Historically, surgical abortion procedures were performed at 6 weeks gestation or beyond. With the latest advances in medical equipment and surgical instruments, combined with specialized technical training, the surgical procedure can now be performed as early as 3 to 4 weeks into a pregnancy. This means the surgical procedure can be performed before the first menstrual period is missed. Patients will have an ultrasound exam performed prior to the procedure and often the entire surgery is performed under ultrasound guidance. This confirms that the pregnancy is completely removed during surgery. Another name for the early abortion procedure is “Menstrual Extraction”. In countries throughout the world, lay women have routinely performed this procedure on each other. It has been safely practiced for over 50 years internationally. This early abortion procedure was introduced in the United States in the mid 1970’s and the surgical techniques have further advanced in their effectiveness and safety throughout the 80’s and 90’s.
Early Surgical Abortion or Menstrual Extraction Procedure: 3 to 6 Weeks from the Last Menstrual Period
Misoprostol is a prostaglandin which is known to cause the uterus (womb) to contract. It can be given orally or vaginally to prime (open and soften) the cervix. This provides for easier opening of the cervix (lower portion of the womb) when the surgery begins, allowing for a significant decrease in cervical lacerations or tears, less cramping or bleeding, and a lower incidence of tissue remaining inside the uterus after completion of surgery.
Upon completion of cervical preparation, patients are taken to an exam room and placed in the same position as with having a Pap Smear. A medical staff member is present in the exam room at all times. The Physician places a speculum (the same type used for your Pap Smear) inside the vagina and then numbs the cervix (lower part of the uterus) with a local anesthetic. Most women have minimal to no discomfort with this portion of the procedure. The cervix is then dilated (stretched open) with dilators if indicated. Quite often it is not necessary to dilate the cervix due to the cervical priming technique described above. Mild cramping may occur with dilating the cervix which can last a few seconds. A sterile curette (thin plastic tube) is placed through the cervix and connected to an aspirator. Generally, the discomfort associated with the early surgical procedure is less because only minimal dilation (opening) of the cervix is required. This part of the procedure lasts about 30 seconds. All instruments are then removed. The surgical procedure takes 3 to 8 minutes to perform.
The patient is dressed and escorted to the recovery room. After 10 to 15 minutes in recovery and for patients who did not receive IV Sedation or have any post-procedure problems, they are discharged home. Patients may return to their normal activities a few hours following the procedure. Patients may have sex the next day if they wish to do so.
Early surgical abortions have a very low complication rate. All surgeries carry certain risks. Complications occur in far less than 1% of early abortion procedures. They include retained gestational tissue, heavy bleeding, passage of large blood clots, severe cramps, laceration of the cervix, cervical tears, uterine perforation (creation of a hole in uterus), bowel or bladder injury, elevated temperature, pelvic infection, and rarely – maternal death. We have experienced no maternal deaths in any of our medical facilities. No hospitalizations have occurred due to complications from this procedure. After extensive evaluation, the majority of randomized medical studies show no evidence of an increased incidence of breast cancer among women who choose to undergo an abortion procedure. Nor is there a higher rate of mental health problems compared to women who carry an unwanted pregnancy to term and keep their child.
The after care of the early surgical abortion is similar to that of our regular surgical procedures which consist of monitoring for elevated temperature (>100.4), bleeding greater than 2 pads an hour for more than two hours, development of moderate to severe lower abdominal pain, dizziness, weakness, diarrhea, vomiting, or inability to walk. These symptoms occur less than 1% of the time. The majority of women are able to return to work the same day and may engage in sexual activity the next day if they choose.
The cost of the early surgical abortion is the same as that of our regular surgical fee. Patients may be eligible for a reduction of $198.00 of the regular price. Please contact the office to inquire.
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