Abortion Types

Abortion Types and Procedures

There are two main types of abortion in the United States:

Medical Abortions

Medical abortions use drugs or chemicals, 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.1 It is even used beyond 10 weeks LMP, despite an increasing failure rate.2,3,4 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.5 Things to consider:6

  • Bleeding can be heavy and lasts an average of 9-16 days.
  • One woman in 100 need 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.7
  • By 10 weeks LMP, the developing baby is over one inch in length with clearly recognizable arms, legs, hands, and feet.8

Did you know that you may be able to reverse a medical abortion that has already begun? Click here to find out more.

Surgical Abortions

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/Suction9 – 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 Evacuation9,10(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 Viability9,10– 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.

Resources

1U.S. Food & Drug Administration. (2016, March 30). Mifeprex (mifepristone) Information. Retrieved April 8, 2016, from http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111323.htm.

2Raymond, E. G., Shannon, C., Weaver, M. A., & Winikoff, B. (2013). First-trimester medical abortion with mifepristone 200 mg and misoprostol: a systematic review.Contraception, 26-37. Retrieved from http://dx.doi.org/10.1016/j.contraception.2012.06.011.

3Chen, Q. (2011). Mifepristone in combination with prostaglandins for termination of 10–16 weeks’ gestation: a systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology, 159, 247–254.85.

4Chen, M. J., & Creinin, M. D. (2015). Mifepristone With Buccal Misoprostol for Medical Abortion. Obstetrics & Gynecology, 126(1), 12-21. doi:10.1097/aog.0000000000000897

5U.S. Food & Drug Administration. (2016, March 30). Mifeprex (mifepristone) Information. Retrieved April 8, 2016, from http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111323.htm.

6U.S. Food & Drug Administration. (2016, March). Mifeprex label information. Retrieved from http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf.

7The Endowment for Human Development. (2006). The Rapidly Growing Brain. Retrieved from http://www.ehd.org/movies.php?mov_id=28.

8The Endowment for Human Development. (2006). Right- and Left-Handedness. Retrieved from http://www.ehd.org/movies.php?mov_id=44.

9Creinin, M. , Danielsson, KG.(2009). Medical Abortion in Early Pregnancy. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp.114, 120-29). Chichester, UK: Wiley-Blackwell.

10Kapp, N., von Hertzen, H. (2009). Medical Methods to Induce Abortion in the Second Trimester. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp. 178-88). Chichester, UK: Wiley-Blackwell.

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