Abortion

Options for Women is a group of pregnancy resource centers that takes a life-affirming stance with regards to abortion and contraception. This means that this Center does not offer abortion services or abortion referrals. Any information about abortion is intended for general educational purposes only and should not be relied upon as a substitute for professional medical advice.

Abortion methods used prior to 14 weeks

Early Non-Surgical Abortion

  • A drug is given that stops the hormones needed for the fetus to grow. In addition, it causes the placenta to separate from the uterus, ending the pregnancy.
  • A second drug is given by mouth or placed in the vagina causing the uterus to contract and expel the fetus and placenta.
  • A return visit to the doctor is required for follow up to make sure the abortion is completed.

    Possible Complications

    • incomplete abortion
    • allergic reaction to the medications
    • painful cramping
    • nausea and/or vomiting
    • diarrhea
    • fever
    • infection
    • heavy bleeding

Vacuum Aspiration Abortion

  • A local anesthetic is applied or injected into or near the cervix to prevent discomfort or pain.
  • The opening of the cervix is gradually stretched with a series of dilators. The thickest dilator used is about the width of a fountain pen.
  • A tube is inserted into the uterus and is attached to a suction system that will remove the fetus, placenta and membranes from the woman’s uterus.
  • A follow up appointment should be made with the doctor.

    Possible Complications

    • incomplete abortion
    • pelvic infection
    • heavy bleeding
    • torn cervix
    • perforated uterus
    • blood clots in uterus.

Dilation and Curettage Abortion

  • A local anesthetic is applied or injected into or near the cervix to prevent discomfort or pain.
  • The opening of the cervix is gradually stretched with a series of dilators.
  • The thickest dilator used is about the width of a fountain pen.
  • A spoon-like instrument (curette) is used to gently scrape the walls of the uterus to remove the fetus, placenta, and membranes.
  • A follow up appointment should be made with the doctor.

    Possible Complications

    • incomplete abortion requiring vacuum aspiration
    • pelvic infection
    • heavy bleeding
    • torn cervix
    • perforated uterus
    • blood clots in uterus.

Abortion methods used After 14 weeks

Dilatation and Evacuation (D&E)

  • Sponge-like tapered pieces of absorbent material are placed into the cervix. This material becomes moist and slowly opens the cervix. It will remain in place for several hours or overnight. A second or third application of the material may be necessary.
  • Following dilation of the cervix, intravenous medications may be given to ease discomfort or pain and prevent infection.
  • After a local or general anesthesia has been administered, the fetus and placenta are removed from the uterus with medical instruments such as forceps and suction curettage. Occasionally for removal, it may be necessary to dismember the fetus.

    Possible Complications

    • blood clots in the uterus
    • heavy bleeding
    • cut or torn cervix
    • perforation of the wall of the uterus
    • pelvic infection
    • incomplete abortion
    • anesthesia-related complications.

Labor Induction (Including Intra-Uterine Instillation)

  • Labor induction may require a hospital stay.
  • Medicine is placed in the cervix to soften and dilate it.
  • There are three ways to start labor early:
  • Medication is given directly into the bloodstream (vein) of the pregnant woman starting uterine contractions.
  • Medication inserted into the vagina to start uterine contractions.
  • Medication injected (instillation) directly into the amniotic sac by inserting a needle through the mother’s abdomen and into the amniotic sac (bag of waters). This stops the pregnancy and starts uterine contractions.
  • Labor and delivery of the fetus during this period are similar to the experiences of childbirth.
  • The duration of labor depends on the size of the baby and the contractility of the uterus.
  • There is a small chance that a baby could live for a short period of time depending on the baby’s gestational age and health at the time of delivery.

    Possible Complications

    • If the placenta is not completely removed during labor induction, the doctor must open the cervix and use suction curettage (removal of uterine contents by low-pressure suction).
    • Labor induction abortion carries the highest risk for problems, such as infection and heavy bleeding.
    • When medicines are used to start labor, there is a risk of rupture of the uterus.
    • As with childbirth, possible complications of labor induction include infection, heavy bleeding, stroke and high blood pressure.
    • Other medical risks may include blood clots in the uterus, heavy bleeding, cut or torn cervix, perforation of the wall of the uterus, pelvic infection, incomplete abortion, anesthesia-related complications.

Hysterotomy (similar to a Caesarean Section)

  • This method requires that the woman be admitted into a hospital.
  • A hysterotomy may be performed if labor cannot be started by induction, or if the woman or her fetus is too sick to undergo labor.
  • A hysterotomy is the removal of the fetus by surgically cutting open the abdomen and uterus.
  • Anesthetic medication, given into the woman’s vein or back, or inhaled into the lungs, is administered so the woman will not feel the surgery.

    Possible Complications

    • Complications are similar to those seen with other abdominal surgeries and administration of anesthesia
    • Severe infection (sepsis)
    • Blood clots to the heart and brain (emboli)
    • Stomach contents breathed into the lungs (aspiration pneumonia)
    • Severe bleeding (hemorrhage)
    • Injury to the urinary tract
    • Blood clots in the uterus
    • Heavy bleeding
    • Pelvic infection
    • Retention of pieces of the placenta
    • Anesthesia related complications

Dilation and Extraction

  • This method may be performed between 20 and 32 weeks gestation.
  • Sponge-like tapered pieces of absorbent material are placed into the cervix. This material becomes moist and slowly opens in the cervix. It will remain in place for one to two days. A second or third application of the material may be necessary.
  • After a local or general anesthesia has been administered, the fetus and placenta are removed from the uterus with medical instruments such as forceps, suction and curette (a spoon-like instrument). It may be necessary to dismember the fetus.

    Possible Complications

    • Risks are similar to childbirth
    • Uterine infection
    • Heavy bleeding
    • High blood pressure
    • Rare events such as blood clot, stroke or anesthesia-related death

Short-term medical risks

The risk of complications for the woman increases with advancing gestational age (see above for a description of the abortion procedure that your doctor will be using and the specific risks listed in those pages).

Pelvic Infection (Sepsis): Bacteria (germs) from the vagina may enter the cervix and uterus and cause an infection. Antibiotics are used to treat an infection. In rare cases, a repeat suction, hospitalization or surgery may be needed. Infection rates are less than 1% for dilation and suction curettage/vacuum aspiration abortion, 1.5% for dilation and evacuation (D & E), and 5% for labor induction.

Incomplete Abortion: Fetal parts or other products of pregnancy may not be completely emptied from the uterus, requiring further medical procedures. Incomplete abortion may result in infection and bleeding. The reported rate of such complications is less than 1% after a dilation and evacuation (D & E); whereas, following a labor induction procedure, the rate may be as high as 36%.

Blood Clots in the Uterus: Blood clots that cause severe cramping occur in about 1% of all abortions. The clots usually are removed by a repeat dilation and suction curettage.

Heavy Bleeding (Hemorrhage): Some amount of bleeding is common following an abortion. Heavy bleeding (hemorrhaging) is not common and may be treated by repeat suction, medication or, rarely, surgery. Ask the doctor to explain heavy bleeding and what to do if it occurs.

Cut or Torn Cervix: The opening of the uterus (cervix) may be torn while it is being stretched open to allow medical instruments to pass through and into the uterus. This happens in less than 1% of first trimester abortions.

Perforation of the Uterus Wall: A medical instrument may go through the wall of the uterus. The reported rate is 1 out of every 1000 with early abortions and 3 out of every 1000 with dilation and evacuation (D & E). Depending on the severity, perforation can lead to infection, heavy bleeding or both. Surgery may be required to repair the uterine tissue, and in the most severe cases hysterectomy may be required.

Anesthesia-Related Complications: As with other surgical procedures, anesthesia increases the risk of complications associated with abortion. The reported risks of anesthesia-related complications is around 1 per 5,000 abortions. Most are allergic reactions producing fever, rash and discomfort.

Long-term medical risks

Future childbearing: Early abortions that are not complicated by infection do not cause infertility or make it more difficult to carry a later pregnancy to term. Complications associated with an abortion may make it difficult to become pregnant in the future or carry a pregnancy to term.

Cancer of the Breast: Findings from earlier studies suggested there was an increased risk of breast cancer among women who had an abortion.

Women who have a strong family history of cancer or who have clinical findings of breast disease should seek medical advice from a physician regardless of their decision to become pregnant or have an abortion.

The emotional side of abortion

Each woman having an abortion may experience different emotions before and after the procedure. Women often have both positive and negative feelings after having an abortion. Some women say that these feelings go away quickly, while others say they last for a length of time. These feelings may include emptiness and guilt as well as sadness. A woman may question whether she made the right decision. Some women may feel relief about their decision and that the procedure is over. Other women may feel anger at having to make the choice. Women who experience sadness, guilt or difficulty after the procedure may be those women who were forced into the decision by a partner or family member, or who have had serious psychiatric counseling before the procedure or who were uncertain of their decision.

Counseling or support before and after your abortion is very important. If family help and support is not available to the woman, the feelings that appear after an abortion may be harder to adjust to. Talking with a professional and objective counselor before having an abortion can help a woman better understand her decision and the feelings she may experience after the procedure. If counseling is available to the woman, these feelings may be easier to handle.

Remember, it is your right and the doctor’s responsibility to fully inform you prior to the procedures. Be encouraged to ask all of your questions.

Post abortion syndrome

Post-Abortion Syndrome is a form of post-traumatic stress disorder. The process of making an abortion choice, experiencing the procedure and living with the grief, pain and regret is certainly, at it’s very core, traumatic. As with any trauma, individuals often try to “forget” the ordeal and deny or ignore any pain that may result. Many simply don’t relate their distress to the abortion experience. At some point, however, memories resurface and the truth of this loss can no longer be denied. During these moments, the pain of post-abortion syndrome reveals itself in the hearts of millions of lives.

(Source: Ramah International, www.ramahinternational.org)

Symptoms

  • Inability to forgive oneself
  • Emotionally numb
  • Guilt
  • Shame
  • Sorrow
  • Depression
  • Grief
  • Rage
  • Regret
  • Fear of another pregnancy or infertility
  • Nightmares
  • Frequent crying
  • Feelings of anger
  • Preoccupation with anniversary date or due date
  • Feelings of hopelessness
  • Troubled relationships
  • Sexual dysfunction
  • Alienation from God
  • Repeat abortions
  • Flashbacks of abortion
  • Fear and anxiety
  • Eating disorders
  • Alcohol and/or drug abuse
  • Suicidal impulses
  • Abusive/tolerates abusive relationships
  • Difficulty with intimacy
  • Wants replacement/atonement child
  • Over-protective of living children
  • Fails to bond with subsequent children

(Source: www.healingafterabortion.org)

Abortion vs. Adoption

Similarities

Abortion Adoption
You can pursue earlier goals. You can pursue earlier goals.
You can live independently. You can live independently.
You will not have to parent prematurely. You will not have to parent prematurely.
You will avoid being forced into a hasty marriage or relationship. You will avoid being forced into a hasty marriage or relationship.
If you are a teenager, you can resume your youthful lifestyle. If you are a teenager, you can resume your youthful lifestyle.
Note: There are no similarities between abortion and parenting.

Differences

Abortion Adoption
Your pregnancy ends with death. Your pregnancy ends with giving life.
You may feel guilt and shame about your choice. You can feel good and positive about your choice.
You will remember taking a life. You will remember giving birth.
Abortion is final; you can’t go back on your decision. You will have plenty of time to plan you and your baby’s future.
You will never know or treasure your baby. You can hold, name, and love your baby.
You will miss the opportunity to see your child develop. You can have continued contact with your baby.

(Bethany Christian Services – www.bethany.org)