What types of abortion are available? When you go to either an abortion clinic or a hospital, it is routine procedure for the health care provider to ask you how far along you are in your pregnancy. In most cases, you will be asked to get an ultrasound to get a better indication of your gestation period. This is necessary as there are many types of abortion that you can choose from based on the gestation period.
Non-surgical abortion The first type of abortion being offered in most clinics and hospitals is the non-surgical abortion. It is also called the medication abortion or medical abortion because it involves the use of drugs/medication to stop the pregnancy. The non-surgical abortion is usually offered to patients whose gestation period is between the 4th and 9th week.
• Methotrexate/Misoprostol - This first medication involves Methrotrexate that is given orally or through injection in the clinic. The Misoprostol, in vaginal suppository form, is then taken home by the patient to be used 5-8 days after the Methotrexate. The Misoprostol works in expelling the pregnancy tissue at home within 24-48 hours after insertion. This will continue, as well as some bleeding and cramping, for one to two weeks, while the uterus completely empties. You will need to visit the clinic again 2-3 weeks after the procedure to make sure that the abortion was successful. Success rate is high if given up to the 7th week of pregnancy but if not, a surgical abortion will be performed at no extra cost.
• Mifepristone/Misoprostol - Better known as the "abortion pill" or RU-486, the process is very similar to the Methotrexate/Misoprostol combination. The Mifepristone is administered by a licensed physician in the clinic, while the 2nd medicine, Misoprostol, will be taken home by the patient. The Misoprostol will cause you to have some bleeding and cramping so scheduling this medication abortion is important. Most women abort within 4-5 hours upon taking the Misoprostol while others may take longer but only up to a couple of days. Bleeding and cramping may still continue for up to 2 weeks after which you need to go back to your health care provider for a follow-up check up to see if the medication worked.
• Vacuum Aspiration or Suction Curettage - If your gestation period is between 4-14 weeks (on the average, some clinics may perform the procedure only up to 13 weeks or up to 16 weeks), doctors will recommend a vacuum aspiration or suction curettage abortion. For this process, the doctor will initially perform a pelvic exam to orient himself as to the size and orientation of your uterus. Then an instrument called a speculum will be inserted into the vagina which allows the doctor to see into the cervix. A local anesthetic will be applied to the cervix. Once the cervix is numb, the doctor will gently open the cervix using dilators and then insert a “cannula” attached to a suction machine. This will be moved in and around the cervix to remove the pregnancy tissue. The whole process takes about 5-10 minutes to be over.
• Dilation and Evacuation (D & E) - If you are in your 2nd trimester of pregnancy, a D & E is the type of abortion for you. This procedure takes longer because the doctor needs to prepare for the manual dilation of the cervix by placing a laminaria (a sterile material that expands by soaking up liquids from the cervix). This can take between 1-2 days depending on the patient. You need to keep coming back to the clinic for monitoring when the dilation is complete. Once ideal dilation is achieved, the laminaria will be taken out and the doctor will use special instruments to evacuate the uterus to remove the pregnancy. The whole process lasts only 10-15 minutes but the actual dilation takes more time.