Your options for abortion care depend upon how far along the pregnancy is. Keep in mind that procedures
vary depending on your provider. Your best source of information is always your provider. The NAF Hotline 1-800-772-9100 can also answer your questions.
Within approximately the first 12-14 weeks of pregnancy (see How Far Along Am I?),
surgical abortions are done using a method called vacuum aspiration or suction curettage.
What to Expect
During a vacuum aspiration, you will lie on an examining table in a clinic or medical office, just as you would
for a routine pelvic exam. The provider inserts an instrument called a speculum into the vagina that will hold the vaginal walls apart, and then administers local
anesthesia to the cervix. The cervix is a ring of muscles at the opening to the uterus, and it is usually tightly closed. After this, the
provider
then begins to dilate, or open, the cervix with tapered rods called dilators.
After the cervix is dilated, a narrow tube attached to an aspirator device, either an electric machine or a hand
held syringe, is then inserted into the uterus and the contents of the uterus are emptied using suction. (When the hand-held syringe is used, the
procedure is sometimes called manual vacuum aspiration or MVA.) The entire procedure usually takes 5 to 15 minutes. Some women experience menstrual-type
cramping during the procedure and for up to an hour afterward.
After the Abortion
After a surgical abortion is completed, you should expect to rest in the clinic in a recovery area for a
minimum of 30 minutes before you go home. During this time, the staff will make sure your blood pressure and heart rate are stable and that you are not
having abnormal bleeding or discomfort. (If you have received certain types of anesthesia, such as conscious sedation or general anesthesia, you should
not operate a vehicle, therefore you will need to have a companion take you home. You may also have to remain in the recovery area for longer than 30 minutes.)
Following the abortion, you will receive instructions for post-operative care. This will include a
24-hour number to use if you become concerned about your condition. It is very important that you follow the after-care instructions and take any
prescriptions you have been given. Read more about aftercare.
After about 14 weeks, procedures are generally provided on an outpatient basis, using dilation and
evacuation
(D&E). Some providers may provide vacuum aspiration slightly later in pregnancy so this may still be an option. A small percentage of abortions in the second trimester are done by inducing labor with medications. This is called induction abortion. Please call the NAF
Hotline with any questions.
What to Expect
D&E is an expansion of the vacuum aspiration described above, but it requires further dilation of the
cervix. This may be achieved using sterile absorbent fiber rods called laminaria, which are inserted into the cervix, usually the day before,
or using a medication called misoprostol which may be taken orally or put in the vagina, usually a few hours before the
abortion.
To perform the abortion, the provider uses suction as in a first trimester abortion and additional instruments to
remove the pregnancy and pregnancy tissue. The procedure takes from 10 to 45 minutes. Women may experience varying degrees of discomfort.
Several anesthesia options may be available.
After the Abortion
After a D&E, you should expect to rest in the clinic in a recovery
area for approximately an hour before you go home. During this time, the staff will make sure your blood pressure and heart rate are stable and that you are not
having abnormal bleeding or discomfort. (If you have received certain types of anesthesia, such as conscious sedation or general anesthesia, you should
not operate a vehicle, therefore you will need to have a companion take you home.)
Following the abortion you will receive instructions for post-operative care. This will include a
24-hour
number to use if you become concerned about your condition, and an appointment or referral for a check up 2-4 weeks later. It is very important that
you
follow the after-care instructions and take any prescriptions you have been given. Read more about aftercare.
Abortions after 24 weeks are generally available only in order
to preserve the health and life of a woman or in cases of severe fetal anomaly. There are very few providers of later abortions and the procedures will vary. If you need information about these providers, please call the NAF Hotline.
There are several types of anesthesia used for surgical abortion. The clinic will help you determine which
type of anesthesia is right for you.
• Local anesthesia (Lidocain, Novacain):
Local sedation is usually an injection that numbs a specific or local area of your body. In this case, your
cervix
will be numbed. Local anesthesia is commonly used in surgical abortions.
• Conscious sedation (IV sedation, twilight sleep):
This is medication given through an IV needle that may cause you to feel drowsy or "out of it." Conscious sedation may
also affect short-term memory, leaving you with no memory of the procedure. Some people have side effects from conscious sedation, including mild
upset stomach or grogginess.
• Nitrous Oxide (laughing gas):
Nitrous oxide is a short-term anesthetic inhaled through a mask. It causes you to have feelings of euphoria
and drowsiness.
• General ( "knocked out" or "put under"):
General anesthesia is a controlled state of unconsciousness and requires monitoring by a qualified anesthesia
practitioner. Some people have side effects from general anesthesia, including mild upset stomach or grogginess. General anesthesia is less
commonly used in first trimester abortions than other anesthesia options.
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