Methods used after 12 weeks (14 weeks from the last menstrual period)
Dilation and Evacuation (D&E)
This procedure can usually be done within 24 to 48 hours.
D&E procedures accounted for 11.3% of all the abortion procedures done in Alaska in 2013.
The steps involved are:
- The cervix must be opened up (dilated) a bit wider for procedures in the second trimester. This takes a little longer. Often an absorbent material is placed in the cervix. As the material absorbs moisture, it slowly dilates the cervix. This may take several hours; sometimes overnight. This may cause some cramping.
- After the cervix is dilated, anesthesia is given. This is often a combination of local anesthesia at the cervix as well as intravenous medication to reduce cramping and promote relaxation. This procedure can also be done under general anesthesia, that is the woman will be "sleeping".
- The uterine contents of pregnancy are then removed by vacuum aspiration.
- After 14 weeks gestation, medical instruments such as forceps, curette (a scraping tool), or suction are often used to grasp and remove the uterine contents of pregnancy. It is not always possible to remove an intact fetus using this procedure.
- Abortion by labor induction is a procedure generally used after 16 weeks' gestation. It also might be done when the fetus has already died in the uterus or has a fatal defect. Labor is started early and a fetus is delivered in much the same way as a full term pregnancy and delivery occur. The process generally takes 1-2 days. Hospitalization is almost always required.
The steps involved in starting early labor are:
- The cervix is prepared by "softening" so it will open easily as labor progresses. To do this, a medicated suppository, a gel, absorbent material, or a combination of these, is placed in the vagina or cervix.
- Labor (uterine contractions) is then started by giving additional medications. This can be done in several ways:
- Vaginal suppository (most often used method)
- By intravenous administration, that is, through an "IV" into an arm vein (often used method)
- By intramuscular injection, that is, a "shot" (sometimes used method)
- By administration directly into the uterus (almost never used method; a last resort)
- The duration of labor depends on the size of the fetus and the strength of uterine contractions.
- The fetus will be pushed out of the uterus and delivered vaginally as a result of the contractions.
Making a decision about your pregnancy
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