Overview Of Abortion
An abortion is a medical procedure that ends a pregnancy. The process involves the removal of the embryo/fetus along with the placenta from the uterus. A licensed health care professional should always do this procedure. Depending on the stage of the pregnancy, it can be either surgical or medicine-based.
The decision on whether or not to get an abortion is a very personal one, and many health care professionals advise counseling to help with the process.
Commonly Associated With:
Surgical Elective Abortion, Surgical Therapeutic Abortion, Suction Curettage.
Abortion – Medical
Medical abortion entails the use of medication to end an undesired pregnancy. The medication helps with removal of the fetus and placenta from the uterus.
There are several different types of medical abortions:
- Therapeutic medical abortions due to some sort of an underlying health condition.
- Elective abortions by choice, as the person “elects” to end the pregnancy.
Do not confuse elective abortions with miscarriages, which are when pregnancies end of their own accord before the 20th week of gestation. Miscarriages are also referred to as spontaneous abortions.
Surgical abortions use surgery to terminate a pregnancy, and are not considered medical abortions.
A doctor will perform a medical abortion within 7 weeks from the first day of the person’s last period. A combination of several prescription medications help the body remove the fetus and placental tissue. A health care provider will give these medications, often after a physical exam and some questions about the patient’s medical history.
A medical abortion will use some common medications include methotrexate, mifepristone, prostaglandins, misoprostol, or a combination of these. A health care professional will prescribe the medication, which the patient takes at home.
The patient’s body will expel the pregnancy-related tissue after they take the medication. Most patients experience moderate to heavy bleeding along with cramping for several hours. A health care provider can prescribe medication for pain or nausea beforehand so they are available if needed to help with the discomfort during this process.
Medical abortion may be considered when:
- The pregnancy resulted after a traumatic event, such as incest or rape.
- The person may not want to be pregnant or have a child (elective abortion).
- The developing baby has a genetic abnormality or birth defect.
- The pregnancy is harmful to the person’s health, and saves their life (therapeutic abortion).
Risks of medical abortion include:
- Pregnancy tissue not passing completely from the body as expected, making surgery necessary
- Persistent bleeding
Before the procedure
The decision to terminate a pregnancy can be very personal. To help with the decision (if necessary) the patient can discuss their feelings with their health care provider, a counselor, or a friend/family member.
Tests that may be performed before the procedure:
- An HCG blood test to confirm the pregnancy.
- An abdominal or vaginal ultrasound to determine the exact gestational stage of the fetus and its location in the uterus.
- A pelvic exam to confirm the pregnancy and estimate the gestational stage of the fetus.
- A blood test to check the patient’s blood type. Based on the test result, they may need a specific injection to prevent health problems if they get pregnant again in the future. The injection is Rho(D) immune globulin (which includes RhoGAM and other brands).
After the procedure
Following up with a health care provider after the procedure is extremely important. This follow-up visit ensures that the process is complete, including the tissue being expelled as expected. For a very small number of people, the medication may not work. If this occurs, another dose of the medication or a surgical abortion procedure may be necessary.
Recovery most often happens within a few days, although the exact amount of time will depend on the stage of pregnancy. Expect some vaginal bleeding and mild cramping for several days after the procedure.
Ease discomfort by using a heating pad set on low, a warm bath, or a water bottle filled with warm water placed on the abdomen. The patient should rest as needed. NO vigorous physical activity for at least 5 days. Avoid sexual intercourse for 2-3 weeks. A normal menstrual period should occur in around 4-6 weeks.
Pregnancy can occur before the next menstrual cycle after an abortion, so the patient needs to be careful and still use birth control methods, particularly during the first month after the abortion.
Abortion – Surgical
A surgical abortion is a procedure that ends an undesired pregnancy by removing the fetus and placenta from the uterus through surgical means. Surgical abortion, just like medical abortion, is not the same as miscarriage.
Surgical abortion involves dilating the cervix (the opening to the uterus) and then placing a small suction tube into the uterus. Doctors use suction to remove the fetus and any other pregnancy-related materials from the uterus.
Before the procedure, a patient may have the following tests:
- An ultrasound test to check how many weeks pregnant the patient is at the time of the procedure.
- A blood test to check the patient’s blood type. Based on the test result, they may need the same injection mentioned earlier (Rho(D) immune globulin (RhoGAM and other brands).
- A urine test to confirm that they are in fact pregnant.
During the procedure:
- A doctor will place the patient in a reclining position on an exam table.
- They may receive a sedative to help with relaxation.
- The patient will place their feet in supports called stirrups. These allow the health care provider to position the patient’s legs so that they can view the vagina and cervix easily.
- The health care provider may numb the cervix to minimize pain during the procedure.
- Small rods called dilators are put into the cervix to gently stretch it open. Sometimes laminaria (sticks of seaweed intended for medical use) are placed in the cervix a day before the procedure to help dilate the cervix very slowly.
- A health care provider will insert a tube into the uterus, then use a small vacuum at the end of the tube to remove pregnancy tissue.
- A doctor will give the patient an antibiotic to reduce the risk of infection after they finish the procedure.
After the procedure, the patient will receive a medication to help the uterus contract. This helps to reduce bleeding.
Reasons a surgical abortion might be considered include:
- The patient has made the personal decision not to carry the pregnancy to term.
- The pregnancy is harmful to the person’s health (therapeutic abortion).
- The fetus has a birth defect or genetic abnormality.
- The pregnancy resulted after a traumatic event, such as rape or incest.
The decision to end a pregnancy can be very personal. To help with the decision, the patient can discuss their feelings with a health care provider, a counselor, or their friends and family. The decision should be the patient’s own, however.
Surgical abortion is a very safe procedure. It is very rare for any complications to occur, and patients should be wary of information suggesting otherwise – these sources may be biased by the person’s opinion against the procedure.
Possible risks of surgical abortion include:
- Uterine perforation (accidentally creating a hole in the uterus with one of the instruments used during the procedure)
- Not removing all of the tissue in one procedure, requiring another procedure to get the rest of it
- Damage to the cervix or uterus
- Allergic reactions to the medications or anesthesia used, such as trouble breathing
- Scarring on the inside of the uterus
- Excessive bleeding
- Infection of the fallopian tubes or uterus
After the procedure
The patient will stay in a recovery area for a few hours after the procedure. Their health care provider will tell them when they can go home. Because they may still be drowsy from the medications used during the procedure, they will need to arrange ahead of time for someone to pick them up.
The patient needs to follow the instructions given to them on how to care for themselves at home. They should make any follow-up appointments as necessary.
Complications are very rare following this procedure.
Physical recovery from the procedure usually occurs within a few days, depending on the stage of the pregnancy when it was terminated. Vaginal bleeding can occur afterwards for around 7-10 days. Cramping most often lasts for a day or two after the procedure.
The patient can get pregnant again before their next menstrual cycle, which will occur 4-6 weeks after the procedure. The patient needs to be sure to use birth control methods during this period of time. They may wish to speak to their health care provider about emergency contraception, just in case.