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Abortion Procedures What are the most common methods of Abortion? Abortion Procedures What Are the Most Common Methods of Abortion? Some of the most common methods of Abortion are the following:
How is a chemical Abortion, non-surgical abortion, RU 486, Abortion Pill, Abortion by pill, instrument-free (Medical Abortion) performed? A chemical abortion is also referred to as an instrument-free, non-surgical abortion, RU 486, Abortion Pill, Abortion by pill, or Medical” abortion because surgical instruments are not used. Medical Abortions (Abortion Pill) are performed over a course of one to three weeks requiring weekly visits. During the first visit the physician will perform a sonogram to determine the length of the pregnancy. The patient is given an oral form of Methotrexate, RU486, or Tamoxifen, or an intramuscular injection of Methotrexate which will stop further development of the pregnancy in the majority of cases. What is the most common abortion medication used in the United States? Up to how many weeks can the Abortion Pill (Medical Abortion, RU 486) be performed? Most Physicians in the U.S. do not go past 9 weeks from the last menstrual period. The European literature shows that the Abortion Pill procedure can be safely performed up to 13 to 14 weeks on an outpatient basis. There is a higher incidence of failure. There are Physicians in our facility that may allow a patient that meets certain criteria to do the Abortion Pill procedure up to 10 to 11 weeks. Are the early term abortion medications safe to use? The medications used to terminate pregnancies in early term have been studied since the early 1980’s which means that they have been used for this indication for close to thirty years. There is less than a 1 percent chance of complications that occur. The most common is failure of the medications to work and the pregnancy continues to grow. Rarely does such heavy bleeding occur that a blood transfusion is required. Other complications include the possibility of retained tissue with possible uterine infection. There have been a few reported deaths related to a rare infection but there is no direct evidence that the deaths were directly caused by the medications that were taken. How will I know if I am having some type of complication with the medical abortion (abortion pill) procedure? The complications that are seen with the abortion pill procedure are the following which occur less than 1%:
What is the chance of the Medical Abortion Procedure (RU 486) working if it fails the first time? The abortion pill procedure has a 94 to 99 percent success rate. No one knows why the procedure is not 100 percent effective. When patients return and either have an incomplete abortion or a failed abortion, they are offered more Misoprostol tablets to take as our experience shows that there is high percentage of success with the second dosage. If the patient decides that she does not want to take the Misoprostol tablets, then we proceed with the surgical abortion. How will I know the abortion is complete after the medical abortion (abortion pill) procedure? You will not know 100 percent until you return for a sonogram to see that there is no presence of fetal or gestational tissue. If the Medication Abortion (Abortion Pill) Procedure does not work, can patients decide not to go through the abortion procedure? Methotrexate and Misoprostol are known to be fetotoxic. In essence, they can cause severe fetal abnormalities and so therefore once these medications are used, one must continue with the abortion procedure. There have not been any fetal toxic problems reported with RU 486 in the literature. It is known for patients less than 6 weeks, there is approximately a 40 percent chance of an abortion occurring without the use of Misoprostol. Is there another abortion medication pill that I can take besides RU 486? Yes. There are actually two pills that have been studied extensively in the medical literature. The first is Methotrexate and the second is Tamoxifen. Methotrexate has been used extensively since the late 1980’s in combination with Misoprostol to terminate pregnancies between 3 and 9 weeks gestation. This combination is 90 to 94 percent effective in causing termination of pregnancy. Tamoxifen has been used since the early 90’s to terminate pregnancies from 3 to 9 weeks gestation. Its success rate is equivalent to Methotrexate. Both medications are very safe and efficient in terminating early pregnancies and can be used as a substitute or if the patient is allergic to RU 486. Can Abortion by Aspirin Be Done? Aspirin is a anti-inflammatory medication that can cause thinning of blood such that it helps to reduce chance of blood clotting. There are no studies that show that taking aspirin will cause an abortion in early pregnancy. As a matter of fact anti-inflammatory medications have been used to help stop premature labor, and they are also used in early pregnancy along with Heparin to prevent miscarriages in patients who have had multiple losses of pregnancies and are found to have connective tissue disorders. Taking high doses of aspirin can lead to gastrointestinal bleeding and maternal death. Where Can I Get the Abortion Pill? There are some people that order their Abortion Pills online from facilities or pharmacies outside of the United States. The problem with this is that patients are getting medications that are potentially unregulated and may or may not contain the medication, or the medication in the appropriate dosages. Without being under the care of a Physician and taking the Abortion Pills can be very dangerous in that if a serious complication occurs and one is not under the care of a Doctor, the patient could end of having a dire emergency which could be a matter of life or death for the patient. It is always advised to get the Abortion Pill from a licensed Medical Physician who is trained to perform surgical termination of pregnancies in case there is a medical problem. In addition; a sonogram should be performed on all patients to assure the exact gestation of pregnancy. The complication rate for medical abortion increases for pregnancies greater than 13 to 15 weeks gestation. There are many women where their pregnancy does not match their last menstrual period which can lead to very serious problems if the patient is not under the supervision of an experienced Physician. Would you please describe the Abortion Process that occurs in your facilities? Because it may be comforting to discuss the procedure prior to coming in for your appointment, we encourage you to call us with any questions. You are also welcome to visit our office ahead of time to become familiar with our location and staff. Your appointment will include the following:
What happens during an abortion? The patient is taken to an exam room where she is placed on the exam table and gets into the same position as if a Pelvic Exam and Pap Smear are going to be performed. If she has elected to have IV Sedation, Advanced IV Sedation, Deep IV Sedation or General Anesthesia, that process is started. After the patient is noted to be comfortable, the remainder of the procedure occurs. The cervix is anesthetized with Lidocaine, which is similar to Novocaine. The cervix is then dilated to allow for access to the uterus. A curette (hollow plastic tube comparable to a drinking straw) is inserted into the uterus, and the contents are then removed by manual or machine suction aspiration. After a certain number of weeks pregnant, your cervix will need to be dilated (opened) with Laminaria (sterile seaweed), or Cytotec (medication that causes the uterus to contract) which causes the cervix to open. You may be asked to go home or to a hotel to return the following day for the actual surgery. Sometimes it may take 3 days in order for the cervix to dilate adequately before surgery is performed by removing or evacuating the pregnancy tissue with oval forceps suction aspiration. How is a surgical abortion performed? The cervix is anesthetized with Lidocaine, which is similar to Novocaine. The cervix is then dilated to allow for access to the uterus. A hollow plastic tube comparable to a drinking straw is inserted into the uterus, and the contents are then removed by manual or machine suction aspiration. After a certain number of weeks pregnant, your cervix will need to be dilated (opened) with Laminaria (sterile seaweed), or Cytotec (medication that causes the uterus to contract) which causes the cervix to open. You may be asked to go home or to a hotel to return the following day for the actual surgery. Sometimes it may take 3 days in order for the cervix to dilate adequately before surgery is performed. How effective is the surgical abortion? In over 99 percent of cases, a surgical abortion is completely effective. A small percent of patients may experience pain, bleeding, fever, or retained tissue (pregnancy tissue remaining inside the uterus). This will require the surgical procedure to be repeated (re-aspiration). It is rare for a perforation of the uterus, bowel damage, bladder damage, or maternal death to occur. How will I feel after the surgical abortion? It is during the first 10 to 15 minutes after surgery that patients have the most discomfort. This is caused by the uterus contracting and is comparable to menstrual cramps. There are a small percentage of patients that have cramps after leaving the office which is usually relieved by the post-operative pain medications provided. Tylenol, Advil and other over the counter anti-inflammatory medications can be used as well. For patients less than six weeks, you may have intercourse the following day after your procedure. For patients more than six weeks, they may not use tampons, have intercourse, or douche for 2 to 3 weeks after the abortion procedure. How long does the procedure take? Depending on the length of your pregnancy the actual procedure may take from only 3 to 7 minutes. How will I know if the abortion procedure was successful? Your pregnancy symptoms (nausea, vomiting, and decrease or increase appetite) will go away almost immediately. It may take a week or two for the breast tenderness and sensitivity to completely subside. If there is no bleeding greater than 2 pads an hour, a temperature greater than 100.4, or severe abdominal pain, then you can be fairly certain that the procedure was successful. If there are any questions or problems, you can always call the office at anytime. Which procedure is better, the surgical or the chemical? This is an individual decision. Some women feel the surgical procedure is better because it is not drawn out over the course of a two to three week period. Other women feel the medical abortion procedure may be more advantageous because it can be done earlier in pregnancy, they do not want to undergo surgery or have pelvic exams, and they feel that the abortion pill offers more privacy since the procedure is generally completed at home. The insertion of the Misoprostol is taken with the patient’s companion, friend, or family member around which can be very important for the patient. Each woman may decide which procedure is best suited for her individual needs. Which procedure is less painful? The level of discomfort varies from person to person because every individual has a different degree of pain tolerance. Most women feel that because the chemical procedure is less invasive, it is therefore less painful. If you are found to be less than 6 weeks gestation, the early surgical procedure has the advantage of immediate completion. You are able to return to your normal activities and have sex the following day.
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