What Is Abortion?
Classification of Abortion Methods
Medical (Non-Surgical) Abortion
- How it works: Two tablets of medication abortion pills are applied to carry out medical abortion:
- One is mifepristone, which blocks the action of progesterone, the hormone that aids in pregnancy
- Two is misoprostol, after 24-48 hours of taking the first medication, which causes uterine cramping to flush out the pregnancy tissue from the body
- The Process: After the first consultation and ultrasound, the first pill is swallowed in a clinic. The second pill is administered at home. Bleeding and cramping will generally begin within hours, and the procedure is experienced as a heavy, crampy period.
- Effectiveness: Medical abortion is around 95-98% effective if completed within the time provided.
Surgical Abortion
Vacuum Aspiration (Suction Abortion)
- Procedure: Cervix is slowly dilated under local anaesthesia or conscious sedation. Thin bore suction cannula is inserted through the cervix into the uterus and pregnancy tissue is aspirated under strict supervision. Procedure time: 5-10 minutes.
- Features: It may be performed as a day case procedure and therefore patients can be discharged on the same operation day. It is highly effective (over 99%) and it is minimally resuscitative.
Read More: Premature Preterm Labor
Dilation and Curettage (D&C)
- Dilation and curettage (D&C) is surgical, although not so frequently performed nowadays for abortion due to the fact that vacuum aspiration has become standard.
- Procedure: Pregnancy tissue and the cervix are dilated and scraped out using a curette (spoon-shaped) from the uterine lining by scraping it. Suction can also be combined with curettage at times. It can be done under local or general anesthetic and can be used to terminate early pregnancy or complete an incomplete miscarriage.
Dilation and Evacuation (D&E)
- Procedure: Progressing deeper into the cervix, sometimes pre-treated with drugs or pre-insertion of dilators several hours or even one day before. Special medical equipment and suction remove pregnancy material. Less invasive than when performed in the first trimester, specialized personnel required, typically 10-30 minutes' duration using sedation or general anesthetic.
Induction Abortion (Late-Term Abortion)
Natural or Spontaneous Abortion (Miscarriage)
Factors to Consider Before Choosing a Method
- Gestational Age: It is of utmost importance in safe abortion options practice. Medical abortion can be done in early pregnancy alone, while surgery is more invasive.
- Medical History: Some diseases are a contraindication for certain procedures. Physicians have certain medical conditions in their minds.
- Personal Preference: Some would prefer confidentiality of medical abortion, while others would prefer quicker termination of surgical procedure.
- Availability and Access: Abortion legislation differs between jurisdictions in what procedure exists and cut-offs at what levels of gestation.
Recovery and Aftercare
- Physical Recovery: There will be cramping and bleeding after medical and surgical abortion but this will come to an end within two weeks to a few days. Patients performing surgical abortion will have lighter bleeding than patients performing medical abortion.
- Follow-Up Care: Follow-up visit ensures procedure was successful and patient is fine.
- Abortion Complications: Abortion is very safe when performed by skilled providers. Serious complication is rare (< 1%) and would be infection, incomplete abortion, or abnormal bleeding. Risks of abortion increase slightly with gestational age.
When to Seek Medical Assistance
- Heavy cramping
- Heavy bleeding (two pads saturated within one hour for two consecutive hours)
- Temperature
- Infection
Conclusion