Claire Dawson
Abortion is a safe and legal procedure when performed by trained medical professionals. There are two main types of abortions: medical and surgical. A medical abortion uses prescription drugs to end a pregnancy and can be done in a clinic or at home if the patient is less than 10 weeks pregnant. A surgical abortion, on the other hand, involves a medical professional performing a procedure in a medical office, clinic, or hospital. This type of abortion is usually done after 10 weeks of pregnancy but can be done before. It involves removing the pregnancy through the vagina using suction or other surgical means.
| Characteristics | Values |
|---|---|
| Types of abortion | Medical or surgical |
| Where it's done | In a clinic, doctor's office, or hospital |
| Medical abortion | Uses a combination of drugs to end an early pregnancy |
| Mifepristone and misoprostol are the most common regimen | |
| Can be done at home if less than 10 weeks pregnant | |
| Surgical abortion | Requires a procedure by a health care provider |
| Usually done after 10 weeks of pregnancy | |
| Suction abortion uses gentle suction to empty the uterus | |
| Dilation and evacuation (D&E) is done later in pregnancy | |
| D&X is done for medical complications or serious problems with the fetus | |
| Pain management | Pain medicine, antibiotics, and sedation are provided |
| Recovery | Bleeding and cramping are common |
| Recovery time varies depending on medications, pregnancy stage, and discomfort |
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What You'll Learn
- Medical abortion: a combination of drugs is used to end an early pregnancy
- Surgical abortion: a doctor performs a procedure in a medical office, clinic, or hospital
- Suction abortion: gentle suction is used to empty the uterus in 5-10 minutes
- Dilation and curettage (D&C) abortion: a surgical procedure involving dilation of the cervix and removal of tissue from the uterus
- In-clinic abortion: an abortion performed in a clinic, involving exams, forms, and a recovery period
Medical abortion: a combination of drugs is used to end an early pregnancy
Medical abortion, also known as medication abortion, is a safe and effective way to end an early pregnancy by using a combination of drugs. This method is preferred by some as it is private, can be done at home, and does not require a procedure. The abortion pills are effective over 98% of the time, with the effectiveness depending on how far along the pregnancy is and how many doses of medicine are taken.
The most common regimen involves taking two pills—mifepristone and misoprostol. Mifepristone blocks progesterone, the hormone required for a pregnancy to grow normally, thereby stopping the growth of the pregnancy. Misoprostol is taken up to 48 hours later and causes cramping and bleeding to empty the uterus. This medicine combination can be used up to 12 weeks for an at-home abortion, although the Federal Drug Administration (FDA) has approved its use for up to 10 weeks of gestation.
The abortion pill regimen may vary depending on how far along the pregnancy is and individual preferences. For instance, misoprostol can be taken alone to have an abortion, although taking both mifepristone and misoprostol together is more effective. Additionally, taking an extra dose of misoprostol can increase the success rate.
It is important to take all medications as prescribed and follow the instructions provided by a healthcare professional. Skipping a dose or deviating from the instructions can pose health risks. Side effects and complications, while rare, may include failure to end the pregnancy, heavy bleeding, diarrhoea, digestive pain, allergic reactions, and infection.
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Surgical abortion: a doctor performs a procedure in a medical office, clinic, or hospital
Surgical abortions are typically performed in a clinic or hospital setting, and are generally considered a safe and effective way to end a pregnancy. This option may be preferred by those who want their abortion completed in a medical facility, as opposed to a medical abortion, which can often take place at home. Surgical abortions are usually carried out after 10 weeks of pregnancy, but they can be performed earlier.
Before the procedure, patients will meet with a nurse, doctor, or counsellor to discuss their options and ensure abortion is the right decision for them. An exam will be performed, and lab tests and an ultrasound may be carried out to determine how far along the pregnancy is. Patients will be given instructions on how to care for themselves post-abortion, and medication to help with cramping may be administered. In some cases, the cervix will need to be prepared by administering medication or inserting dilators to slowly stretch the cervix open.
The surgical abortion procedure itself is quick, typically lasting between 5 and 20 minutes. It involves the use of gentle suction to remove the contents of the uterus, and sometimes medical tools are used to ensure the uterus is empty. The patient will then be taken to a recovery room where they will be monitored for a period of time before being discharged. The whole appointment usually takes around 3 to 4 hours.
Surgical abortions are generally very safe, but patients should not drive immediately after the procedure due to the effects of medication. Patients can usually return to normal activities the next day, but it is recommended that they see their primary care doctor for regular evaluations.
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Suction abortion: gentle suction is used to empty the uterus in 5-10 minutes
Suction abortion, also known as vacuum aspiration, is a common type of in-clinic abortion. It involves the use of gentle suction to empty the contents of the uterus, typically lasting about 5 to 10 minutes. This procedure can be performed with varying levels of sedation, ranging from minimal to deep, depending on the patient's preferences and the clinic's practices.
Before the suction abortion, patients are typically administered Misoprostol, a medication that helps relax the cervix. This medication can sometimes cause mild cramping. Patients may also be offered antibiotics to prevent infection. The procedure room may resemble an operating room or a gynaecologist's exam room. Patients are usually asked to undress from the waist down and are provided with support for their legs.
During the procedure, a speculum is inserted into the vagina to access the cervix. The cervix may need to be dilated using thin rods called dilators or medications. A tube is then inserted through the cervix and into the uterus. Gentle suction is applied using either a handheld device or a suction machine, removing the pregnancy.
After the procedure, patients are advised to rest in a recovery area for about 30 to 60 minutes. They may experience cramping and bleeding, which can last from a few days to several weeks. Pregnancy symptoms typically subside within a week, but a positive pregnancy test may occur up to 3 weeks after the abortion due to lingering hormones. Patients are advised to take a pregnancy test 3 to 4 weeks after the procedure and contact the clinic if the test is positive or if symptoms persist.
Suction abortion is generally considered safe and effective, with a success rate of over 99%. It is typically performed up to 14 to 16 weeks after the last menstrual period. However, it is important to note that abortion care is usually provided in clinics or doctors' offices, and hospitals are only involved if a higher level of care is required.
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Dilation and curettage (D&C) abortion: a surgical procedure involving dilation of the cervix and removal of tissue from the uterus
Dilation and curettage (D&C) is a surgical procedure that involves widening the cervix and removing uterine tissue. It is used for treatment, diagnostic, and therapeutic purposes. D&C is a commonly used method for first-trimester abortions. The procedure typically lasts about 5 to 10 minutes, but the entire appointment will take longer due to preparation, examination, and recovery time.
Before the procedure, patients are placed in the dorsal lithotomy position, and a bimanual examination is performed to assess uterine size and position. A bivalve or weighted speculum is inserted into the vagina to allow for the examination of the cervix. Local anaesthesia is then administered, with 1% lidocaine being the most common choice. A tenaculum is used to stabilise the uterus and reduce the cervicouterine angle, decreasing the risk of uterine perforation.
The first step of the D&C procedure is to dilate the cervix. This can be achieved through the use of Hegar dilators or similar tools. The amount of dilation depends on the amount of tissue to be removed and the size of the instruments used. After sufficient dilation, a curette, a metal rod with a handle on one end and a loop on the other, is inserted through the dilated cervix. The curette gently scrapes the uterine lining to remove tissue. If a suction curette is used, a plastic tubular curette is introduced and connected to suction to remove all tissue.
The removed tissue is examined for completeness in the case of abortion or miscarriage treatment, or by pathology for abnormalities in the case of treating abnormal bleeding. The most common complications associated with D&C include infection, bleeding, and damage to nearby organs, including through uterine perforation. The risk of these complications increases with increasing gestational age. Therefore, it is essential to carefully consider the benefits and risks of the procedure and provide appropriate patient care and monitoring.
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In-clinic abortion: an abortion performed in a clinic, involving exams, forms, and a recovery period
An in-clinic abortion is a one-day medical procedure that ends a pregnancy. It is usually done in a doctor's office or abortion clinic, and in some cases, a hospital. In-clinic abortions are generally performed during the first trimester or early second trimester of pregnancy.
Before the abortion, patients will meet with a nurse, doctor, or health centre counsellor to discuss abortion options and determine whether abortion is the right decision for them. Patients will also undergo an exam, lab tests, and possibly an ultrasound to determine how far into the pregnancy they are. Patients will receive written instructions on how to care for themselves after the abortion and how to take any medication they are given.
On the day of the appointment, patients will need to bring a photo ID and payment. They will also need to arrange for someone to drive them home afterward, as the appointment will include sedative and pain-relief medications that can cause drowsiness.
The abortion procedure itself typically takes 5 to 10 minutes, but the overall appointment will be longer. This is because patients will need to have an exam, read and sign forms, and stay in the recovery room for up to about an hour after the abortion is done. During the procedure, patients may receive antibiotics to prevent infection and pain medication to help with cramping. A staff member will be in the room at all times to support the patient and assist the doctor or nurse.
After the abortion, patients will be taken to a recovery area until they feel better and are ready to leave. During this time, they may receive a snack and something to drink. Birth control options, such as an implant, IUD, shot, or prescription, can be discussed and administered during the appointment as well.
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Frequently asked questions
There are two main types of abortions: medical and surgical. A medical abortion uses prescription drugs to end a pregnancy in its early stages. A surgical abortion, on the other hand, involves a procedure performed by a healthcare provider in a medical office, clinic, or hospital.
A medical abortion typically involves taking two prescription pills, mifepristone and misoprostol. Mifepristone blocks progesterone, the hormone required to sustain a pregnancy, while misoprostol induces cramping and bleeding to empty the uterus.
A surgical abortion involves removing the pregnancy through the vagina using surgical instruments. The cervix is widened to allow the instruments into the uterus, and gentle suction is applied to withdraw the fetus and placenta. The procedure can be performed under local anaesthesia with intravenous sedation.
