Jessa Duggar Says She Had a D&C, How Does That Differ from Other Abortion Procedures?
Jessa Seewald/Instagram Jessa Duggar Seewald
On Saturday, Jessa Duggar Seewald revealed in a nearly 19-minute YouTube video that she suffered a heartbreaking miscarriage with her latest pregnancy.
Due to risks of complications with passing the fetus at home, the 19 Kids and Counting alum, 30, said she decided to check in to a hospital to perform a dilation and curettage procedure (D&C) abortion procedure to remove the fetus from her womb.
While there are different ways an abortion can be performed, here's how a D&C differs from other abortion procedures.
Dilation and curettage is a surgical procedure where the cervix is dilated and an instrument called a curette is used to suction or scrape the uterine lining, removing the baby from inside the uterus. D&C is a surgical abortion done in a doctor's office during the first trimester.
"First, the cervix is opened by stretching the natural opening (dilation) with a series of dilators," Dr. Katharine White, associate professor of OB-GYN at the Boston University School of Medicine and gynecologist specializing in miscarriage care, told Salon. "Then the provider (usually a doctor) removes the pregnancy tissue using suction, either [with] a hand-operated device or an electric vacuum (curettage). Traditionally, a curettage is performed by scraping the lining of the uterus, but most doctors now use a vacuum to remove pregnancy tissue, and the procedure is called a suction curettage or simply aspiration."
When a pregnancy reaches the second trimester, a surgical abortion called dilation & evacuation (D&E) is done. A D&E procedure is done similar to the D&C, however it requires more surgical instruments to remove the tissue (like forceps) because it's done later in the pregnancy.
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In addition to the two surgical abortion options, women can also opt for a medical abortion, often referred to as the "abortion pill."
"We usually use two drugs," Dr. Mary Jane Minkin, a board-certified OB/GYN at Yale University School of Medicine, told PEOPLE. "The first is mifepristone, and it basically blocks the activity of progesterone, which is the hormone that keeps the pregnancy going and maintains the placenta. Any medication that interferes with progesterone will basically antagonize the pregnancy and it causes a miscarriage."
"The other drug is misoprostol, which causes uterine contractibility," continued Minkin, a member of PEOPLE's Health Squad. "It's actually an ulcer-treating drug. In a medical abortion, it helps to contract and expel the pregnancy inside of the uterus."
The main difference between the types of abortions is timing of the procedures.
Medication abortions can only happen through 10 weeks of pregnancy, which means 8 weeks of gestational age.
"The further you go in pregnancy, there's a higher chance of failure, and you'll need a D&C" or D&E — surgical abortions, Minkin explained.