Abortion: What to Expect

First Trimester Abortion (between 3-10 weeks):

Most abortions done here are by suction Dilation and Curettage. D&C is usually considered a “minor operation,” however, as a pregnancy advances, a much higher level of skill is required than that which may suffice for most D&Cs.

Since the difficulty and complication rates of abortion rise as pregnancy advances, it is always best to abort as soon as possible. When a surgical abortion is performed, the surgeon cannot see into the uterus, the organ within which the surgery is being performed. Immediately prior to doing the abortion, we will do an ultrasound to determine the size and position of the uterus. (We may use the ultrasound to guide the abortion instruments within the uterus and we will do a post-operative ultrasound to ensure that the uterus appears empty.)

The following is a step by step explanation of the abortion procedure:

Either the nurse or doctor will start an IV after which the IV tubing will be used to administer Valium and midazolam for relaxation and amnesia. Most patients remember little or nothing about the procedure once the midazolam is given.
The perineum (the area between the legs where the anus and vagina are located) and vagina are then swabbed with an antiseptic solution to reduce the chance of infection.
Then the doctor will numb the mouth of the womb (the cervix) with a local anesthetic.
The cervix is dilated with a combination of long, thin tapered rods called dialators.
Finally the doctor will insert a tube into the uterus that is attached to a vacuum aspirator. The aspirator creates a gentle suction that empties the contents of the uterus.

Some things to remember...

You will be here about an hour or so, depending on multiple factors, including how soon you are awake and conscious. Very early pregnancies can be very difficult to locate, and it is extremely important that if you have an abortion prior to the fourth week of pregnancy that you return for a two-week post-operative visit and that you contact us if you develop fever, excessive bleeding or more pain than you anticipated. Very early pregnancies may not be clear on an ultrasound, therefore if you have a surgical abortion prior to 4 weeks we may miss an ectopic pregnancy (one outside the uterus) and may even miss an intrauterine pregnancy on rare occasions. Undetected ectopic pregnancies can be very dangerous unless properly treated and the above symptoms might be indicators of just such a pregnancy.

Second Trimester Abortion (between 10-18 weeks):

For pregnancies that are beyond 10 weeks, we dilate the cervix using Cytotec tablets (which are placed between the cheek and gum), or one or more small water absorbing sticks inserted into the cervix called laminaria. This is usually done one and a half hours or so before the abortion, or the day before for those pregnancies beyond 16 weeks.

The abortion procedure that follows is very similar to the first trimester procedure:

Either the nurse or doctor will start an IV after which the IV tubing will be used to administer Valium and midazolam for relaxation and amnesia. Most patients remember little or nothing about the procedure once the midazolam is given.
The perineum (the area between the legs where the anus and vagina are located) and vagina are then swabbed with an antiseptic solution to reduce the chance of infection.
Then the doctor will numb the mouth of the womb (the cervix) by giving injections of a local anesthetic.
The pregnancy is then removed with a combination of forceps and suction.

For Your Comfort...

For those who are having surgical abortions, we require that you have a friend or relative with you who can provide comfort in the operating room and drive you home afterward. You should plan to sleep and rest for several hours after the abortion, and you should avoid driving or operating dangerous equipment for 24 hours after the procedure.