In as much as the talk about abortion has been here for a while, there is not so much that is known about the methods of abortion. While there are various abortion methods that are used to terminate early pregnancies, they are broadly grouped into are two main categories; medical abortion and surgical (also called aspiration abortion or suction abortion). In medical, the abortion entails taking of certain medications, prescribed by a doctor. In surgical procedures, however, there are different techniques that are employed to remove the foetus from the womb.
Abortion methods heavily link on the pregnancy period. There are procedures that are suitable for every trimester of the pregnancy period.
Here, the various abortion methods are grouped according to pregnancy trimesters:
First trimester (0-14 weeks of pregnancy)
- Dilation and Sharp Curettage (D&C)
Using a sharp instrument, the cervix is slowly opened and the placenta, foetus and membranes are scrapped from the inside.
This procedure involves methotrexate being injected into the muscle, followed by insertion of misoprostol into the vagina. If successfully done, the placenta, foetus and membranes are expelled the next day. If not, another dosage of misoprostol is administered.
- Mifepristone/Misoprostol (RU-486)
Taken by mouth, mifepristone is normally given up to 5 weeks of conception or roughly 7 weeks after the first day of your last period. A day or two later misoprostol is given after which expulsion takes place.
- Vacuum aspiration
The most common procedure during the first weeks of pregnancy, a suction catheter is inserted to the cervix and a specially designed catheter or suction vacuum is used to remove the placenta, foetus and membranes.
Second trimester (14-26 weeks of pregnancy)
- Dilation and evacuation
Currently the most common used procedure during the second trimester, it is performed under local anaesthesia. An opening on the cervix is made and removal of the foetus, placenta and membranes are done by alternating suction and sharp curettage.
- Abdominal hysterectomy
Likened to a caesarean birth, anaesthesia is given to the patient and the foetus is removed after an incersion on the uterus is made. This is done after another abortion procedure by the name prostaglandin or intra-amniotic instillations, fails.
- Vaginal prostaglandin
In form of vaginal suppositories or gel, it is applied to the cervical canal causing the uterus to contract and the cervix to soften and open. This leads to the expulsion of the foetus, placenta and membranes.
Third trimester (26-40 weeks of pregnancy)
- Abdominal hysterectomy
Abdominal hysterectomy is a form of abortion in which the uterus is opened through an abdominal incision and the fetus is removed, similar to a caesarean section, but requiring a smaller incision.As major abdominal surgery, hysterotomy is performed under general anaesthesia.
- Intact dilation and extraction
With the head lodged inside the uterus, the doctor pulls the foetus with feet first out of the birth canal. Using sharp instruments the skull is punctured at the base. A catheter is then inserted to remove the foetus’s brain and remaining parts using a powerful suction machine.
As a result, the skull collapses allowing for easy expulsion of the foetus.
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