Abortion Procedures

Different methods at different stages

There are two kinds of abortion, surgical and medical. The method used depends on how long you have been pregnant—the number of days since your last monthly period (LMP).

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The Morning-After Pill (MAP): within 72 hours of sex

The most common brand of morning-after pill sold in the United States is called Plan B®. It is reported to work within 72 hours after sex and can lower your chance of pregnancy. There are things you should consider before you take this drug. Although it is advertised as safe and effective, it is good to know all the facts before you take it. Your body and your health are important.

Mifepristone (RU-486): within 4-7 weeks after LMP

Also known as the Abortion Pill, this medical abortion is used for women who are within 30 to 49 days after their last menstrual period. This procedure usually requires three office visits. The RU-486 or mifepristone pills are given to the woman who returns two days later for a second medication called misprostol. The combination of these medications causes the uterus to expel the fetus.

Dilation and Curettage (D&C): within 6-8 weeks after LMP

This surgical abortion is done early in the pregnancy up until 8 weeks after the woman’s last menstrual period. The cervical muscle is stretched with dilators (metal rods) until the opening is wide enough to allow the abortion instruments to pass into the uterus. A hand held curette or surgical scraper is inserted into the uterus and the fetus is scraped off the uterine wall and removed.

Suction Aspiration: within 6 to 14 weeks after LMP

In this procedure, the doctor opens the cervix with a dilator (a metal rod) or laminaria (thin sticks derived from plants and inserted several hours before the procedure). The doctor inserts tubing into the uterus and connects the tubing to a suction machine. The suction pulls the fetus’ body apart and out of the uterus. One variation of this procedure is called Dilation and Curettage (D&C). In this method, the doctor may use a curette, a looped-shaped knife, to scrape the fetal parts out of the uterus.

Dilation and Evacuation (D&E): within 13 to 24 weeks after LMP

This surgical abortion is done during the second trimester of pregnancy. Because the developing fetus doubles in size between the eleventh and twelfth weeks of pregnancy, the body of the fetus is too large to be broken up by suction and will not pass through the suction tubing. In this procedure, the cervix must be opened wider than in a first trimester abortion. This is done by inserting laminaria a day or two before the abortion. After opening the cervix, the doctor pulls out the fetal parts with forceps. The fetus’ skull is crushed to ease removal.

Dilation and Extraction (D&X): from 20 weeks after LMP to full-term

Also known as Partial-birth Abortion, this procedure takes three days. During the first two days, the cervix is dilated and medication is given for cramping. On the third day, the woman receives medication to start labor. After labor begins, the abortion doctor uses ultrasound to locate the baby’s legs. Grasping a leg with forceps, the doctor delivers the baby up to the baby’s head. Next, scissors are inserted into the base of the skull to create an opening. A suction catheter is placed into the opening to remove the skull contents. The skull collapses and the baby is removed.