Introduction
Abortion is a procedure that is performed to terminate a pregnancy. The type of Abortion used depends on the pregnancy stage, the mother's health, and other factors. There are three main types of abortions: medical, surgical, and induced labor. Medical abortions are those abortions where the termination of pregnancy is done with the help of medications. In contrast, surgical abortions require a medical procedure to remove the fetus from the uterus. Induced labor abortions, also known as late-term abortions, are a type of abortion where a medical practitioner induces labor to deliver a fetus that is not viable or threatens the mother's health. There are different laws and regulations regarding abortion in different countries and regions. Therefore, consulting with a healthcare provider is essential to understand the options and legal implications.
Before the Abortion
Your doctor will give you instructions over the phone when you plan an abortion. You will complete papers and provide information about your medical history at the clinic. Also, you'll receive a pre-abortion workup that includes a physical exam, pregnancy test, blood test, screening for STDs, and maybe more tests. Medical professionals frequently use ultrasound to determine how far along you are in your pregnancy and to look for fetal, placental, or uterine abnormalities. They will use this information to decide which procedure is best for you.
Types Of Abortion
There are two main categories of abortion- Medication and Surgical Abortion. Here is a list of all the types of abortion procedures with their advantages, disadvantages, risks, and complications.
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Medical Abortion
A Medical Abortion, also known as Medication Abortion, involves the administration of abortion pills to terminate a pregnancy. The procedure requires an intake of two pills at appropriate intervals for complete abortion. These two pills are Misoprostol and Mifepristone. Moreover, this approach is effective for up to ten weeks following the last menstrual period.
How it works/ Procedure
Medical termination of pregnancy is a lengthy process that involves a pregnancy test, USG, and medical examination. Gynecologists recommend MTP abortion pills for non-surgical methods, which consist of two medications, Mifepristone and Misoprostol. These medications can be administered orally or by injection. To prevent infection, doctors also recommend Antibiotics.
Progesterone is a female hormone that is produced by the placenta. The hormone nourishes the embryo and helps maintain pregnancy. Mifepristone is consumed at first and hinders progesterone's effects, causing the uterine lining to rupture.
After 24-48 hours, the second medication, Misoprostol, is administered. Misoprostol increases contractions and expels the pregnancy. The patient may experience severe bleeding for a week depending upon the gestation period. The symptoms of a medically assisted pregnancy termination may also include fever, cramping, severe back pain or stomach pain, and foul-smelling vaginal discharge.
Medical abortions can lead to complications, such as failure to expel the pregnancy material, heavy bleeding, uterine infection, and life-threatening infections. These complications can be life-threatening if not addressed quickly. Doctors perform a medical examination a week later to ensure the termination of the pregnancy and rule out any complications.
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Labor Induction Abortion- Late-Term Abortion
Labor Induction Abortion is a medical abortion a doctor may advise if a pregnant person's life is at risk. This procedure is usually done after 16 weeks of pregnancy.
How it works/ Procedure
During a labor induction abortion, the woman is given medications to soften and open the cervix, which is the uterine opening. Once the cervix is ready, the healthcare provider will administer medications that cause contractions, expelling the fetus and placenta from the uterus. These medicines can be consumed by mouth. Alternatively, the doctor could inject them into the uterus or implant them in the vagina. The medications that induce labor result in the uterus emptying for 12 to 24 hours.
Due to the severe cramping during this kind of abortion, doctors also frequently give patients painkillers or local anesthetics.
Complications of labor induction abortion are rare but can include bleeding, infection, and damage to the uterus or other organs. Women who undergo this procedure will need to be monitored closely after the abortion to ensure that all pregnancy tissue has been expelled and that there are no complications.
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Surgical Abortion
A Surgical Abortion, also known as In-clinic Abortion, is an abortion that requires some surgical procedure to expel the pregnancy. Surgical Abortion is further divided into three types of abortions based on the stage of pregnancy:
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Suction Abortion/ Vacuum Aspiration- First Trimester
It is the most common surgical abortion performed to expel pregnancy up to a gestation period of 12 weeks after your last menstrual cycle. In Vaccum Aspiration, gentle suction is used to remove the pregnancy.
How it works/ Procedure
During a vacuum aspiration abortion, the woman lies on her back with her feet in stirrups. A speculum is inserted into the vagina to hold it open, and the cervix is numbed with a local anesthetic. A thin tube called a cannula is then inserted through the cervix and into the uterus. The cannula is attached to a vacuum pump, which gently suctions out the pregnancy tissue, including the embryo or fetus, placenta, and membranes.
Vacuum Aspiration Abortion usually takes 10-15 minutes to complete. The procedure is relatively pain-free, but some people experience cramping, sweating, nausea, or a combination. Recovery involves resting for up to 1 hour after treatment, taking antibiotics to prevent infection, and avoiding sex for one week. Potential complications include bleeding and infection, but the risk is low. People should immediately consult their doctor if signs of bleeding or new symptoms occur.
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Dilation and Evacuation- Second Trimester
Dilation and Evacuation is a surgical abortion that expels the pregnancy with a gestation period of 13 to 24 weeks.
How it works/ Procedure
Before the procedure, the woman is given medication to soften and dilate the cervix. D&E is typically performed under general anesthesia, meaning the woman is asleep and feels no pain during the procedure. Doctors may also use local anesthesia and sedation.
Once the woman is under anesthesia, the healthcare provider will use a series of Dilators to widen the cervix. This allows them to access the uterus. The healthcare provider will use a combination of suction and surgical instruments, such as forceps and curettes, to remove the pregnancy tissue from the uterus. This includes the fetus, placenta, and other uterine contents.
D&E is a safe and effective method of abortion. It is typically used for pregnancies beyond the first trimester, as the fetus is more extensive, and the procedure requires more preparation and specialized equipment than first-trimester abortions. Recovery from dilation and evacuation involves resting, mild pain and cramping, and some bleeding for up to 2 weeks. Potential complications include infection, heavy bleeding, and injury to the uterus, but the risk of injury is less than 1 in 1,000.
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Dilation and Extraction- Late-Term Abortion
Dilation and extraction (D&X), or partial-birth abortion, is a surgical procedure used to perform an abortion after the first and second trimesters of pregnancy (around 20-24 weeks or later). Doctors typically save this surgery when the mother's health is seriously compromised, or the fetus has a significant issue.
How it works/ Procedure
The procedure is typically performed under general anesthesia, although local anesthesia and sedation may also be used. The entire process can take several hours, although it can be shorter if the pregnancy is not as advanced.
During a D&X procedure, the cervix is dilated (widened) using a series of rods of increasing size. This allows the healthcare provider to access the uterus. The healthcare provider then partially delivers the fetus, usually feet first, until only the head remains in the uterus.
At this point, the healthcare provider punctures the base of the fetal skull with scissors or another sharp instrument and creates an opening for a suction catheter. The brain is then suctioned out, which collapses the skull and allows for the rest of the fetus to be removed from the uterus.
Complications of D&X are rare but can include bleeding, infection, and damage to the uterus or other organs. After the procedure, women may experience cramping, bleeding, and discomfort, which medications can manage.
After the Abortion
The patient will rest in a recovery area until they are ready to head home. They will likely have some cramping for a few days and light bleeding for up to 2 weeks, which can be treated with an over-the-counter or prescription painkiller like acetaminophen, ibuprofen, or codeine. Plan to rest on the day of the procedure. If you have severe pain, a fever over 100 F, or soak through more than two pads per hour, you should immediately call your provider or the emergency contact they gave you. Most providers will have you return for a follow-up appointment in 1 to 4 weeks to ensure you've physically recovered and are no longer pregnant. Jennifer Hastings, an obstetrician-gynecologist at Wushy Mommy, also states that many ”experience a range of emotions after an abortion, including relief, sadness, guilt, and grief. These emotions are normal and can vary in intensity and duration.”
Cost of the Abortion
The cost of an abortion can vary depending on several factors, including the type of procedure, the location and availability of providers, the stage of pregnancy, and whether the woman has insurance coverage that will cover the process.
The Final Thought
Abortion is a controversial topic, and the cost and availability of the procedure can vary widely depending on where a woman lives and her insurance coverage. Women must research their options and talk to their healthcare providers to make informed decisions about their reproductive health.
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