What are the abortion types?
Pregnant or Think You Might Be? We Can Help.
Get the Facts before you decide
Abortion is a medical procedure that terminates a pregnancy. This procedure affects your body, so you owe it to yourself to get complete and accurate medical information on how the procedure works and what it will do to you, before deciding if this option is right for you. You owe it to yourself to be fully informed.
Morning After Pill (also known as Plan B, Plan B One Step, or Ella)
The morning after pill is considered emergency contraception and is FDA approved to take within 72 hours of unprotected sex to prevent pregnancy. It is not the same as RU486. The morning after pill works by delaying ovulation, and it may also interfere with fertilization and/or prevent implantation.
Before taking the morning after pill, you should know that it won’t work if you are already pregnant. It does not protect against STIs, and it is not recommended as a routine contraception. In addition, common side effects include nausea, abdominal pain, fatigue, headache, and menstrual changes.
*(Source: Manufacturer’s Prescribing Information for Plan B (Levonorgestrel) tablets.)
RU486, Mifepristone (Abortion Pill, Chemical Abortion)
Up to 10 weeks after last menstrual period (LMP)
This drug is only FDA approved for use in women up to the 70th day after their last menstrual period. It is recommended that the procedure take place over three, in-person office visits. On the first visit, the woman is given medication to cause embryonic death or stop further embryo development. Two days later at the second visit, a second medication called misoprostol is taken which induces uterine contractions– at the same intensity and pain level as labor pains– to expel the body in various pieces. The misoprostol pill has been known to cause severe pain and last up to several days after consumption. The further along you are in your pregnancy, the more bleeding and cramping you will experience.
A follow up visit is required about two weeks after the initial visit to determine if all the body parts of the fetus have been expelled and the procedure has been completed. If the medical abortion is incomplete, a surgical abortion procedure will be required. If you have taken RU486 and are having doubts about continuing with the procedure, contact us. Help may be available to reverse the effects of the medication.
If you have taken RU486 and are having second thoughts, call the Abortion Pill Reversal helpline at 1-877-558-0333 to connect with a nearby medical professional anytime, 24/7.
RU486 will not work in the case of an ectopic pregnancy. This is a potentially life-threatening condition in which the embryo lodges outside of the uterus, usually in the fallopian tube. If not diagnosed early, the tube may rupture, causing internal bleeding and in some cases, the death of the woman. For this reason, an ultrasound is required to confirm the location of the pregnancy before being prescribed RU486.
Possible complications
- Incomplete abortion
- Allergic reaction to the medications
- Painful cramping
- Nausea and/or vomiting
- Diarrhea
- Fever
- Weakness and/or fainting
- Increased risk to Pelvic Inflammatory Disease
- Long term mental health conditions
- Infection
- Heavy bleeding and/or hemorrhaging – emergency medical care may be needed for you
FDA Warning!! It is dangerous to your health to buy Mifepristone over the Internet because in doing so, you will bypass important safeguards designed to protect your health (and the health of others). Drugs that are non-FDA approved carry risks above and beyond expected side effects.
Manual Vacuum Aspiration
First Trimester – Up to 13 weeks after LMP
This surgical abortion is done early in a pregnancy up until 14 weeks after the woman’s last menstrual period. Local anesthetic is usually provided. The cervix is dilated using dilators to allow a tube to be inserted into the uterus. Depending on the gestational age of the fetus, a syringe may be injected into the fetus to stop the heartbeat and begin removing parts of the body, or a suction system is attached to the tube to “vacuum” the body out in pieces. The fetus, placenta, and membranes are then removed from the uterus using suction.
Possible complications
- Incomplete abortion
- Pelvic infection
- Heavy bleeding
- Torn cervix
- Perforated uterus
- Blood clots in uterus
- Injury to the uterus, cervix, or nearby parts of your body
- Allergic reaction to anesthesia
Dilation and Curettage (D&C)
First Trimester – Up to 13 weeks after LMP
This is the most common type of surgical abortion. The cervix is dilated using dilators and local anesthetic is injected into the cervix. The anesthetic used can be cost effective but not suitable for pain management. Dilating the cervix can cause cramping. After the cervix is stretched open, the provider inserts a spoon-like, but sharp, instrument called a curette into the uterus and scrapes it along the walls of the uterus to remove the fetus, placenta, and membranes. During this procedure, providers do not have an ultrasound running at the same time as the scraping so they often work blindly, scraping at the insides of your body hoping to get all the pieces of the fetus out. In doing so, they may puncture your other organs -which in severe cases can cause infection and hemorrhaging- or damage your uterus, cervix, and nearby parts of your body.
Before you leave their clinic, the provider will go to another room to reassemble all the body parts of the fetus to make sure everything has been removed.
A follow up visit is important to ensure the abortion was completed. If the abortion was not completed, an additional appointment with vacuum aspiration may be required.
Possible complications
- Incomplete abortion requiring vacuum aspiration
- Pelvic infection
- Heavy bleeding or hemorrhaging
- Cervical Laceration
- Long term uterine scarring
- Perforated uterus
- Blood clots in uterus
- Injury to the uterus, cervix, or nearby parts of your body
- Allergic reaction to anesthesia
Dilation and Evacuation (D&E)
Second Trimester – 13 weeks after LMP and up
This surgical abortion is done during the second trimester of pregnancy. In this procedure, the cervix must be opened wider than in a first trimester abortion. This can be done using medication or by placing absorbent dilators, like laminaria, into the cervix several hours or the day before the abortion procedure to open the cervix. During the dilation process, a woman can still change her mind about whether or not she wants to continue the process. Forced dilation of the cervix will cause cramping.
Once the cervix is stretched open, the provider administers anesthesia, inserts a large catheter to suction out the amniotic fluid (sometimes referred to as ‘vacuuming’). However, the body is too large to undergo suctioning, so the provider uses medical instruments to dismember the body, limb by limb. The provider uses a Sopher Clamp – a grasping instrument with rows of sharp “teeth” to grab and pull the fetus’s limbs off its body. The provider continues until the spine, heart, lungs, and intestines have been removed. Once the heart has been located, the provider will use medication to stop the fetal heartbeat. Until then, the fetus will feel pain. The hardest part for providers is usually grasping and crushing the fetus’s head. You may feel added pressure and movement while the provider feels around for it. Then, the curette (a sharp metal device) is used to scrape the uterus and remove other parts of its body and placenta. Additional suctioning may be needed.
Separately, the provider will reassemble all the body parts of the fetus to make sure everything has been removed. If they are missing anything, an additional appointment may be needed to remove remnants of the fetus from your uterus.
Possible complications
- Blood clots in the uterus
- Heavy bleeding or hemorrhaging
- Cut or torn cervix
- Perforation of the wall of the uterus
- Pelvic infection
- Long term uterine scarring
- Incomplete abortion
- Anesthesia-related complications
- Emotional trauma
- Damage to adjacent parts of your body
- Future difficulty having children
Dilation and Evacuation (D&E After Viability)
Late term – From about 24 weeks and up
This procedure can take up to three days. The cervix is first dilatedby placing absorbent dilators into the cervix which will typically stay in place up to two days. Dilating the cervix will cause cramping. On the third day, the provider will administer local or general anesthesia before the abortion procedure based on your insurance type, health history, and pain management level. The fetus will receive a drug to end its heartbeat and during the procedure its body will be dismembered in the same manner as D&E, above, and removed using instruments such as forceps, suction, and/or curettes.
Possible complications
- Retained tissue, including placenta
- Uterine perforation. (As a result, a major surgery may be required, including possible hysterectomy).
- Cervical laceration, perforation, and heavy bleeding
- Emotional trauma
- Future difficulty having children
Consider the Emotional Risks of Abortion
- Depression and anxiety
- Drug and alcohol abuse
- Post-traumatic stress disorder
- Suicidal thoughts, attempts, and deaths
- Relationship difficulties
If you have had an abortion and regret your decision, you are not alone. Studies show an increased risk of 81% of mental health problems after abortion compared to women who gave birth. If you regret your decision, call one of these hotlines or groups to find a support group and/or resources near you.
- Support After Abortion: call or text (844) 289-4673
- Columbia PC (in Maryland) at (410) 730-3223
- Option Line (24/7) at 1-800-712-4357 or 1-800-712-HELP
Contact Us
Find us
CT Women’s Center
12247 Georgia Ave
Silver Spring, MD 20902
Feeling Pressured?
You are the only one who can choose the outcome of your unplanned pregnancy. You should not allow anyone to force you into a decision or allow yourself to make the decision out of pressure by the many stressors that may be impacting you. Abortion is a long term decision, and irreversible if you change your mind too late or without proper information. Our staff wants to support you as you explore your options. If you’re feeling pressured, visit CT Women’s Center first.
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