Surgical abortion procedures
The type of surgical abortion
procedure used depends on the stage of the woman's pregnancy. Before seeking a
surgical abortion procedure, you must undergo an ultrasound to determine if the
pregnancy is viable (uterine, ectopic pregnancy) and for the exact date of
pregnancy.
You can always contact an
alternative abortion specialist to discuss procedures.
Aspiration
Aspiration is a surgical
abortion procedure performed during the first 6 to 16 weeks of pregnancy. It is
also called vacuum aspiration, aspiration curettage, or vacuum aspiration. Your
abortion specialist will give you pain medication and possibly a sedative. You
will lie on your back with your feet in stirrups and a speculum will be
inserted into your vagina.
A local anesthetic is applied
to the cervix to make it numb. Then, using a tenaculum (a surgical instrument
with long handles and a clamp at the end), the cervix is held in place so
that the cervix is dilated with absorbent rods of various sizes.
The rods may also be placed a
few days before the procedure. When the cervix becomes wide enough, a cannula
is inserted into the uterus, which is a long plastic tube connected to a
suction device, to suck the fetus and placenta.
The procedure usually takes
10-15 minutes, but recovery may require a hospital stay of several hours. Your
doctor will also prescribe antibiotics for you to prevent infection.
What are the side effects and risks of vacuum aspiration?
Common side effects of the
procedure include cramps, nausea, sweating, and feeling weak. Less common side
effects include severe or prolonged bleeding, blood clots, cervical damage, and
uterine perforation.
Infection due to leftover
tissue or bacteria entering the uterus can cause fever, pain, tenderness in the
abdomen, and possibly scar tissue. Call your doctor right away if your side
effects persist or worsen.
Dilation and evacuation
Dilation and evacuation is a
surgical abortion procedure performed after 16 weeks of pregnancy. In most
cases, 24 hours before the actual procedure, your abortion provider will insert
a synthetic kelp or dilator into your cervix. When the procedure begins the
next day, the abortion provider will use a brace to hold the cervix and uterus
in place, and increasing size tapered rods are used to continue the dilatation
process.
Pain medications will be
applied to the cervix. An injection may be given prior to the procedure to
ensure that fetal death has occurred. A cannula (long tube) will then be
inserted to begin removing the mucosa.
The mucosa is then scraped off
using a curette (surgical instrument shaped like a spatula or spoon) to remove
any debris. If necessary, forceps can be used to remove larger fragments. The
last step is usually a final push to make sure the content is completely removed.
The procedure usually takes 15
to 30 minutes. Usually the fetal remains are examined to make sure everything
is removed and the abortion is complete. An antibiotic will be given to help
prevent infection.
What are the side effects and risks of dilation and evacuation?
Common side effects include
nausea, bleeding, and cramping, which can last up to two weeks after the
procedure.
The following additional
risks, although rare, are associated with dilation and evacuation: damage to
the uterine lining or cervix, uterine perforation, infection, and blood clots.
Seek immediate medical attention if your symptoms persist or worsen.
Expansion and extraction
The expansion and extraction
procedure is used after 21 weeks of pregnancy.
Two days before the procedure,
Laminaria is injected vaginally to dilate the cervix. Your water should stop on
the third day and you should return to the clinic. The fetus is turned over,
and with the help of forceps, the legs, shoulders and arms are grasped and
pulled through the birth canal.
A small incision is made at
the base of the skull through which a suction catheter is passed. The catheter
removes brain material before the skull collapses. The fetus is then completely
removed.
What are the side effects and risks associated with dilation and extraction?
Side effects are the same as dilation and evacuation. However, there is an increased risk of emotional problems due to the reality of more advanced fetal development. Seek immediate medical attention if your symptoms persist or worsen.