Abortion is a procedure to end a pregnancy. It uses medicine or surgery to remove the fetus from the uterus. An abortion could also be the solution to save the woman from complications and life-threatening medical conditions.
The decision to have an abortion is a very personal and sensitive matter, and there are healthcare providers who provide counselling and information on the types of abortion procedures.
According to emdecinehealth, around 20-30 million legal abortions are performed every year, and about 10-20 million abortions are performed illegally. Illegal abortions can be unsafe and cause complications that lead to death.
Before getting acquainted with the types of abortions, these are some points to consider.
Things to Keep in Mind –
1. Confirm Your Pregnancy
You need to find out if you are pregnant or not. Home pregnancy kits can be faulty at times, so it is better to go to a clinic or hospital and get a pregnancy test.
2. Is the Pregnancy Viable?
After finding out that you are pregnant, you need to find out whether your pregnancy can continue or not. An ultrasound can help in determining if the fetus in the uterus has a heartbeat.
If the pregnancy is not viable, then you could be having a miscarriage or an ectopic pregnancy. This can lead to complications if not treated immediately.
3. Track Your Pregnancy
Sometimes, you might not know when your last menstrual was cycle or whether you have a regular one.
An ultrasound can help in finding which type of abortion procedure is suitable to terminate the pregnancy.
4. Having any STD
It would be best if you got yourself tested for STDs before undergoing the abortion procedure. The STD will not affect your future fertility, but the infection can lead to pelvic inflammatory disease.
Types of Abortions –
1. Medical Abortion
One of the common types of abortion is medical abortion.
There are two pills for abortion, the first one is mifepristone, and the second is misoprostol. These pills (mifepristone and misoprostol) have to be taken together for the abortion process to happen, reducing the side effects.
The first pill, mifepristone, helps block the progesterone and the uterus lining from breaking down. It will make the uterus contract and expel the embryo and uterine lining. After 24-48 hours, you need to take misoprostol.
1.1. Eligibility for Abortion Pill
Women who are within ten weeks into their pregnancy are eligible to take this. However, after ten weeks, surgical abortion is considered.
1.2. Non-eligibility for Abortion Pill
- Women who have ectopic pregnancy or mass on their ovaries
- Women suffering from genetic diseases
- Women who are unable to understand the following procedures
- Women who don’t have easy access to medical facilities
- Women who have molar pregnancies where the placenta develops abnormally.
- Women suffering from heart, kidney, or liver problems
1.3. Side Effects of the Abortion Pill
- Hot flashes
The abortion will start within a couple of hours to a day or two after the second medication. However, you will have light bleeding, spotting, and cramps for about a month. It is crucial to know that you can get pregnant immediately after an abortion.
Medical abortion has about a 98 % effectiveness rate. Even with this high effectiveness rate, there is still a chance for failure, following which you may have to go for a surgical abortion. The term of pregnancy, or how far along it is, impacts the effectiveness of medical abortion.
Important – Emergency contraceptives or morning-after pills have to be taken within five days of unprotected sex. If you are already pregnant, emergency contraception won’t work. You can buy the pills without a prescription at the drugstore, and there is no age bar for purchase.
2. Vacuum Aspiration
Vacuum aspiration is one of the types of abortion, which is a surgical abortion that uses suction to end a pregnancy.
Women who choose in-clinic abortion in their first trimester or 12 weeks of pregnancy go for vacuum aspiration, also known as suction abortion.
The doctor looks into your uterus and inserts a speculum into your vagina. Later he injects medication into or near your cervix to numb the pain. Then the doctor opens the cervix by using thin rods called dilators.
Then, the suction device is used, and it empties the uterus. You will have cramps that are similar to period pain.
2.1. Advantages of Vacuum Aspiration
- The procedure is quick and takes only 5-10 minutes.
- It is usually painless but varies among people. Some women may experience cramps, nausea, and sweating.
- You don’t need a general anesthetic.
2.2. Disadvantages of Vacuum Aspiration
It is only suitable for the first trimester or 12 weeks into the pregnancy, not for the second or third trimesters.
After the procedure, you are asked to walk to the recovery area, where trained medical professionals monitor you. It would help if you rested for an hour after treatment.
It is suggested to take antibiotics to avoid infections. During the recovery stage for a week after the procedure, you need to avoid sex.
The risks are usually low in the suction abortion or vacuum aspiration types of abortion. It could be only bleeding and infection. If you experience any of these, consult the doctor immediately.
3. Dilation and Evacuation (D&E)
Dilation and evacuation are the types of abortion procedures done in the second trimester of pregnancy. There are a set of things to be done, including vacuum aspiration, dilation and curettage, and use of forceps.
Before the procedure, an ultrasound is done to know the size of the uterus and the number of weeks of pregnancy.
The procedure begins as a speculum is inserted inside your vagina, and a sedative is administered to numb the area within your legs.
A cervical osmotic dilator is inserted into the cervix to dilate the cervix. This reduces the risk of having any injury.
Misoprostol is given before the surgery, and it helps in softening the cervix. A cannula is attached by tubing to a bottle and provides a gentle vacuum to remove the tissue in the uterus. Forceps are used for large pieces of tissue.
3.1. After-effects of D & E
- There might be severe bleeding.
- There may be headaches, dizziness, and muscle aches.
- There could be vomiting, and hot flushes.
- You may experience irritation, inflammation, or itching in the vaginal area.
3.2. Risks of D & E
- Heavy bleeding
- Injury to the uterus.
The procedure doesn’t require a hospital stay, and it can be done within a half-hour. Rest is important for recovery as there can be mild pain and cramping for a few days.
One of the advantages of D&E is that it is safe and effective to end a pregnancy in the second trimester.
This is one of the types of abortion procedures that requires a general anesthetic.
4. Labor Induction Abortion
Labour induction abortion, also known as second-trimester labour induction, is one of the types of abortion procedures that requires a hospital stay of around 2-3 days. It is done after 16 weeks of pregnancy.
This abortion is rarely done and is adopted when there is a congenital disability or complications in pregnancy that leave the woman’s life in danger.
You will be given medication to begin contractions, which will make your cervix dilate, after which misoprostol is administered. The side effects can be abdominal pain, nausea, vomiting, diarrhea, and fever.
Pitocin is then given to cause contractions and opening of your cervix. It is administered through a vein. The fetus is removed within around 24 hours.
Usually, abortions are rare in the third trimester, but sometimes doctors might perform even after 29 weeks of pregnancy if the woman’s and/or baby’s life is at risk. The method for trimester abortion is usually the same as that used in the second trimester.
4.1. Risks of Labor Induction Abortion
- Heavy bleeding
- Failed induction
- Injury to the cervix
After the abortion procedure is complete, the woman needs to remain in the clinic or hospital for a few hours to 1-2 days, depending on the health condition.
The obstetricians and gynecologists will inform you how long you will have to stay there before the procedure.
Every woman is different physically, mentally, and emotionally. An abortion can have a toll on your mental and physical health, and many go through post-traumatic stress disorder (PTSD) after the procedure.
It is better to see a doctor, therapist, or counsellor to ensure mental and emotional well-being after the procedure.