- Suction aspiration abortions are done in the first trimester of pregnancy, generally between 6 and 12 weeks. The doctor uses cone-shaped tools to open the cervix, and then inserts a vacuum attached to a thin tube to remove the fetus and placenta. This procedure takes about 15 minutes to complete.
- Dilation and curettage is the procedure used to end pregnancies between 12 and 15 weeks of gestation. The cervix is opened as in a suction aspiration procedure, but because the fetus and placenta are a little larger, the doctor uses a long, loop-shaped knife, called curette, to scrape the fetus and placenta from the uterus before removing them with the vacuum tube.
- According to the American Pregnancy Association, abortions after 15 weeks of gestation are usually performed in hospitals because of the increased risk to the woman. Between 15 and 21 weeks of gestation, a dilation and evacuation procedure may be performed. A dilation and evacuation procedure is similar to a dilatation and curettage, but the doctor inserts a dilator inside the cervix 24 hours before the surgery, to start dilation. The doctor uses a knife and vacuum to separate the fetus and placenta from the uterus and forceps may be used as well to remove larger pieces.
- Another late-term pregnancy termination is called an induction abortion, where medication is used to induce contractions and the uterus is filled with saline or potassium chloride. This type of abortion is usually only performed if either the mother or baby is seriously ill because the fetus dies in utero and must be delivered vaginally.
- After 21 weeks of pregnancy, a dilation and extraction is usually performed. Three days before the procedure, the doctor inserts medicated sticks into the cervix to dilate it and induce labor. After the waters have broken, the baby is partially delivered with forceps. The doctor makes an incision in the skull and removes the cerebral material with a suction catheter in order to let the head pass more easily through the birth canal. Dilatation and extraction abortions are traumatic for the mother, so the American Medical Association recommends they should only be performed if the baby has a life-threatening birth defect.
- In most abortions, local anesthetics are used to reduce pain in the cervix and uterus. Nitrous oxide or general anesthesia might also be used to make the woman more comfortable, and she is advised to fast for at least six hours prior to the procedure. Cramping, sweating, nausea, and fatigue are all common side effects after an abortion. Some bleeding is also normal, but if there is heavy bleeding, clotting, severe pain or fever, the American Pregnancy Association advises patients to seek immediate medical attention. In rare cases, the uterus or cervix can be damaged or perforated, and infection is possible from bacteria entering the vagina or if parts of the fetus or placenta were not completely removed.
