Most of us are aware of the rudiments of how does abortion work; particularly that which is performed during the first trimester. However abortion later than the first trimester is far less common and we tend to know less about this.
How does abortion work in the first trimester?
During the first trimester, abortion is possible using a variety of different techniques, both surgical as well as medical. The most commonly used surgical method of abortion is suction aspiration or vacuum abortion where the embryo, placenta and other contents of the uterus are removed using manual or electrical vacuum devices.
In the very early weeks of the pregnancy a procedure that doesn’t require cervical dilation called menstrual extraction or mini-suction can be used to end a pregnancy.
And how does abortion work when it is medically induced? This form of abortion is safe and effective only until about 50 days of gestation.
Here the combined administering of methotrexate or mifepristone, followed by a prostaglandin causes the pregnancy to be aborted and the contents of the uterus to be expelled along with blood.
How does abortion work after the first trimester?
Nearly 90% of abortions take place during the first trimester however due to circumstances or due to medical reasons some do take place later. Sometimes the fetus may fail to thrive and develop in the uterus as required, or at times the pregnancy may be life threatening to the woman. There are many other circumstances where there may be the need to terminate a pregnancy later rather than sooner.
It is important to know that second trimester abortions are more complex and are longer procedures (typically two day procedures), where there is greater likelihood or complications.
Abortions are generally not safe to perform much after the half way mark of the pregnancy and may be options only until about 20 weeks gestation.
The procedures usually used are D&C (dilation and curettage), D&E (dilation and evacuation). A process called intact dilation and extraction (IDX) is also used after the 16th week of the pregnancy.
How does abortion work when D&C is used?
Due to the size of the fetus, the cervix has to be dilated to a sufficient extent to permit passage of the contents of the uterus out of the uterus. After this a curette is used to clear the inside of the uterus of any parts of the pregnancy that got left behind.
How does abortion work in other second trimester procedures?
With intact dilation and extraction (IDX), this procedure requires surgical decompression of the head of the fetus before the extraction or evacuation. This procedure also known as partial birth abortion is banned in the United States. Prostaglandin injections can also be used to induce premature labor to induce abortion.
In addition the procedure called hysterotomy abortion is sometimes used, which is similar to a cesarean section delivery and requires general anesthesia. In the surgical abortion procedure, it is usually recommended that an injection be used to first stop the fetal heartbeat to ensure that the fetus is not born alive.