First Trimester Aspiration Abortion (5-14 weeks after last menstrual period (LMP)
Often promoted as the fastest abortion method, an embryo or fetus can be removed from the patient’s uterus in just 15 minutes in a first trimester (first 12 weeks) aspiration abortion.
Although the procedure itself doesn’t take much time, patients who are further into the first trimester need to be dilated several hours—and sometimes a day—ahead of time. Some patients are given a dose of misoprostol, which is used in medication abortions, to soften the cervix before the abortion.
In the procedure itself, the abortion provider introduces a plastic tube called a “cannula” through the patient’s cervix and into her uterus. Once it’s inside the cervix, the cannula uses suction to pull the embryo or fetus out of the patient’s uterus.
An early-stage aspiration abortion (5-9 weeks) can be done using a hand-held syringe. A machine-operated pump is often required for an aspiration abortion from 10-14 weeks.1
The suction also empties the placenta from the patient’s uterus, and the provider can reduce the risk of infection and complication by making sure no tissue or fetal body parts are left in the uterus.2
For the most part, first trimester aspiration abortions require only local anesthesia, although some do require general anesthesia.
Although most states require aspiration abortions to be executed by licensed physicians, new legislation in California has allowed registered nurses, midwives, and physicians assistants to begin performing the procedure.3
Some women get a first trimester aspiration abortion to finish a failed medication abortion. Some first trimester aspiration abortions fail as well, requiring a dilation and curettage procedure to complete the abortion.4
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Dilation and Evacuation (D&E)
A dilation and evacuation (D&E)1 is a method providers use to abort during the second 12 weeks (second trimester) of a pregnancy. A D&E uses a combination of vacuum aspiration, dilation and curettage (D&C), and forceps to remove the fetus from the patient’s uterus.
A similar procedure known as intact D&E is used to end pregnancies into the final 12 weeks (third trimester).
In a D&E abortion, the provider first locates the fetus using an ultrasound machine, then determines whether to use a vacuum aspiration or D&C procedure to remove the fetus from the patient’s uterus. The decision is based upon the size and level of development of the patient’s fetus.
Remember, you as the patient have the legal right to change your mind about an abortion decision at any time prior to the actual procedure. To find out more about your legal rights in this decision, chat with us here, text HELPLINE to 313131, or call us at 1-800-712-4357.
It is also your choice to decide whether or not your provider will induce fetal demise before he or she begins a D&E procedure.2 Induced fetal demise means a fetus’ heart is injected with a lethal dose of a chemical such as potassium chloride prior to the abortion procedure itself. This method is used in Labor Induction abortions.
If patient is 16 weeks or less into her pregnancy, the more common route for a provider to take is vacuum aspiration, where the fetus is removed from the patient’s uterus using suction force.
If the fetus is more than 16 weeks old—or is slightly above average in size—a provider may choose to do a D&C, where a scraping instrument is used to detach the fetus from the patient’s uterus.3
An intact D&E may require the provider to crush the skull of a fetus in order for the body to be removed from a patient’s uterus. To do this, a provider uses forceps to make an opening at the base of the skull, then uses suction to pull out the skull’s contents, causing the skull to collapse in the process.
In a D&C, the provider follows his or her initial procedure by introducing forceps through the patient’s vagina and cervix, into her uterus. Using an ultrasound to locate the fetus, the provider uses the forceps to pull the fetus out of the uterus piece-by-piece.
The doctor keeps track of what fetal parts have been removed so that none are left inside that could cause infection. Finally, a curette4 and/or suction instrument is used to remove any remaining tissue or blood clots to ensure the uterus is empty.
At least a day before the abortion itself takes place, a patient’s cervix is dilated using Misoprostol or a dilation tool called a “laminaria” to allow the provider to introduce the instruments needed to remove the fetus.
If you are looking for more information to make this decision, please chat with us here, text HELPLINE to 313131, send us a message, or call us at 1-800-712-4357. You deserve to have all the information and support you need to protect yourself during an unexpected pregnancy.
Labor Induction Abortion (Second and Third Trimester)
Although it is far less common for women to choose to abort using labor induction, some women abort with this procedure during the second or third trimesters of pregnancy.
This abortion procedure ends a pregnancy by first causing the death of a fetus by chemical injection, then birthing the fetus, which can take 10 to 24 hours in a hospital labor and delivery unit.
The first step in the process is what abortion doctors refer to as, “fetal demise.” The doctor injects a lethal dose of potassium chloride directly into the fetus’ heart with a 25-gauge needle, causing fetal death. The patient then is induced to labor and delivers the dead fetus.1
Misoprostol, which is also used to induce labor in an early medication abortion, is then given to start labor. Mifepristone, also used in an early medication abortion, is sometimes given as part of the process of a labor induction abortion.2
Mifepristone causes the amniotic sac (containing the fetus, placenta and pregnancy-related tissue) to detach from the uterus, resulting in fetal death. Misoprostol is then given to induce labor to deliver the fetus, placenta and other pregnancy-related tissue.
Over 40% of women who abort using labor induction do so because their fetus has been diagnosed with a fetal anomaly.3 If you are facing this situation, you have three legal options: abortion, parenting, or placing for adoption.