Abortion Procedures.
It is important to fully understand a medical procedure before you consent to having it performed. Below we outline the different types of procedures available to you, depending on the stage of your pregnancy.
The physician and facility performing the abortion may have specific protocols that differ or may decide that terminating the embryo or fetus in your pregnancy requires a specific procedure.
Medical Abortion
Up to 10 Weeks
The medical abortion procedure is more commonly known as the “abortion pill”, or a medication abortion. There are two parts to the medical abortion. During the first visit, an ultrasound is done to determine the gestational age. A medical abortion is generally only performed until 10 weeks of pregnancy. After this is confirmed, a pill called Mifepristone is taken orally to block the hormone progesterone, which will stop the growth of the embryo or fetus by cutting off the supply of blood and nutrients.
The second abortion pill, Misoprostol, along with other medication and information will be sent home with the patient. One to two days later, the Misoprostol pills are inserted into the vagina which will cause uterine contractions (cramping) meant to expel the dead or dying embryo or fetus as well as the accompanying pregnancy tissue. This can occur and continue from several hours to days after insertion of the Misoprostol. The amount of cramping and bleeding varies from person to person. Typically, you will return to the clinic about two weeks later for a second visit to determine if the abortion is complete and no embryonic or fetal body parts remain in your body.
Surgical Abortion
Vacuum Aspiration / Dilation & Curettage – Up to 16 Weeks
The surgical abortion procedure is usually performed between weeks 5-20 of pregnancy. During pregnancy, your cervix naturally tightens to prevent a miscarriage. The doctor must stretch the cervix by dilating it, usually with metal rods or laminaria sticks (dried kelp that absorbs water and expands). Once the cervix is dilated, the doctor will insert a surgical tube called a cannula into the uterus. This tube connects to a suction machine that is 4 times more powerful than your home vacuum. The suction pulls the fetus’ body apart and out of the uterus. The doctor may then use a curette (a loop-shaped instrument) to scrape the uterus to make sure all fetal body parts and placental tissue are removed.
Dilation & Evacuation - Up to 20 Weeks
The surgical abortion procedure is usually performed between weeks 5-20 of pregnancy. During pregnancy, your cervix naturally tightens to prevent a miscarriage. The doctor must stretch the cervix by dilating it, usually with metal rods or laminaria sticks (dried kelp that absorbs water and expands). Once the cervix is dilated, the doctor will insert a surgical tube called a cannula into the uterus. This tube connects to a suction machine that is 4 times more powerful than your home vacuum. The suction pulls the fetus’ body apart and out of the uterus. The doctor may then use a curette (a loop-shaped instrument) to scrape the uterus to make sure all fetal body parts and placental tissue are removed.
References:
Risks
There are potential physical and emotional risks associated with an abortion. Information Abortion procedure complications in Canada are not well-studied, and much of the reporting is either only given voluntarily or missing because abortions are performed in different facilities e.g. clinics and hospitals (1). We do know that, as with any medical and surgical procedure, there are risks. You may experience any of these complications from an abortion procedure: infection, uterine or cervical damage, hemorrhaging, placenta previa, pelvic inflammatory disease, retained products of conception (fetal parts, placenta, umbilical cord, or amniotic sac), and future premature birth. Some women and men may experience strong negative disturbances soon after the abortion or several months/years later. It varies from person to person. For more info on risks associated with abortion, please read our FAQs.
References:
(1) Stevenson MM, Radcliffe KW. Preventing Pelvic Infection after Abortion. International Journal of STD & AIDS. 1995;6(5):305-312. doi:10.1177/095646249500600501
Barrett JM, Boehm FH, Killam AP. Induced abortion: a risk factor for placenta previa. Am J Obstet Gynecol. 1981 Dec 1;141(7):769-72. doi: 10.1016/0002-9378(81)90702-x. PMID: 7315904
Karami, M., & Jenabi, E. (2017). Placenta previa after prior abortion: a meta-analysis. Biomedical Research and Therapy, 4(07), 1441-1450. https://doi.org/10.15419/bmrat.v4i07.197
Phillippa Goodwin & Jane Ogden (2007) Women's reflections upon their past abortions: An exploration of how and why emotional reactions change over time, Psychology & Health, 22:2, 231-248, DOI: 10.1080/14768320600682384
Sajadi-Ernazarova KR, Martinez CL. Abortion Complications. [Updated 2021 May 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430793/
https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/expert-answers/abortion/faq-20058551