Types of Abortion

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Abortion is a procedure, either surgical or medical, to end a pregnancy by removing the fetus and placenta from the uterus. Any interruption of a human pregnancy before the third trimester is known as abortion. There are several different types of abortions but there are two major categories. One is a spontaneous abortion, called miscarriage. Usually this is not done intentionally and it usually happens after the first few weeks of pregnancy. A miscarriage is the natural loss of a fetus and has little danger to the mother.

Then there is the induced abortion that is done intentionally. Induced abortions are of various kinds, including nonprofessional efforts by the pregnant woman or others to end an unwanted pregnancy.

In the first week there are micro-abortions caused by 'contraceptive drugs and devices. Contraceptive agents such as intrauterine device (IUD), Norplant,

Depo- Provera, progesterone only pills, low-dose contraceptive combination pills, and the morning after pills prevent implantation which kills the unborn baby at one week of life. Custom Essays on Types of Abortion

Other abortions that are performed in the first trimester are menstrual extraction, suction aspiration, and dilation and curettage.

The menstrual extraction is done before the pregnancy test is even positive. It takes out the uterine lining and fertilized egg if present. A menstrual extraction is done by suction. A smaller tube is used which requires less dilation of the cervix.

The suction-aspiration is also known as the vacuum aspiration. It usually takes between 10 and 15 minutes and can be done safely in a clinic. It is a minor surgical abortion. The abortionist immobilizes the womb opening and stretches it open. This is often difficult because it is not ready to open. Then, a hollow plastic tube with a knife-like edge and a suction device at the other end is put into the uterus. This suction tears the babies body into pieces. Then the placenta is cut from the inner wall of the uterus. The scraps are sucked into a bin and the pieces are often recognizable. This suction is times more powerful than a home vacuum cleaner. The uterine tissue is examined to make sure that all the tissue has been removed and the abortion is complete. Sometimes a D&C is needed afterwards if all the tissue is not removed. A normal recovery includes irregular bleeding similar to a menstrual period, cramps, and emotional reactions. There is no evidence of childbearing problems among women who have had this procedure says Dr J.C Wilke.

The dilation and curettage (D&C) is used for many different reasons. The most common is used to determine the health of the uterine lining. Sometimes the procedure can correct some of the problems in the uterus such as polyps, scar tissue, or overgrowth. It is normally very short and the patient can go home soon afterwards. When a D&C is used, as an abortive method, the procedure is similar to the suction aspiration. The difference is an abortionist inserts a curette, a loop-shaped steel knife, into the uterus and cute the placenta and the baby into pieces then scrape them out into a plastic tub.

Second trimester abortions include prostaglandin, saline amniocentesis, dilation and evacuation, and intra-cardiac injections. Prostaglandins are naturally produced chemical compounds that normally assist in the birthing process. Prostaglandin is injected into the amniotic sac which induces a violent labor and the birth of a child usually too young to survive. The labor and contractions are more violent than normal and sometime the child will die from that alone.

In the 770s and 180s, the most common second trimester was the saline amniocentesis or salt poisoning abortion. An abortionist inserts a large needle into the abdominal wall of the mother and in the babys amniotic sac. A salt solution is injected into the amniotic fluid. At this point, the baby breathes in and swallows the poison. The solution also burns of the outer layer of the babys skin and the baby usually convulses, and then dies. The mother is usually also giving prostaglandin which is used to induce violent premature labor and delivery. When successful the mother goes into labor about one day later and delivers a dead baby. Some maternal deaths have been reported from accidental injection of the saline solution into the circulatory system. The deaths have been from acute kidney failure, seepage through the uterine puncture to the abdominal cavity, and from infections. J.A Stallworthy et al., "Legal Abortion A Critical Assessments of its Risks." Lancet, December 4, 176, p.145

Dilation and Evacuation (D&E) is usually done in an operating room. Sometimes a D&E is recommended for women diagnosed in the nd trimester with a fetus that has severe medical problems or abnormalities. First, a laminaria or synthetic dilator is inserted 4 hours before the procedure to help dilate the cervix. Dilating the cervix reduces the risk of any injury. An abortionist then inserts an instrument that resembles pliers into the uterus and grabs a hold of a part of the babys body, and, with a twisting motion, tears it from the babys body. This is repeated over and over again until all body parts are torn apart. The spine is then snapped in half and the skull is crushed. This is done because the spine and skull are too big to be removed.. After the procedure is done, a nurse will reassemble the body parts to make sure all of them were removed. This method is very dangerous but a report from the U.S. Center for Disease Control, stated that it is still safer for the mother than the salt poisoning or Prostaglandin method.

Multi-fetal pregnancies have become more common says William Cates, there for intra-cardiac injections are being used. This is usually used to kill a baby from a multi-fetal pregnancy or one that has birth defects. At about 4 months, a needle is inserted through the mothers abdomen, into the chest and heart of one of the fetal babies and a poison is injected to kill him or her. Sometimes this method results in the loss of all the babies.

Third Trimester Abortions include the partial birth abortion, hysterectomy, RU 486, and methotrexate. The Partial Birth Abortion (D&X) is done after 4 or 5 months of pregnancy. This procedure is one over a three-day period. The first day the patient is evaluated with an ultrasound. The womans cervix is prepped, anesthetized, and dilated to -11mm. Five, six, or seven large Dilapan is placed into the cervix to dilate over night. The second day is just more dilation and a check up. This time anywhere between 15 and 5 Dilapan are put into the cervix to help dilate over night. Then finally on the third day the surgical assistant will rupture the water bag if it has not been done already. An ultrasound is done to help the surgeon locate the position of the baby. Then the surgeon will insert a large grasping forceps through the vagina and onto the uterus. The full body, except the head, of the baby is delivered and a pair of scissors is forced into the base of the skull and the scissors are opened to make the whole larger. A suction aspiration is then performed to empty the uterus. The woman is observed for a minimum of hours following surgery. A Pad check and vital signs are taken every 0 minutes. Women with minimal bleeding after 0 minutes are encouraged to walk about the building or outside between checks. This method was abandoned decades ago because it was too dangerous. Abortionist now use something similar to the cesarean section, called the hysterectomy. (Cates 8)

Like a cesarean section, the abdomen and the womb are opened surgically. This procedure nearly almost results in a live birth. While the baby is still inside the womb, the umbilical cord may be cut which then suffocates the baby. Or the baby will be fully delivered and after it is lifted away, a nurse will place a towel over the babys head to suffocate him. By the time the baby is taken to the laboratory, he is usually already dead.

RU 486, also known as the french Abortion Pill, mifeprestone, mifeprex, is an early option pill that is used to end a pregnancy from the time you find out youre pregnant to 4 days after your last menstrual period. This pill can only be taken during this time. This method is %- 5% effective. RU 486 kills a developing baby after his or her heart has begun to beat. This drug blocks a vital nutrient hormone, Progesterone. The baby will usually starve to death and die. This type of procedure takes four visits to the clinic. During the first visit, the doctor/abortionist will do a full history, physical exam, and blood count on the woman. An Ultrasound exam is done to confirm the age of the baby and to see if there is a tubal pregnancy. The woman must also sign permission and, in some states wait one or more days. At some clinics, a counseling session is required. The second visit is very short. The woman is given two mifeprestone tablets to take. (Each containing 00 micrograms of misoprestol) Misoprestol causes uterine contractions that helps end a pregnancy. She is sent home and will return the next day for her third visit. Normally a prostaglandin drug is given to produce hard labor. Usually the body parts are delivered that day. And finally, the fourth visit is just to check if the pregnancy has completely ended. The fourth visit is especially important because if she has not completely aborted or if there is still bleeding, she will need an ultrasound to determine if the uterus is empty. If not, a D&C procedure is done. Sometimes a D&C is performed just because the woman is bleeding badly.

RU 486 will produce an abortion 5% of the time. The other 5% will be advised to have a surgical abortion. If the RU 486 doesnt work and the mother decides to carry the baby full term, there could be long-term complications for the infant. These deformities can either show up at birth or 0 years later. These drugs can result in a heart attack of the woman so therefore, a crash cart with defibrillator, EKG, and IV equipment are in the facility.

There is another type of pill that is called methotrexate. It was invented to attack fast growing cancer cell but it is also kills an unborn baby. It works roughly within the same time frame as RU 486, but in a different fashion. RU 486 starves the baby until it dies; where as, methotrexate is a direct poison and kills the developing baby. Methotrexate is administered by an intramuscular injection instead of a pill. (Hausknecht, M.D. "New England Journal of Medicine p. ) It disintegrates the protective and nourishing enviroment killing the baby after his or her heart has begun to beat. The baby dies of not only starvation but of oxygen and fluids, he or she needs to survive. This pill works along with prostaglandin. Just like the RU 486 pill, a mother can abort anywhere from to 7 days later.

There are risks that occur with any abortion done. The most common side effects are nausea, cramping, diarrhea, bone marrow depression, severe anemia, and liver damage. One of the risks following a surgical abortion is that scar tissue will form in the uterus, making it difficult to conceive again because the fetus cannot implant on the scar tissue. Scar tissue can also block the fallopian tubes either partially or completely which often results in an "ectopic" or "tubal" pregnancy. ("BC Health Guide" p1)

If even a tiny piece of tissue remains, severe infection can develop. This infection can lead to bleeding, cramping, fever, and even sterility. That is why after several abortions a D&C is done.

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