Abortion, sometimes known as a ‘termination of pregnancy,’ is the medical process of ending a pregnancy to ensure that it does not end in the birth of a baby. Women have abortions for many reasons, including personal circumstances, a risk to the mother or a high chance that the baby will have a serious genetic or physical abnormality.
There are a number of types of abortion, and options depend on the duration of the pregnancy. An abortion is a medical means of ending a pregnancy.
Worldwide, around half of all reported unintended pregnancies end in abortion. Abortion is legal throughout the majority of the United States and in many other countries.
When can a woman have an abortion?
Where abortion is legal in the U.S., doctors usually perform them in the first trimester or the early part of the second trimester.
The first trimester lasts from conception to week 12 of pregnancy. The second trimester is from week 13 to week 28. Some states allow abortion in the latter part of the second trimester. In 2015, two-thirds (65.4%) of reported abortions in the country took place when the pregnancy had lasted fewer than 8 weeks.
In the first trimester, options for abortion commonly include:
- medical abortion
- vacuum aspiration
A woman can usually access medical abortion until about 10 weeks after her last period. It involves taking two types of medication.
Surgical options, such as vacuum aspiration and dilation and evacuation, are more common after 10 weeks.
In the second trimester, a woman may undergo:
- dilation and evacuation
- labor induction abortion
Abortion is rare during the third trimester, but a doctor may perform it after 29 weeks of pregnancy if a woman’s life is in danger. They may use the same methods that are used during the second trimester.
A medical abortion requires a woman to take pills at separate times.This type of abortion involves taking two medications, mifepristone and misoprostol.
A doctor or nurse will advise about the timing, but a woman should take the second medication, misoprostol, no more than 48 hours after taking the first, mifepristone.
Mifepristone stops the pregnancy from developing. Misoprostol triggers the uterus to empty, which will begin 1–4 hours after taking the pill.
A woman will experience cramping and bleeding as the uterus empties, which may feel like having an unusually heavy period. Some women feel more severe cramping than others.
Within around 4–5 hours, the pregnancy tissue will likely have passed from the body, but it can take longer.
Some advantages of a medical abortion are:
- It does not involve surgery.
- It is available in the first trimester.
- It does not require an anesthetic.
Some disadvantages of a medical abortion are:
- It is not available in the second trimester.
- Only part of the treatment takes place in a clinic.
- It may cause painful cramping.
- Rarely, it is not effective.
It may be a good idea to have a partner or friend close by for support while the tissue is passing.
Recovery from a medical abortion involves:
- some bleeding and spotting that may last for several weeks
- a check-up with the doctor to monitor recovery
Some women experience side effects of the medications. These can include:
- heavy vaginal bleeding
- mild fever
Vacuum aspiration is a type of surgical abortion that involves using gentle suction to end a pregnancy. Doctors typically recommend this during the first trimester.
How it works
A doctor begins the vacuum aspiration procedure by inserting a speculum into the woman’s vagina. They then apply medication or use an injection to numb the area.
Next, they use thin rods called dilators to open the cervix, then insert a tube into the uterus. Then, they use either a manual or mechanic suction device to empty the uterus.
The advantages of vacuum aspiration are:
- It is available in the first 12 weeks of pregnancy.
- It is quick, with the procedure only taking 5–10 minutes.
- It is relatively pain-free, though some women experience cramping, sweating, nausea, or a combination.
- It does not require a general anesthetic.
The main disadvantage of vacuum aspiration is that it is not available in the second trimester.
Recovery from vacuum aspiration involves:
- resting for up to 1 hour after treatment
- taking antibiotics to prevent infection
- avoiding sex for 1 week after treatment
Also, some women experience cramping for a few days following the procedure, and irregular bleeding or spotting can occur for several weeks.
The potential complications of vacuum aspiration include bleeding and infection. However, the risk of these complications is low.
Speak to the doctor right away if signs of bleeding or new symptoms occur.
Dilation and evacuation
Dilation and evacuation is a type of surgical abortion that doctors commonly use during the second trimester.
How it works
A doctor may give a general anesthetic before performing a dilation and evacuation. This type of anesthetic ensures that a person does not feel anything during the procedure.
The doctor begins by inserting a speculum into the woman’s vagina. Then, they use dilators to open the cervix.
Next, they remove the pregnancy tissue with small forceps. Finally, they use suction to remove any remaining tissue.
The advantages of dilation and evacuation are:
- It is available in the second trimester.
- It is a safe and effective way to end a pregnancy.
The disadvantage of dilation and evacuation is that it can require a general anesthetic.
Recovery from dilation and evacuation involves resting.
Mild pain and cramping can occur for a few days after the procedure, and there may be some bleeding for up to 2 weeks.
Potential complications of dilation and evacuation include:
- heavy bleeding
- injury to the uterus
The risk of injury to the uterus or other organs during a second-trimester abortion is less than 1 in 1,000, according to The American College of Obstetricians and Gynecologists.
Labor induction abortion
Labor induction abortion is a late-term method of ending a pregnancy in the second or third trimester.
This type of abortion is rare, and a doctor may recommend it if a woman’s life is in danger.
How it works
Labor induction involves using medications to start labor, which causes the uterus to empty over a period of around 12–24 hours. A woman can take these medications by mouth or the doctor may place them into the vagina or inject them into the uterus.
Doctors usually also administer pain relief medication or a local anesthetic, as intense cramping occurs during this type of abortion.
After the abortion is complete, a woman tends to remain in the clinic or hospital for anywhere from a few hours to 1–2 days, depending on health and other factors.
The doctor can help determine the length of the stay, and they may be able to estimate it before the abortion.
The medications that induce labor can cause side effects, such as:
- nausea and vomiting
Complications are rare but can include:
- cervical injury
- rupture of the uterus
- incomplete release of the pregnancy tissue