Types of Abortion
The type of abortion procedure that is needed is highly dependent on how far along the pregnancy is. An ultrasound is by far the most accurate way to determine the age of the embryo.
First Trimester Abortions
RU-486, Mifepristone (The Abortion Pill)
The RU-486 is used within 30-49 days after the woman’s last menstrual period. It uses two powerful synthetic hormones with the generic names of mifepristone and misoprostol to chemically induce abortions in women less than 7 weeks pregnant. The combination of the drugs causes the fetus to expel from the uterus.
Another medication used for medical abortion is methotrexate, a drug that was originally developed as chemotherapy for cancer patients. The procedure with methotrexate is similar to the one using mifepristone, though mifepristone is the most commonly used.
In 5% to 10% of cases, a surgical abortion is necessary to complete a medical abortion.
Manual Suction Aspiration
Usually performed up until 7 weeks after the woman’s last period. The cervix is dilated with metal rods until it is large enough to allow abortion instruments to pass into the uterus. A hand held syringe is attached to tubing inserted into the uterus and the fetus is suctioned out.
Suction Curretage (D&C)
This procedure is the most common and can only be used up to 12 weeks, before the fetus’s cartilage is transformed into bone. The cervix is opened and a tube connected to a suction machine is inserted into the uterus. The suction pulls the fetus’s body apart and out of the uterus. In some cases a curette, a loop shaped knife, is used to scrape fetal parts and placenta out of the uterus. This referred to as a D&C (dilation and curettage). The D&C is also used for other medical reasons, not related to an abortion, such as in cases where the fetus has died but the mother’s body has not fully miscarried.
Second Trimester Abortion
Dilatation and Evacuation (D&E)
This procedure is similar to the D&C and is done between the 13th and 24th after the woman’s last menstrual period. Because the fetus doubles in size between the 11th and 12th week, the body is too large to be suctioned out through the tubing. Instead, after the cervix is opened, forceps are used to grasp parts of the fetus’s body, which are then torn away until the entire body of the fetus is removed from the womb. Because the skull of the fetus has often hardened to bone by this time, the skull must sometimes be compressed or crushed to ease removal.
Dilation and Extraction (D&X)
A D&X is a late-term abortion performed at 20 to 32 weeks after the woman’s last menstrual period and sometimes even later. This procedure takes 3 days. During the first 2 days, the cervix is dilated and medication is given for cramping. On the third day medication is given to induce labor. Guided by ultrasound, the doctor reaches into the uterus, grasps the leg of the fetus with forceps, and pulls the fetus into the birth canal, except for the head, which is kept just inside the womb. Scissors are inserted into the base of the skull to create an opening. A suction catheter is placed in the opening and the skull contents are removed. Once the skull collapses the fetus is removed.
Third Trimester Abortion
A D&X, as described above, is the primary method used for abortions after 28 weeks. These are also called “late-term abortions” or “partial-birth abortions,” because in most cases the fetus is big enough to survive outside the womb. In the cases of a severe fetal anomaly or if the pregnancy is threatening the mother’s life, it is more common to induce labor without intentionally ending the baby’s life.