What Happens During an Abortion

11 May

How many times have you heard antis say, “if only she knew what happens during an abortion, she wouldn’t do it!” I hardly think that’s the case. Most abortion clinics review what happens in the procedure with a patient beforehand, giving her ample time to ask questions and voice her concerns. For anyone curious about what exactly it is that we say, here’s abortion procedure 101. Of course, all of this information is available in much greater detail from the National Abortion Federation. The information below is meant to serve as a vary basic overview of what happens in clinics, with the caveat that each clinic may explain and perform these procedures differently. Also note that I am not a doctor, and that this is in no way an catch all of every possible abortion procedure.

Abortion by pill, also called a medical abortion: This type of procedure is usually done no later than 9 weeks of pregnancy. A woman will go into a clinic, go through all the steps (ultrasound, counseling, labwork, payment, etc) and then meet with a doctor or nurse. She will be given a set of pills to take orally, and then be instructed to take another set of pills 24-48 hours later. This second set of pills may be something she swallows or she might have to insert them in her vagina.  The first set of pills starts the abortion by stopping the growth of the pregnancy. The second set of pills causes her uterus to contract and expel the pregnancy. This process may take anywhere form 2-9 days in which a woman may experience cramping and bleeding similar to a heavy period. She will make a follow-up appointment to return to the clinic two weeks later to make sure the abortion was successful. Of course, protocol and procedure vary from clinic to clinic. Here is more info on medical abortion, such as safety concerns, different types of medication used and how they work, and how women usually feel during an abortion by pill.

Why do women choose an abortion by pill? Lots of reasons. Your partner can be with you during the process for support. You can have the abortion in the privacy of your own home instead of at a clinic. If successful, there is no surgery involved.

First trimester abortion: First trimester usually means an abortion before 12 weeks in the pregnancy. If a woman elects to have a surgical procedure, she’ll go through the basic clinic steps (ultrasound, counseling, labwork, payment, etc) and then meet with a doctor. She’ll lay on her back as if she was at a GYN appointment, with her legs in stirrups (that awkward position women know too well). The clinician will perform a pelvic exam, and if the woman is getting any kind of sedation (whether it’s general anesthesia or conscious sedation), it will likely be administered at this time, maybe through a vein in her arm or through her mouth. The clinician will insert a speculum into her vagina to keep it open and so that s/he can see the patient’s cervix. If she is getting local anesthesia, the doctor will administer it into her cervix, which can feel like 10 seconds of a burning sensation. A canula, which is a straw-like tube, is inserted through her vagina, through her cervix, and into her uterus, and the pregnancy is removed. The pregnancy is removed by suction, which, in the first trimester, usually takes somewhere between two and seven minutes and can feel like intense period cramps. This type of abortion is approximately 99% effective. For more information about first tri procedure, here’s info from the National Abortion Federation.

Why would a woman have a surgical abortion? The surgical aspect only takes a few minutes. Depending on the state’s abortion laws, it may only take one visit to the clinic. It has a very high success rate, and you have the confidence of knowing that a doctor and her/his staff are there during the procedure to make sure everything goes smoothly.

Second trimester abortion: These procedures vary slightly more than the above two simply because a woman’s stage in pregnancy determines what the clinician has to do in order to be able to perform a safe procedure. She will go through the same clinic steps as stated above. Depending on where she is in her pregnancy, the doctor may dilate her cervix using cytotec, a pill that can be given by mouth or inserted into her vagina. The doctor may also use cervical dilators (such as laminaria or dilapan) to dilate her cervix slowly and safely. Her cervix doesn’t have to dilate the way it does when a woman gives birth, but just enough for the clinician to be able to perform the abortion.

She may have to wait a few hours for her cervix to dilate in order for the abortion to be performed in the safest way. Usually, if this is the case, she’ll wait in a room where nurses can attend to her and help her manage any pain or cramping that she feels. Often women are allowed to bring books, magazines, iPods, etc to keep them occupied. If a woman is later in her second trimester (between 18 and 24.6 weeks), she may have dilators inserted, go home, and come back to the clinic early the next morning for the procedure. Here is information about what happens during the surgical aspect of the abortion.

Why would a woman have an abortion after 12 weeks? Maye she just found out that she was pregnant. Maybe she has been trying to save up money for the abortion for the last 3 months. Maybe she has medical complications or a severe fetal abnormality. Maybe she’s been trying to jump through the hoops of anti-choice laws in her state. Maybe she’s a teen who can’t tell her parent, or who’s trying to go through judicial bypass. Maybe it took her a while to make the decision to have an abortion.

Does abortion seem so scary? I certainly don’t think so.  If a woman decides to have an abortion, medical information will not intimidate her. In fact, many clinics encourage women to gather all the information they can before the procedure so that clinic staff can address questions and concerns. We don’t hide information from women, we provide it to them, and empower them to make informed decisions about their bodies and their future.

10 Responses to “What Happens During an Abortion”

  1. Mr. Jack May 11, 2010 at 6:01 pm #

    And also remember that abortions of all kinds are some of the safest procedures you can get; I can’t remember the exact number, but it’s some ridiculously low rat of complications and / or failure.

  2. Not Guilty May 11, 2010 at 8:47 pm #

    I think all that really matters (with respect to the rate of complications) is that the rate of complications for abortions are far lower than for pregnancy and childbirth.

  3. Jaleesa May 11, 2010 at 10:13 pm #

    You mean there’s no throwing baby-dissolving acid into the uterus or crushing the baby’s head with scissors or any of that stuff???!???!? What???!!?? /sarcasm

    As long as people won’t research what an abortion actually is, the movement against it will always exist. Sadly.

  4. Aoife June 18, 2011 at 12:14 am #

    Does anyone know if saline abortions are still performed? Someone on Twitter told me the current rate in the US stands at 0.8%. Apart from saline commonly being used as a method of abortion in the seventies and eighties, I’ve found it difficult to obtain any information regarding this.

  5. Divine Oubliette August 27, 2011 at 3:49 pm #

    To Aoife –

    In 1973, limited data existed to compare
    the relative safety advantages of
    D&E vs medical abortion or hysterotomy
    in the second trimester. Data from
    the Joint Program on the Study of Abortion,
    a prospective chart review of thousands
    of abortions cosponsored by
    The
    Population Council and the CDC during
    the 1970s, suggested lower rates of hemorrhage
    and infection with D&E compared
    with other methods used at the
    time.10 Indeed, patients undergoing
    abortion through instillation of urea or
    hypertonic saline experienced twice the
    rate of major complications than patients
    undergoing D&E.
    As a result, the proportion of US abortions performed
    by D&E at 13 weeks’ gestation increased
    from 31% in 1974 to 97% in
    2004, whereas the percentage of abortions
    performed by intrauterine instillation
    at 13 weeks’ gestation decreased
    from 57-0.5% during the same time period.
    Observational data and several
    retrospective cohort trials in the 1980s
    consistently confirmed the safety advantages
    of D&E vs medical induction
    throughout much of the second trimester.
    These studies included comparison
    with older induction agents, such as
    oxytocin, prostaglandin (PG) F2, and
    urea.

    http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS000293780802214X.pdf

    2009

  6. genn October 30, 2011 at 10:24 am #

    I am about to have my first (and hopefully last) abortion, i am roughly 12-13 weeks, and i know this is the right choice, but im so afraid. I dont want to be in conscious sedation, i would rather not be awake to experience any of it. Can anyone who has gone through this offer me reassurance? It was a complete accident and something i was never planning on doing. i have always been pro-choice, and there is no doubt in my mind of my decision. i am worried that i will arrive at the clinic and back out, but i really cant. i havent told anyone about this. Im so scared somethign will go wrong during or afterwards.

  7. Steph October 30, 2011 at 3:28 pm #

    Hi Genn. It sounds like you’re making the right decision for you. Abortion can be a difficult thing to go through even if you’re 100% sure of your decision. I recommend these two hotlines, Backline or Exhale, if you need someone to talk to. A Guide to Emotional and Spiritual Resolution After an Abortion may also be helpful. This might be helpful too. If you arrive at the clinic and back out, it’s ok. You have the right to feel however you feel. The clinic will be there for you if and when you’re 100% emotionally ready for the procedure.

    Abortion is one of the safest procedures a woman can have. If you don’t feel safe at the clinic you’re at, it’s your right to find a clinic that provides quality and compassionate health care. Check out these clinic guidelines from the Abortion Care Network and this list of clinics from the National Abortion Federation for clinics that meet high medical standards.

    Genn, it sounds like you’re a good person who’s trying to make the best of a bad situation. I hope that it goes smoothly and that you find the support you need, whether from a friend or from one of those hotlines.

  8. Sophia October 30, 2011 at 3:39 pm #

    Genn,

    It’s normal to be nervous, but don’t be scared. As Steph pointed out above, this is one of the safest procedures a woman can have. When I had an abortion I chose the awake-option and it went by very quickly. The staff was amazing and very compassionate, i think it’s safe for you to expect that at the clinic you have chosen as well.

    You’re in my thoughts

    Sophia

  9. Drea December 2, 2011 at 1:00 pm #

    Hey I’m in High school and i just wanted to understand why or what reason a woman thought their best choice was to have an abortion? I’m doing an essay about abortions and i have my beliefs to keep a child no matter WHAT happen,but thats me. I really want to understand why someone would choose to abort their baby then rather raising the child? please :)

  10. Alicia December 3, 2011 at 4:36 pm #

    http://www.guttmacher.org/pubs/fb_induced_abortion.html

    This is a good place to start for facts about abortion in the US, Drea. Under the section “Who has Abortions,” There’s a list of the most commonly cited reasons for terminating. Guttmacher has a report (rather than a fact sheet) that focuses entirely on reasons women give for aborting as well, called “Reasons U.S. Women Have Abortions:Quantitative and Qualitative Perspective.” Another good web source for you could be the National Abortion Federation. WebMD also has a page on the reasons women abort. I’m Not Sorry and 45 Million Voices are both sites you can go to to read personal stories submitted by women who have had abortions, as well and A Heartbreaking Choice is a site where people who terminated due to medical issues post their stories.

    Good luck.

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