Abortion information

Review of surgical abortion methods

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1st and 2nd Trimester Abortions:

About 90% of abortions are done in the first trimester (three months) of pregnancy. 9% are done in the second trimester. If an abortion has been decided upon, it is best to do it early in pregnancy, because the likelihood of complications is very much reduced.

Rather than risk having the need for an abortion, many women are choosing Emergency Contraception (a.k.a. the Morning After pill) very soon after unprotected intercourse in the off chance that they might otherwise become pregnant. (Unprotected intercourse refers to penile-vaginal sexual activity without birth control, or when a condom broke, or when a diaphragm became dislodged.) If taken immediately, this pill will prevent ovulation and/or conception; thus pregnancy cannot occur. Other women wait for two weeks or so and use a home pregnancy kit to determine if they are pregnant. They can then choose Non-surgical, Medically Induced Abortions including RU-486, or Manual Vacuum Aspiration if these procedures are available in their local clinic.

The alternative is to wait until she reaches the 6 week point in pregnancy and then opt for a surgical abortion. Most physicians are reluctant to perform surgical abortions before the 6th week of pregnancy because the embryo is too small. A few physician will agree to perform abortions during the 5th week of gestation.

At the Orlando Women's Center ₁ a surgical abortion typically takes on the order of three hours:

	After one of procedures described below, the woman will be observed for a while before she leaves the clinic . She will normally be given pain pills and some medication to cause the uterus to contract.
	She is cautioned to avoid certain activities ("heavy lifting, prolonged standing, running, jogging, or excessive climbing of stairs") for 3 days, and other activities for 3 weeks ("baths, swimming, intercourse, use of tampons").
	A follow up visit to the clinic is scheduled for 3 weeks after the abortion. She is checked over at that time and given a pregnancy test to confirm that she is no longer pregnant.

The selection of a surgical abortion technique depends primarily on the stage in pregnancy:

	Suction Curettage (Vacuum Aspiration): This technique is used early in pregnancy. The cervix is dilated (widened) with a series of instruments. A tube is inserted into the uterus and connected to a strong vacuum. The embryo is removed by suction.
	Dilation and Curettage (D & C): This is used later in the first trimester. It is the same technique that is used after miscarriages. The cervix is dilated. A instrument with a sharp loop at the end is inserted into the uterus. The inside wall of the uterus is scraped; the lining and the embryo is removed by suction.
	Dilation and Evacuation (D & E): This is a less commonly used method, but is the preferred option for most of the 9% of abortions that are done in the second trimester. A material made from seaweed (laminaria) is placed in the cervix in order to dilate it. Forceps are then used to remove the fetus, in pieces. The Ohio Right to Life group says that this method is preferred by abortion providers. "because, unlike other second trimester methods, they insure the baby's death." This comment does not really apply to most second trimester abortions, because the fetus is not viable (i.e. it cannot live outside the womb) until it reaches about 21 weeks gestation -- just before the end of the second trimester.

3rd Trimester Abortions:

At this stage in pregnancy, the fetus is probably viable. That is, it has a chance of surviving outside the woman's body. The supreme court decision "Roe vs. Rae" allows individual states to place very severe limitations on third trimester abortions. In addition, the medical societies in the states of the US and provinces in Canada have regulations that prohibit the termination of a pregnancy at this stage, unless it is to preserve the life of the mother. Medical associations usually place a limit of 20 or 21 week gestation. Some states and associations allow later termination if the pregnancy was induced as a result of rape or incest, or if the continued pregnancy would pose a very serious health risk to the woman. Of all the pregnancies that are terminated, fewer than 1% are done in the third trimester. One main justifications for such a late termination of pregnancy is that the fetus has a severe genetic defect. Often the defect cannot be detected until very late in pregnancy; when it is, the woman and her partner almost always choose to terminate the life of the fetus. A second justification is that the fetus has died.

Baptists for Life, Inc describe two termination methods:

	Saline or prostaglandin abortions: These totaled about 1.5% of all abortions - perhaps 25,000 in a typical year. A needle is fed through the woman's abdomen into the liquid that surrounds the fetus. A saline solution, made of salt and water, is passed through the needle. The fetus dies of salt poisoning. Labor follows, and a dead fetus is delivered. The salt burns the skin of the fetus.
	Hysterotomies: These are almost identical to a Cesarean section. An incision is made in the woman's abdomen and the fetus is removed.
	Partial Birth Abortions: These total perhaps 0.2% of all pregnancies. They are normally performed in emergency situations where a delivery is posing an extreme danger to the woman. This might be a threat to her life, or might cause her to be seriously injured, perhaps permanently disabled. ₃

There is a consensus among physicians and researchers that the fetus is unable to feel pain until the 26th week of gestation. A committee in the U.K. has recommended that if the fetus is near or passed the 26 week, that pain killers be used to prevent the fetus from pain.)

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