There are two main types of abortion:
Medical abortions use drugs, instead of surgical instruments, to end a pregnancy. Early Medical Abortion – Up to 10 weeks from the last menstrual period (LMP) “The Abortion Pill” (mifepristone plus misoprostol) is the most common form of medical abortion. It was approved by the Food & Drug Administration (FDA) for use in women up to 10 weeks after LMP.11 It is even used beyond 10 weeks LMP, despite an increasing failure rate.12, 13, 14 It is done by taking a series of pills that disrupt the embryo’s attachment to the uterus, and cause uterine cramps which push the embryo out.15 Things to consider:16
- Bleeding can be heavy and lasts an average of 9-16 days.
- One woman in 100 needs a surgical scraping to stop the bleeding.
- Pregnancies sometimes fail to abort, and this risk increases as pregnancy advances.
- For pregnancies 8 weeks LMP and beyond, identifiable parts may be seen.17
- By 10 weeks LMP, the developing baby is over one inch in length with clearly recognizable arms, legs, hands, and feet.18
- Methotrexate is FDA-approved for treating certain cancers and rheumatoid arthritis, but is used off-label to treat ectopic pregnancies and to induce abortion.19,20 Given by mouth or injection, it works by stopping cell growth, resulting in the embryo’s death.
Medical Methods for Induced Abortion21,22 – 2nd and 3rd Trimester. This procedure induces abortion by using drugs to cause labor and delivery of the fetus and placenta. Drugs may be injected into the fetus or the amniotic fluid to stop the baby’s heart before starting the procedure to avoid a live birth. There is a risk of heavy bleeding, and the placenta may need to be surgically removed.
Surgical abortions are done by opening the cervix and passing instruments into the uterus to suction, grasp, pull, and scrape the pregnancy out. The exact procedure is determined by the baby’s level of growth.
Aspiration/Suction23,24 – Up to 13 weeks LMP. Most early surgical abortions are performed using this method. Local anesthesia is typically offered to reduce pain. The abortion involves opening the cervix, passing a tube inside the uterus, and attaching it to suction device which pulls the embryo out.
Dilation and Evacuation25,26 (D&E) – 13 weeks LMP and up. Most second trimester abortions are performed using this method. Local anesthesia, oral, or intravenous pain medications and sedation are commonly used. Besides the need to open the cervix much wider, the main difference between this procedure and a first trimester abortion is the use of forceps to grasp fetal parts and remove the baby in pieces. D&E is associated with a much higher risk of complications compared to a first trimester surgical abortion.
D&E After Viability27-29 – 24 weeks LMP and up. 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. Drugs may be injected into the fetus or the amniotic fluid to stop the baby’s heart before starting the procedure. The cervix is opened wide, the amniotic sac is broken, and forceps are used to dismember the fetus. The “Intact D&E” pulls the fetus out legs first, then crushes the skull in order to remove the fetus in one piece.
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