Whittier Pregnancy Care Clinic
ABORTION
The type of procedure is based on how far along  you are in pregnancy.  It is extremely important that you confirm  your pregnancy (by a limited diagnostic ultrasound) and make sure it is a viable pregnancy (non-ectopic) before making the decision to terminate your pregnancy.  Making the decision to terminate your pregnancy is a huge decision and it is important that you understand the procedures because it is a surgery and can be evasive to your body.  Whatever your choice may be WPCC is here to help you.  

WPCC does not refer or perform abortions.
Medical Abortion
  • Methotrexate & Misoprostal (MTX): a medical abortion procedure used up to the first seven weeks of pregnancy

  • Mifepristone & Misoprostol:  A medical abortion procedure used up to the first seven to nine weeks of pregnancy.  It is also referred to as RU-486, the abortion pill and Mifeprex
        Side Effects:

    • Incomplete abortion:  The procedure is unsuccessful approximately 10% of the time, requiring an additional surgical abortion to complete termination.

    • Cramping, nausea, diarrhea, heavy bleeding and fever

    • Not advised for women who have anemia, bleeding disorders, liver or kidney disease, seizure disorder, acute inflammatory bowel disease, or use an IUD.
    • An allergic reaction to either of the pills

    • Infection

    • Undetected ectopic pregnancy

    • Very heavy bleeding

    • Very serious complications may be fatal. 
Surgical Abortion
  • Suction Aspiration: a surgical abortion procedure used to terminate pregnancy between 6 to 12 weeks gestation.  It is also referred to as suction curettage or vacuum aspiration

  • Dilation & Curettage ( D&C): a surgical procedure used to terminate a pregnancy between 13-15 weeks gestation.  It is also referred to as suction curettage or vacuum aspiration.

  • Dilation  Evacuation (D&E): a surgical abortion procedure used to terminate a pregnancy between 15 to 21 weeks gestation.

  • Induction Abortion:  Salt water, urea, or potassium chloride is injected into the amniotic sac; prostaglandins are inserted into the vagina and pitocin is injected intravenously.

  • Dilation and Extraction:  a surgical abortion procedure used to terminate a pregnancy after 21 weeks gestation.  This procedure is also known as D & X, Intact D&X, Intrauterine Cranial Decompression and Partial Birth Abortion.
Side Effects:

    •  an allergic reaction

    •  blood clots in the uterus

    •  Incomplete abortion - part of the baby is left inside the uterus

    •  Infection

    •  Injury to the cervix or other organs

    •  Undetected ectopic pregnancy

    •  Very heavy bleeding (hemorrhage)

    •  Very serious complications may be fatal. 
RU-486 How it works
Mifepristone and misoprostol use is a two-step method.

Step 1: You will take three of the RU-486 pills (mifepristone or mifeprex). These pills block the effects of progesterone, altering the blood supply to the uterus and placenta, cutting off the supply of blood and nourishment to the developing embryo

Step 2: Two days later, you will return to the doctor to take another drug, misoprostol either by mouth or by inserting it in your vagina (some doctors allow you take take them home, FDA DOES NOT recommend this.) Misoprostol causes your uterus to contract and expel the embryo.

Lastly a third visit to confirm that the abortion is complete (5-8 percent of women will still require a surgical procedure.)
Surgical Abortion Procedures
Manual Vacuum Aspiration
The cervical muscle is stretched with dilators (meal rods) until the opening is wide enough to allow the abortion instrument to pass into the uterus.  A hand held syringe is attached to tubing that is inserted into the uterus and the fetus is suctioned out.

Suction Curettage
The doctor inserts tubing into the uterus and connects the tubing to a suction machine.  The suction pulls the fetus' body apart and out of the uterus.  One variation of this procedure is called Dilation and Curettage (D&C).  In this method, the doctor may use a curette, a loop-shaped knife, to scrape the fetal parts out of the uterus.

Dilation and Evacuation (D&E)
The cervix must be opened wider than in a first trimester abortion.  This is done by inserting laminaria a day or two before the abortion.  After opening the cervix, the doctor pulls out the fetal parts with forceps.  The fetus' skull is crushed to ease removal.

Dilation and Extraction (DX) 
Partial Birth Abortion

This procedure takes three days.  During the first two days, the cervix is dilated and medication is given for cramping.  On the third day, the woman receives medication to start labor.  After labor begins, the abortion doctor uses ultrasound to locate the baby's legs.  Grasping a leg with forceps, the doctor delivers the baby up to the baby's head.  Next, scissors are inserted into the base of the skull to create an opening.  A suction catheter is placed into the opening to remove the skull contents.  The skull collapses and the baby is removed.
http://women.webmd.com/mifepristone-and-misoprostol-for-abortion
American Pregnancy Association - Medical Abortion Procedures Retrieved January 14, 2010
Planned Parentood http://www.plannedparenthood.org/health-topics/abortion/abortion-pill-medication-abortion-4354.htm Retrieved January 14, 2010