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Early and Late Medical Abortion Procedures

woman preparing for medical abortion

In most countries, abortion procedures can – and should – only be performed in registered medical facilities. Usually, the procedure is performed on an outpatient basis, meaning the woman can return home the same day.

Preparing for Abortion
Women will always first be offered the chance to talk about their decisions. The different ways of performing an abortion will then be discussed and advice will be given in terms of which abortion procedure is the best for the current situation. Naturally, possible risks and complications will also be discussed. The patient’s medical history will be taken into full consideration and it will be determined what her blood group is and whether she has sufficient red blood cells. A test for STIs will also be performed and antibiotics prescribed if any infections are present.

A doctor will then determine how far along the pregnancy is through an ultrasound scan and an internal examination. If necessary, a cervical screening test will also be performed. Family planning advice will be given for after the abortion and a consent form will need to be signed.

Abortion Types
The first method of abortion is the early medical abortion. An early abortion can take place up to nine weeks of pregnancy. Here, over the course of 48 hours, a woman will take two different types of medicine, which will induce a miscarriage. It is very rare for women to notice any ill effects after the first pill, although some women may notice some abdominal cramping. After 48 hours, a second pill will be administered, which will induce the miscarriage through vaginal bleeding. Many women do report feelings of nausea and having diarrhea. Usually, the actual abortion can be managed at home.

The second type of abortion is the suction termination or vacuum aspiration, which happens between 7 and 15 weeks of pregnancies. Here, gentle suction removes the fetus from the womb. Local anesthetic is applied and the procedure itself only takes about five to ten minutes. Usually, some medication is given first to soften the cervix. A tube is then inserted that will remove both the fetus and any other tissue. Some bleeding is expected for around two weeks after the procedure.

Then, there is the late medical abortion, between 9 and 20 weeks of pregnancy. Usually, this method of abortion is done in the same way as early medical abortion, but with stronger doses of medication. It is more common for women to need an overnight stay in hospital with this type of abortion.

A fourth type is the surgical dilation and evacuation (D&E) also called curettage, which can be used from 15 weeks of pregnancy onwards. This procedure is performed under general anesthetic, which means an overnight stay in hospital is possible, but many women are able to return home the same day. Here, the cervix is dilated and the fetus is removed through a suction tube. The procedure takes around 20 minutes to complete.

Lastly, there is the late abortion, which is between 20 to 24 weeks. This is the most controversial of abortion methods, because most would argue that a fetus of this age is no longer a fetus but rather a baby. Two options are possible, and an overnight stay in hospital is always needed. The first way is the two stage abortion, which is a surgical procedure. Here, the fetus’ heartbeat is stopped and the cervix softened. The next day, the fetus and tissue is removed under general anesthetic. The second method is the medically induced abortion. Here, prostaglandin is injected into the womb, which essentially makes a woman go into labor. This procedure can take up to six hours and it is quite common for dilation and evacuation to be used afterwards in order to completely empty the womb.

Accidental Abortion
Some medical professionals would say a miscarriage is an accidental abortion. There are also instances of accidental abortion where they are caused by accidentally applying to wrong type of medicine to a woman who is pregnant. Lastly, accidental abortions can happen due to trauma. If you want more information read on about abortion facts.

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