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Abortion Procedures

If you're thinking about abortion, below are some important facts to consider before making your final decision. At Alpha Omega Care Center, we're committed to providing you with medically accurate information, emotional support and HOPE while you process a stressful decision.

What is an abortion?

Webster’s dictionary defines abortion as a medical procedure used to end a pregnancy…

Two abortion terms:

  • “Spontaneous abortion” refers to a naturally occurring miscarriage.
  • “Induced abortion” refers to the voluntary process a woman chooses to end pregnancy.

Immediate Risks of Abortion...Be Good to Yourself...Get the facts.

Some side effects may occur with induced abortion. Common symptoms include:
  • abdominal pain and cramping
  • nausea
  • vomiting
  • diarrhea

Complications may occur in as many as 1 out of every 100 early abortions and in about 1 out of every 50 later term abortions.

What kind of abortion procedures are there?

Abortion procedures vary depending on the stage of the pregnancy. Abortion is considered a medical procedure that requires a licensed, medically trained professional (doctor) to perform.

It is important to get a medical diagnosis before having an abortion procedure done. Why? Because, a medical diagnosis actually helps determines if the pregnancy if its the criteria for a particular type of abortion procedure. (Natural miscarriage is common in early, undiagnosed pregnancies. An obstetrical ultrasound can help determine if your pregnancy is at risk of miscarriage and disqualified for an abortion procedure.)

A pregnancy diagnosis can be obtained through an obstetrical ultrasound and it can provide necessary information about your pregnancy.

What are First Trimester abortion options?

MEDICATION ABORTIONS: A First Trimester Medical Abortion is performed between 4-13 weeks after your last menstrual period. A Medical Abortion is also referred to as a "medication or chemical abortion" or "The Abortion Pill.”

"The Abortion Pill" - RU486 (Mifeprex/Mifepristone)

This chemical form of abortion is approved by the Food and Drug Administration (FDA) for use in women up to 49 days after their last menstrual period; however, it is commonly used “off label” up to 63 days. This procedure usually requires three office visits. On the first visit, the woman is given pills (mifepristone) that cause the death of the embryo. Two days later, and providing the abortion has not occurred, she is given a second drug (misoprostol) which causes cramping to expel the embryo. The last visit is to determine if the procedure has been completed.

Risks Associated with RU-486; Abortion Pill (Mifeprex/Mifepristone)

Heavy Bleeding...

Some vaginal bleeding after abortion is normal. However, if the cervix is torn or the uterus is punctured, there is a risk of severe bleeding known as hemorrhaging. When this happens, surgery or a blood transfusion may be required.

Infection...

A bacterial infection may occur and lead to persistent fever over several days and extended hospitalization. According to the Food and Drug Administration (FDA), “Cases of serious bacterial infection, including very rare cases of fatal septic shock, have been reported.” Mifeprex users have died as a result of total body infection. A health advisory was issued in 2005 to ward users of the risk.

Incomplete or Failed Abortion...

Some fetal parts may have remained in the uterus after the abortion. Bleeding and infection may occur. RU486 fails in 8% of uses up to 49 days, 17% at 50-56 days and 23% at 57-63 days gestation. A surgical abortion is usually done to complete a failed medical abortion.

Undiagnosed Ectopic (Tubal) Pregnancy...

Typical medical or surgical abortions will not work in the case where an ectopic pregnancy lodges outside the uterus, usually in the fallopian tube. If not diagnosed early, there can be a risk of the tube bursting, internal hemorrhage and death in some cases.

Continuation of Pregnancy...

While some abortion procedures fail and pregnancy continues, some women change their mind after beginning a chemical, medication abortion. In those situations, it is imperative to seek the help of an obstetrician immediately. In some instances, there has been success in reversing an RU-486 abortion.

Risk of Fetal Malformations...

In cases where chemical abortions fail and pregnancy continues, research associates the use of misoprostol during the first trimester with certain types of birth defects.

Risks Associated with Methotrexate:

  • Mouth Ulcers
  • Low White Blood Cell Count
  • Nausea
  • Abdominal Distress
  • Fatigue
  • Chills
  • Fever
  • Dizziness
  • Decreased Resistance to Infection
  • Anemia
In some cases:
  • Bone Marrow Suppression
  • Intestinal Toxicity
  • Liver Toxicity
  • Cancer
  • Fatal Skin Reactions

Misoprostol Only...

This form of medication abortion uses only the second drug given in the RU-486 method. It is typically inserted vaginally, requires repeated doses and has a significantly higher failure rate than the full RU-486 method. It is associated with nausea, vomiting, diarrhea, and with potential birth defects (central nervous system and limb defects) in pregnancies that continue.

Surgical Abortions

In the Second Trimester there are both Surgical and Medication methods of abortion. Surgical is the most common method used. Second trimester abortions are performed between the 13th and 24th weeks of gestation.

Vacuum Aspiration (up to 7 weeks)...

This surgical abortion is done early in the pregnancy up to 7 weeks after the woman’s last menstrual period (LMP). A long, thin tube is inserted into the uterus which is attached to a manual suction device and the embryo is suctioned out. Varying degrees of pain control are offered ranging from local anesthetic (typically) to full general anesthesia.

Suction Curettage (6-13 weeks after LMP) – Most Common...

In this procedure the cervix may need softening before the procedure. Medication and/or laminaria (thin sticks derived from plants) may be placed in the vagina the day before. On the day of the procedure, further stretching of the cervix may be required using metal dilating rods. Next, the doctor inserts plastic tubing into the uterus and applies suction by either an electric or manual vacuum device. The suction removes fetal body parts. The doctor may also use a loop-shaped tool, called a curette, to scrape any remaining fetal parts from the uterus. This procedure can be painful, so local anesthesia is typically used.

What are Second Trimester abortion options?

SECOND TRIMESTER ABORTIONS: In the Second Trimester there are both Surgical and Medication methods of abortion. Surgical is the most common method used. Second trimester abortions are performed between the 13th and 24th weeks of gestation.

Surgical: Dilation and Evacuation (D&E)...

The cervix must be opened wider than in the first trimester surgical abortion due to the size of the developing fetus. This is done by inserting laminaria (seaweed sticks) a day or two before the abortion or by giving other oral or vaginal medications to further soften the cervix. Up to about 16 weeks gestation, the procedure is identical to that of the first trimester one (mentioned above). After the cervix is stretched open and the uterine contents suctioned out, any remaining fetal parts are removed with a grasping tool (forceps). A curette (a loop-shaped tool) may also be used to scrape out any remaining tissue.

After 16 weeks, much of the procedure is done with the forceps to pull fetal parts out through the cervical opening, as suction alone will not work due to the size of the fetus. The doctor keeps track of what fetal parts have been removed so that none are left inside as this can potentially cause infection. Lastly, a curette, and/or the suction machine are used to remove any remaining tissue or blood clots, which if left behind could cause infection and bleeding.

Medication Method for 2nd Trimester...

This technique induces abortion by using medicines to cause labor and eventual delivery of the fetus and placenta. Like labor at term, this procedure typically involves 1—24 hours in a hospital’s labor and delivery unit. Digoxin or potassium chloride is injected into the amniotic fluid, umbilical cord or fetal heart prior to labor to avoid the delivery of a live fetus. The cervix is softened with the use of laminaria (seaweed sticks) and/or medications. Next, oral mifepristone and oral or vaginal misoprostol are used to induce labor. In most cases, these drugs result in the delivery of the deceased fetus and placenta. The patient may receive oral or intravenous pain medications. Occasionally, scraping of the uterus is needed to remove the placenta.

What are Third Trimester abortion options?

Late Term Methods...

This late term procedure typically takes 2-3 days and is associated with increased risk to the life and health of the mother. Because a live birth is possible, injections are given to cause fetal death. This is done in order to comply with the federal Partial-Birth Abortion Ban Act of 2003 which requires that fetal demise occur before complete removal from the mother’s body. The medications (digoxin and potassium chloride) are either injected into the amniotic fluid, the umbilical cord or directly into the fetus’ heart. The remainder of the procedure is the same as the second trimester D&E. Fetal parts are reassembled after removal from the uterus to make sure nothing is left behind to cause infection.

An alternate technique, called “Intact D&E” is also used. The goal is to remove the fetus in one piece, thus reducing the risk of leaving parts behind or causing damage to the woman’s reproductive organs. This procedure requires the cervix be opened wider; however, it is still often necessary to crush the fetus’ skull for removal as it is difficult to dilate the cervix wide enough to bring the head out intact.

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