The following is a brief description of the different abortion procedures and is intended for informational purposes only. As with any medical procedure, there are risks and side effects.
Morning After Pill (MAP or EC): within 72 hours of sexual intercourse
Also known as “Emergency Contraception,” this procedure consists of a pregnancy test and one (One-Step) or two doses of pills. The woman must first take a pregnancy test and receive a negative test result before taking the pills. If a negative test result occurs from the pregnancy test, then the woman is instructed to take the first dose of levonorgestrel followed by a second dose 12 hours later, or an initial high dose of levonorgestrel with no second dose. NOTE: a negative result indicates that the woman is probably not pregnant from intercourse during her previous monthly cycle, but it will not show whether or not she just became pregnant from intercourse the “night before.” The MAP protocol must be started no later than 72 hours after intercourse. If conception already occurred within the 72 hour time frame, that life is typically expelled from the uterus.
Ella: as soon as possible but no later than 5 days (120 hours) after unprotected sex
A woman needs a pregnancy test to determine if she is already pregnant from a previous intercourse. If the test is positive, she should not take ella. If the pregnancy test is negative, the woman takes one ulipristal acetate pill orally no later than five dates after unprotected sex. If fertilization has already taken place, ella may prevent implantation, ending the new life.
MTX: 3-10 weeks LMP
The pregnancy should be documented by a pregnancy test and ultrasound to establish an intra-uterine pregnancy and gestational age of the fetus. The woman is given an injection of methotrexate which interferes with or even stops the growth of the embryo and placenta. At a second visit five to six days later, a Cytotec suppository is inserted to cause uterine contractions. Then the embryo/fetus is expelled from the uterus. A third visit is important so a physician can confirm that the abortion has taken place.
RU486 (Mifepristone): 4 to seven weeks since last menstrual period (LMP)
Pregnancy needs to be documented by a pregnancy test and ultrasound to establish an intra-uterine pregnancy and gestational age. RU486 should not be used more than 49 days after LMP. This medical abortion usually requires three office visits. At the first visit, the woman is given three RU486 pills to be taken orally. Two days later, the woman returns for a dose of misoprostol (a prostaglandin) to induce labor. The combination of the two drugs causes the uterus to expel the fetus. A third visit occurs approximately two weeks afterward for a physician to confirm that the abortion occurred.
Early Vacuum Aspiration: 7 weeks after LMP
This surgical abortion is done early in the pregnancy up until 7 weeks after the woman's last menstrual period. The cervical muscle is stretched with dilators (metal rods) until the opening is wide enough to allow the abortion instruments to pass into the uterus. A hand held syringe is attached to tubing that is inserted into the uterus and the fetus is suctioned out.
Suction Curettage: 6 to 14 weeks after LMP
In this procedure, the doctor opens the cervix with a dilator (a metal rod) or laminaria (thin sticks derived from plants and inserted several hours before the procedure). The doctor inserts tubing into the uterus and connects the tubing to a suction machine. The suction pulls the fetus' body apart and out of the uterus. One variation of this procedure is called Dilation and Curettage (D&C).
In this method, the doctor may use a curette, a loop-shaped knife, to scrape the fetal parts out of the uterus.
Dilation and Evacuation (D&E): within 13 to 24 weeks after LMP
This surgical abortion is done during the second trimester of pregnancy. Because the developing fetus doubles in size between the thirteenth and fourteenth weeks of pregnancy, the body of the fetus is too large to be broken up by suction and will not pass through the suction tubing. In this procedure, the cervix must be opened wider than in a first trimester abortion. This is done by inserting laminaria a day or two before the abortion. After opening the cervix, the doctor pulls out the fetal parts with forceps. The fetus' skull is crushed to ease removal.
There are other second- and third-trimester abortion options with significantly higher risks to the mother.
Immediate Risks of Abortion
Some side effects may occur with induced abortion. These include abdominal pain and cramping, nausea, vomiting, and diarrhea. In most abortions, no serious complications occur. However, complications may happen in as many as 1 out of every 100 early abortions and in about 1 out of every 50 later abortions. Such complications may include:
Some bleeding after abortion is normal. There is, however, a risk of hemorrhage, especially if the uterine artery is torn. When this happens, a blood transfusion may be required.
Bacteria may get into the uterus from an incomplete abortion resulting in infection. A serious infection may lead to persistent fever over several days and extended hospitalization.
Some fetal parts may not be removed by the abortion. Bleeding and infection may occur. RU486 may fail in up to 1 out of every 20 cases.
Allergic Reaction to Drugs
An allergic reaction to anesthesia used during abortion surgery may result in convulsions, heart attack and, in extreme cases, death.
Tearing of the Cervix
The cervix may be cut or torn by abortion instruments.
Scarring of the Uterine Lining
Suction tubing, curettes, and other abortion instruments may cause permanent scarring of the uterine lining.
Perforation of the Uterus
The uterus may be punctured or torn by abortion instruments. The risk of this complication increases with the length of the pregnancy. If this occurs, major surgery, including a hysterectomy, may be required.
Damage to Internal Organs
When the uterus is punctured or torn, there is also a risk that damage will occur to nearby organs such as the bowel and bladder.
In extreme cases, other physical complications from abortion including excessive bleeding, infection, organ damage from a perforated uterus, and adverse reactions to anesthesia may lead to death. This complication is very rare and occurs, on average, in less than 20 cases per year.
Other Risks of Abortion
Abortion and Breast Cancer
Medical experts are still researching and debating the linkage between abortion and breast cancer. However, a 1994 study in the Journal of the National Cancer Institute found: "Among women who had been pregnant at least once, the risk of breast cancer in those who had experienced an induced abortion was 50% higher than among other women." Here are more important facts:
1.Carrying a pregnancy to full term gives protection against breast cancer that cannot be gained if abortion is chosen. 2.Abortion causes a sudden drop in estrogen levels that may make breast cells more susceptible to cancer. 3.Many studies conducted so far show a significant linkage between abortion and breast cancer.
Effect on Future Pregnancy
Scarring or other injury during an abortion may prevent or place at risk future wanted pregnancies. The risk of miscarriage is greater for women who abort their first pregnancy.
Some women experience strong negative emotions after abortion. Sometimes this occurs within days and sometimes it happens after many years. This psychological response is known as Post-Abortion Stress (PAS). Several factors that impact the likelihood of Post-Abortion Stress include: the woman's age, the abortion circumstances, the stage of pregnancy at which the abortion occurs, and the woman's religious beliefs.
Post-Abortion Stress Symptoms
•Guilt •Anger •Anxiety •Depression •Suicidal Thoughts •Anniversary Grief •Flashbacks of Abortion •Sexual Dysfunction •Relationship Problems •Eating Disorders •Alcohol and Drug Abuse •Psychological Reactions
People have different understandings of God. Whatever your present beliefs may be, there is a spiritual side to abortion that deserves to be considered. Having an abortion may affect more than just your body and your mind -- it may have an impact on your relationship with God. What is God's desire for you in this situation? How does God see your unborn child? These are important questions to consider.
Explore Your Options
You have the legal right to choose the outcome of your pregnancy. But real empowerment comes when you find the resources and inner strength necessary to make your best choice. Here are some other options.
Choosing to continue your pregnancy and to parent is very challenging. But with the support of caring people, parenting classes, and other resources, many women find the help they need to make this choice.
You may decide to place your child for adoption. Each year over 50,000 women in America make this choice. This loving decision is often made by women who first thought abortion was their only way out.
Help Is Available
Facing an unexpected pregnancy can seem overwhelming. That is why knowing where to go for help is important. Talking to someone about your fears, your future plans, and your values can help you sort through your conflicting emotions. The caring staff at Lifeline of Berks County are available to help you through this difficult time.