RU486, Mifepristone: within 4 to 7 weeks after LMP
Also known as the Abortion Pill, this medical abortion is used for women who are within 28 to 49 days after their last menstrual period. This procedure usually requires three office visits. The RU 486 or mifepristone pills are given to the woman who returns two days later for a second medication called misoprostol. The combination of these medications causes the uterus to expel the fetus.
Early Vacuum Aspiration: within 7 weeks after LMP
This surgical abortion is done early in the pregnancy up until 7 weeks after the woman’s last menstrual period. The cervical muscle is stretched with dilators (metal rods) until the opening is wide enough to allow the abortion instruments to pass into the uterus. A hand held syringe is attached to tubing that is inserted into the uterus and the fetus is suctioned out.
Suction Curettage: within 6 to 14 weeks after LMP
In this procedure, the doctor opens the cervix with a dilator (a metal rod) or laminaria (thin sticks derived from plants and inserted several hours before the procedure). The doctor inserts tubing into the uterus and connects the tubing to a suction machine. The suction pulls the fetus’ body apart and out of the uterus. One variation of this procedure is called Dilation and Curettage (D&C). In this method, the doctor may use a curette, a loop-shaped knife, to scrape the fetal parts out of the uterus.
Dilation and Evacuation (D&E): within 13 to 24 weeks after LMP
This surgical abortion is done during the second trimester of pregnancy. Because the developing fetus doubles in size between the thirteenth and fourteenth weeks of pregnancy, the body of the fetus is too large to be broken up by suction and will not pass through the suction tubing. In this procedure, the cervix must be opened wider than in a first trimester abortion. This is done by inserting laminaria a day or two before the abortion. After opening the cervix, the doctor pulls out the fetal parts with forceps. The fetus’ skull is crushed to ease removal.
Dilation and Extraction (D&X): from 20 weeks after LMP to full-term
Also known as Partial-birth Abortion, this procedure takes three days. During the first two days, the cervix is dilated and medication is given for cramping. On the third day, the woman receives medication to start labor. After labor begins, the abortion doctor uses ultrasound to locate the baby’s legs. Grasping a leg with forceps, the doctor delivers the baby up to the baby’s head. Next, scissors are inserted into the base of the skull to create an opening. A suction catheter is placed into the opening to remove the skull contents. The skull collapses and the baby is removed.
Immediate Risks of Abortion
Heavy Bleeding – Some bleeding after abortion is normal. There is, however, a risk of hemorrhage, especially if the uterine artery is torn. When this happens, a blood transfusion may be required.
Infection – Bacteria may get into the uterus from an incomplete abortion resulting in infection. A serious infection may lead to persistent fever over several days and extended hospitalization.
Incomplete Abortion – Some fetal parts may not be removed by the abortion. Bleeding and infection may occur. RU486 may fail in up to 1 out of every 20 cases.
Allergic Reaction to Drugs – An allergic reaction to anesthesia used during abortion surgery may result in convulsions, heart attack and, in extreme cases, death.
Tearing of the Cervix – The cervix may be cut or torn by abortion instruments.
Scarring of the Uterine Lining – Suction tubing, curettes, and other abortion instruments may cause permanent scarring of the uterine lining.
Perforation of the Uterus – The uterus may be punctured or torn by abortion instruments. The risk of this complication increases with the length of the pregnancy. If this occurs, major surgery, including a hysterectomy, may be required.
Damage to Internal Organs – When the uterus is punctured or torn, there is also a risk that damage will occur to nearby organs such as the bowel and bladder.
Death – In extreme cases, other physical complications from abortion including excessive bleeding, infection, organ damage from a perforated uterus, and adverse reactions to anesthesia may lead to death. This complication is very rare and occurs, on average, in less than 20 cases per year.
Other Risks of Abortion
Abortion and Breast Cancer – Medical experts are still researching and debating the linkage between abortion and breast cancer. However, a 1994 study in the Journal of the National Cancer Institute found: “Among women who had been pregnant at least once, the risk of breast cancer in those who had experienced an induced abortion was 50% higher than among other women.” Here are more important facts:
- Carrying a pregnancy to full term gives protection against breast cancer that cannot be gained if abortion is chosen.
- Abortion causes a sudden drop in estrogen levels that may make breast cells more open to cancer.
- Most studies conducted so far show a significant linkage between abortion and breast cancer.
Effect on Future Pregnancy – Scarring or other injury during an abortion may prevent or place at risk future wanted pregnancies. The risk of miscarriage is greater for women who abort their first pregnancy.
Emotional Impact – Some women experience strong negative emotions after abortion. Sometimes this occurs within days and sometimes it happens after many years. This psychological response is known as Post-Abortion Stress (PAS). Several factors that impact the likelihood of Post-Abortion Stress include: the woman’s age, the abortion circumstances, the stage of pregnancy at which the abortion occurs, and the woman’s religious beliefs.
Post-Abortion Stress Symptoms
- Suicidal Thoughts
- Anniversary Grief
- Flashbacks of Abortion
- Sexual Dysfunction
- Relationship Problems
- Eating Disorders
- Alcohol and Drug Abuse
- Psychological Reactions
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