Abortion is a procedure in which a doctor terminates a pregnancy. Pregnancies are terminated for many reasons, including medical. But once an expectant mother is out of the first trimester of her pregnancy, her options for abortion begin to diminish. In fact, the longer the mother carries the child, the more surgical and invasive the methods become for abortion.
Dilation and Curettage
Also called a D&C, this is a procedure that can also be used in the second trimester of pregnancy (13 to 24 weeks). This option works best when the pregnancy is at 13 to 15 weeks. Doctors dilate the cervix to open up the uterus so there's room to insert a curette, which is primarily used to remove tissue (the placenta and fetus included) from the uterus. The doctor can also use suction during the procedure. If this procedure is used during the third trimester, it's likely the fetus is either very small or is actually a tumor that forms on the placenta, instead of a fetus.
Dilation and Evacuation
Also called a D&E, this is another procedure used in the second trimester, though if the conditions allow, can also be used in the third trimester. Like the D&C, the doctor starts by dilating the cervix, which is actually begun by dilation 24 hours before the procedure with the use of a synthetic dilator. Doctors then start the procedure with a cannula to remove larger tissues, followed by a curette. Forceps can also be used to remove larger parts.
Induction Abortion
This is a rare procedure that is used in both the second and third trimester. Most doctors only use it if there's a problem with the mother or the fetus. The doctor will use a solution of salt water, urea or potassium to terminate the pregnancy. Prostaglandins will be inserted in the vagina, and pitocin will be administered intravenously. The procedure begins when the cervix is completely dilated. The main concern during this procedure is the solution accidentally being introduced into the mother's bloodstream, which can lead to side effects such as excessive bleeding and cramping.
Dilation and Extraction
This is a procedure used exclusively in the third trimester. Dilation of the cervix begins two days before the surgery. By day three, the mother's water will break and doctors will begin the procedure. Doctors rotate the fetus until its legs, body and arms are outside the birth canal. Doctors then insert a suction catheter into the base of the skull and drain the fetus' brain until the head collapses. This is by far the most invasive of the third trimester procedure and can lead to mental issues for the mother.
What Can't Be Done
While abortion options in the third trimester get gradually invasive, there is one option that is not on the table--medication. There is no drug that will help a mother with a second- or third-term abortion, like the morning after pill, which works up to nine weeks into the pregnancy.
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