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 one.  Hope Pregnancy Centers can provide you with more detailed information through our Before You Decide booklet.

Morning After Pill

Within 72 hours of sexual intercourse.
Also known as “Emergency Contraception” and the most common product used is Plan B One-Step.  It is a single pill that contains a large amount of a progesterone hormone (levonorgestrel) found in some birth control pills.  It is recommended to be taken within 72 hours of sex.

How does it work? It works primarily by preventing the egg and sperm from meeting.  It may also prevent a newly formed life from implanting in the uterus and continuing to develop.  However, it cannot disrupt an implanted pregnancy.

What are the side effects?  They may include changes in your period, nausea, lower abdominal pain, tiredness, headache, and dizziness.  If your period is more than a week late, you may be pregnant.  It should not be used as a routine form of birth control because it isn’t as effective.   Women who experience severe abdominal pain after taking the drug may have an ectopic (tubal) pregnancy, and should get immediate medical help.

What else should I know?  There are no long-term studies on the safety of using this drug frequently over long periods of time.

RU-486, Mifepristone (Abortion Pill)

The abortion pill (also known as Mifeprex, mifepristone, or RU-486) uses two drugs and is approved by the Food and Drug Administration (FDA) for use in women up to 70 days (10 weeks) after their last menstrual period (LMP).  However, it is used “off-label” beyond 10 weeks.  It is the most common form of medical abortion.

What if you change your mind? Some doctors have begun using natural progestrone off-label to counteract the effects of the abortion pill.  Under a doctor’s care, some women have successfully continued their pregnancies and given birth to healthy babies aftre taking just the first pill (mifeprestone) of a medical abortion.  For more information visit abortionpillreversal.com or call 877-558-0333

When – Up to 10 weeks after LMP

How

  • Day 1: Swallow mifepristone, causing death of embryo (This is not immediate, but will occur at some point over the next 24-48 hours.)
  • Day 2 or 3: Take misoprostol, cramping expels baby
  • Day 7 to 14: Follow up with provider to check if abortion is complete.

Side Effects

  • Abdominal pain
  • Severe cramping
  • Nausea
  • Vomiting
  • Diarrhea
  • Headaches
  • Dizziness
  • Fever & chills

Risks

  • Seeing embryonic parts expelled
  • Some fail to abort
  • 1% of women need a D&C to stop hemorrhaging
  • Undiagnosed ectopic pregnancy
  • Possible life-threatening infection
  • Birth defects possible in pregnancies that continue

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.

Warning – Do not buy Mifeprex over the Internet!  The abortion pill has special safety restrictions on how it is distributed to the pubic.  Using drugs bought online can be risky.  Online purchases of the abortion pill bypass important safeguards designed to protect their health.  Because drugs purchased online are not subject to Food and Drug Administration (FDA) manufacturing controls or FDA inspection of manufacturing facilities, there is no way to be sure exactly what they contain. 

Aspiration / Suction

This surgical procedure is used throughout the first trimester of pregnancy.  Most first trimester surgical abortions are performed using this method.  Local anesthesia is typically offered to reduce pain, however sedation may also be available.

When – Up to 13 weeks LMP

How

  • Cervix sometimes softened using laminaria and/or vaginal medication the night before
  • Local anesthetic injected in cervix
  • Cervix stretched open using metal dilating rods
  • Plastic tube inserted in the uterus & connected to an electric or manual vacuum device that pulls the baby’s body apart & out
  • A curette may also be used to scrape any remaining fetal parts out of the uterus
  • Removed tissue examined to verify completeness

Risks 

  • Serious physical complications are infrequent
  • Bleeding
  • Infection
  • Incomplete abortion
  • Allergic reaction to meds
  • Organ damage

Dilation & Evacuation (D&E)

Most second trimester abortions are performed using this method.  Local anesthesia, oral or intravenous pain medications, and sedation are commonly used.  General anethesia may be used, if available.

When – Within 13 to 24 weeks after LMP

How

  • Cervix softened using laminaria and/or vaginal medication for 2 days before procedure
  • Local anesthetic & sedation given, or general anesthesia, if available
  • Cervix further stretched open with metal dilating rods
  • Forceps used to pull fetal parts out through the cervix
  • Account for all the parts of the baby including skull, spine, ribcage and four limbs
  • A curette or suction is used to remove any remaining tissue or blood clots

Risks

  • Incomplete abortion with retained tissue
  • Heavy bleeding
  • Reactions to anesthesia
  • Infection
  • Organ damage
  • Risk of complication & death increases with duration of pregnancy

Dilation & Extraction (D&X) - After Viability

This procedure typically takes 2-3 days and is associated with increased risk to the life and health of the mother.  General anesthesia is usually recommended, if available, otherwise, intravenous sedation will often be used.

When – From 24 weeks after LMP to full-term

How

  • Takes 2-3 days
  • Lethal injections may be given to stop the baby’s heart
  • Cervix softened & dilated for 3 days prior using laminaria & vaginal medication
  • General anesthesia may be used, if available, or IV sedation & local anesthetic
  • Surgical instruments used to grasp & pull fetal parts out through the open cervix
  • An alternative procedure, “Intact D&E,” attempts to remove the baby in one piece, reducing risk to the mother
  • Fetal skull usually needs to be crushed before removal.

Risks

  • Increased risk to the life & health of the mother
  • Highest risk of death with a rate of about 1 per 11,000 abortions of this type
  • Anesthesia complications
  • Heavy bleeding
  • Embolism
  • Infection
  • Organ damage