procedure itself takes about 5 to 10 minutes, although extra time might be required to prepare the cervix.
Another kind of in-clinic surgical abortion procedure is called D&E or dilation and evacuation. D&E is typically performed on women who are more than 16 weeks pregnant, in the second trimester. This procedure is typically carried out under general anaesthetic, and is done by removing the pregnancy through a narrow forceps via the neck of the womb. In later second trimester abortions, in order for D&E to be performed, a shot may need to be administered through the abdomen to ensure effectiveness of termination. The cervix will also be typically prepared before the procedure and you may be given medication or dilators to slowly stretch the opening beforehand. D&E typically takes between 10 and 20 minutes to complete.
Women can expect to feel some pain similar to menstrual cramps during these surgical abortion methods, and they may also experience bleeding after the abortion, which is absolutely normal.
Passing clots, spotting, and heavy and intermittent bleeding is all normal to have following the procedure for a few days or weeks afterward. However, it is also normal to not have any bleeding after the abortion.
All abortion methods are generally very safe procedures, although there may generally be some risks or complications depending on prior health conditions and use of sedation or general anesthesia. The risk also increases the further along in your pregnancy you are when you have the abortion.