Menstrual Extraction: This method is used in early pregnancy (3 to 6 weeks). A hand held manual suction device along with a sterile curette is inserted inside the cervix and the pregnancy tissue is removed.
Dilation and Curettage (D&C): This procedure is performed between 3 to 12 weeks gestation. The patient electively receives IV Sedation, Deep Sedation, Advanced IV Sedation, or General Anesthesia. The cervix is anesthetized with Lidocaine and then dilated with sterile dilators followed by insertion of a sterile curette (the size of a straw) inside the uterus and the pregnancy tissue is gently removed. The procedure is a 3 minute pain free safe abortion.
Dilation and Evacuation (D&E): This procedure is performed between 12.5 to 24 weeks gestation. This can require cervical preparation where the cervix is dilated and softened using Laminaria and prostaglandins. Laminaria is sterile seaweed that is placed generally over night that allows dilation of the cervix to occur. This reduces the incidence of cervical tears, bowel and bladder problems, and uterine perforation from occurring during the procedure. The procedure is described as in number 2 above, plus there may be special forceps used to help to manually evacuate the pregnancy tissue from the uterus. Patients that are further than 21 weeks will also undergo fetal intra-cardiac injection with Digoxin which stops the fetal heartbeat instantly on day one of the D&E procedure.
Prostaglandin or Oxytocin Inductions: This procedure is performed in patients that are 17 weeks and beyond. Both of these medications cause the uterus to contract which allows the cervix to open and within several hours there is passage of the fetal tissue.
Hysterotomy: Rarely performed but occurs where there is a small incision made on the mother’s abdomen and the uterus is opened and the fetus removed.
Medical Abortions: Early Medical abortions are generally performed between 3 to 14 weeks gestation. Late Medical abortions can occur between 15 and 24 weeks.