Abortion Procedure Education
Termination procedures vary depending on several factors, including how far along you are in your pregnancy. Listed below are the most common procedures and information about each:
Morning After Pill
Within 72 hours of sexual intercourse.
Also known as “Emergency Contraception,” this procedure consists of a pregnancy test and two doses of pills. The woman first must take a pregnancy test and receive a negative test result before taking the pills. If a negative test result occurs from the pregnancy test, then the woman is instructed to take the first dose of the MAP. Note: a negative result indicates that the woman is probably not pregnant from intercourse during her previous monthly cycle, but it will not show whether or not she just became pregnant (from intercourse the “night before”). She is instructed to take this first dose as soon as possible, but not more than 72 hours after intercourse. The woman takes a second dose 12 hours after the first dose. If conception already occurred within the 72 hour time frame (that is the “night before”), the life is expelled.
Note: Although not commonly considered an abortion, the MAP is designed to deter the embryo (genetically considered a unique human being) from attaching to the uterine wall if conception occurs. This embryo, unable to sustain itself, is then expelled from the uterus, causing an abortion to occur. An abortion has only occurred if conception has taken place.
RU-486, Mifepristone (Abortion Pill)
Within 4 to 10 weeks after LMP
Also known as the “Abortion Pill”, this medical abortion is used for women who are within 28 to 70 days after the first day of their last menstrual period. Mifeprex is used, together with another medication called misoprostol, to end an early pregnancy. The approved Mifeprex dosing regimen (effective March 2016) is:
On Day One: 200 mg of Mifeprex taken by mouth. Note: It is possible to reverse a medical abortion between Day One and before taking the misoprostol. More information can be found at the abortionpillreversal.com website.
24-48 hours after taking Mifeprex: 800 mcg of misoprostol taken buccally (in the cheek pouch), at a location appropriate for the patient. State laws may apply.
About seven to fourteen days after taking Mifeprex: follow-up with the healthcare provider.
Note: The Food & Drug Administration (FDA) changed their position on RU-486 in March 2016 and approved use up to 10 weeks. The FDA also reaffirmed their position for a Risk Evaluation and Mitigation Strategy (REMS) to ensure its safe use. The REMS includes: Mifeprex must be ordered, prescribed and dispensed by or under the supervision of a healthcare provider. Healthcare providers who wish to prescribe Mifeprex must complete a Prescriber Agreement Form prior to ordering and dispensing the drug. Mifeprex may only be dispensed in clinics, medical offices, and hospitals, or under the supervision of a certified healthcare provider. The Healthcare provider must obtain a signed Patient Agreement Form before dispensing Mifeprex. Healthcare providers who prescribe Mifeprex are required under FDA regulations to provide the patient with a copy of the Mefeprex Medication Guide.
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.
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 & 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 & 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.