Types of Abortion Throughout Pregnancy
According to the Guttmacher Institute, which is a leading organization that researches American reproductive health policy and tracks statistics, about 25% of American people with female reproductive systems will have an abortion before age 45. A majority terminate their pregnancy in the first trimester, although second trimester abortions are also legal in some states. Third trimester abortions are only performed if the mother's life is in jeopardy or the baby has a serious medical condition. Here's what you need to know about getting an abortion in every stage of pregnancy.
First Trimester Abortions
Two-thirds of abortions happen during the first eight weeks of gestation, according to the Guttmacher Institute. About 89% take place in the first trimester, which extends to the end of week 12. At this stage of pregnancy, the options are abortion pills or vacuum aspiration.
Abortion Pills
A patient can take abortion pills, also known as a medication abortion, within 10 weeks of their missed menstrual period. "Two types of medications are used," says Rebecca Taub, M.D., a fellow with Physicians for Reproductive Health and an Ob-Gyn in Washington. First you'll take 200 mg of mifeprex (mifepristone) to thin the lining of the uterus. Within 72 hours, you'll follow up with 800 mcg of misoprostol to promote uterine contractions, which expel the embryo to terminate the pregnancy. Dr. Taub says patients often take mifeprex in the clinic and misoprostol at home.
Medication abortions usually work within hours or days, although you'll need a follow-up appointment to make sure everything went smoothly (an incomplete abortion can lead to infection). These types of first trimester abortions are about 95% effective. Side effects include heavy bleeding with large clots, cramping, nausea, diarrhea, mild fever, and fatigue. In rare cases, abortion pills may cause allergic reaction, heavy bleeding, or uterine blood clots.
Vacuum Aspiration
As an in-clinic surgical procedure, vacuum aspiration (also called suction abortion) can be completed until the 16th week of pregnancy. Doctors use gentle suction to remove the fetus from the uterus. The procedure isn't painful and lasts about five minutes. You can get vacuum aspiration at a clinic, health center, or hospital.
Vacuum aspiration is more than 99% effective, according to Planned Parenthood, and incomplete abortions need to be followed up with pills or another procedure. "It's normal to have bleeding and cramping for several days to weeks after an aspiration abortion. The cramping usually feels like period cramps and resolves quickly," says Dr. Taub. Other side effects include nausea, fatigue, and dizziness. You might want to take a few days off of work to recover.
Second Trimester Abortions
In the early second trimester (weeks 13-16), many people opt for vacuum aspiration. However, another in-clinic surgical procedure is available after the 14th week of pregnancy: dilation and evacuation (D&E).
Dilation and Evacuation (D&E)
A person can receive a D&E later than medication abortion and vacuum aspiration—usually up to 24 weeks of pregnancy. Most of the time, they'll undergo D&E if they couldn't decide whether to have an abortion in the first trimester, if the fetus has a health condition, or if they didn't have money for an earlier abortion.
To start the D&E procedure, doctors will dilate your cervix to reduce the risk of injury. One day later, the fetus and placenta will be removed with suction and instruments—specifically forceps, a tube, and a scraping tool called a curette. You'll be put under mild anesthesia. "This abortion can be safely performed in a clinic, rather than an operating room, and involves no incisions and minimal anesthesia," says Dr. Taub. You may also take misoprostol to prepare the cervix for the procedure, as well as antibiotics to prevent infection.
A dilation and evacuation can usually be completed in under 30 minutes, and you're able to head home shortly afterwards. Like vacuum aspiration, D&E is more than 99% effective as a second-trimester abortion method. Common side effects include bleeding, cramping, and nausea. Given the invasiveness of D&E, recovery may take longer than with other abortion methods, and the cost will be significantly higher. Consider taking some time off work or school to recuperate.
Late-Term Abortions
In rare cases, a person may induce labor as a second or third trimester abortion method. Late-term abortion is illegal in many states. However, it can sometimes be used if a pregnant person is past 24 weeks pregnant (the cut-off point for D&E) and the baby has a serious medical condition, or if the pregnancy puts the parent's life at risk. For example, if a fetus is developing without life-sustaining organs and would not survive outside of the womb.
Induction abortion takes place in a hospital. You'll get labor-inducing medication injected into the fetus, amniotic sac, vagina, or vein. This medication will cause the uterus to contract. The cervix may also be dilated, and you'll likely get an epidural or sedatives. You'll go through the labor and delivery as if you're birthing a baby.
After an induction abortion, you may also experience bleeding, cramping, diarrhea, nausea, and other symptoms. Late-term abortions rarely come with more serious side effects like hemorrhage, lacerations, infection, and more. Plan to spend one or two days recovering.
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Support for All Types of Abortion
Abortion laws vary across the country and are changing quickly as more states pass heavier restrictions. With the possibility of the overturning of the landmark Roe v. Wade Supreme Court decision that gives a constitutional right to abortion, many abortion providers are finding it difficult to be available to patients who need them. If you are pregnant and want an abortion, it is important that you check your state laws to find out if abortion is legal.
Visit Planned Parenthood for more information about legality and to find an abortion clinic near you. Websites like the Safe Place Project can also help you locate a clinic.
The decision to get an abortion isn't always easy, and you may feel a wide range of emotions afterwards. Don't hesitate to contact a mental health professional if needed.
