Abortion Procedures and Techniques

First Trimester Abortion Procedures



Suction Aspiration


Suction aspiration or vacuum curettage, is used in most first trimester abortions. A powerful suction tube with a sharp cutting edge is inserted into the womb through the dilated cervix. The suction dismembers the body of the developing baby and tears the placenta from the wall of the uterus, sucking blood, amniotic fluid, placental tissue, and fetal parts into a collection bottle. Great care must be taken to prevent the uterus from being punctured during this procedure, which may cause hemorrhage and necessitate further surgery. Also, infection can easily develop if any fetal or placental tissue is left behind in the uterus. This is the most frequent post-abortion complication.


D&C (Dilatation (Dilation) and Curettage)


The cervix is dilated or stretched to permit the insertion of a loop shaped steel knife. The body of the baby is cut into pieces and removed and the placenta is scraped off the uterine wall. Blood loss from D & C, or mechanical curettage is greater than for suction aspiration, as is the likelihood of uterine perforation and infection. This method should not be confused with a routine D&C done for reasons other than undesired pregnancy (to treat abnormal uterine bleeding, dysmenorrheal, etc.).


RU 486 Abortion Pill


While many people focus solely on RU 486 (also called French abortion pill), this technique actually uses two powerful synthetic hormones with the generic names of mifepristone and misoprostol to chemically induce abortions in women that are five-to-nine weeks pregnant.

The RU 486 procedure requires at least three trips to the abortion clinic. In the first visit, the woman is given a physical exam, and if she has no obvious contra-indications (such as smoking, asthma, high blood pressure, obesity, etc.) that could make the drug deadly to her, she swallows the RU 486 pills. RU 486 blocks the action of progesterone, the natural hormone vital to maintaining the rich nutrient lining of the uterus. The developing baby starves to death as the nutrient lining disintegrates.

At the second visit which comes 36 to 48 hours later, the woman is given a dose of artificial prostaglandins, usually misoprostol, which initiates uterine contractions and causes the embryonic baby to be expelled from the uterus. Most women abort during the 4-hour waiting period at the clinic, but about 30% abort as many as 5 days later.

A third visit about 2 weeks later determines whether the abortion has occurred or a surgical abortion is necessary to complete the procedure.

There are several serious well documented side effects associated with RU 486/prostaglandin abortions, including prolonged severe bleeding, nausea, vomiting, pain, and even death. At least one woman in France died while others had heart attacks from the technique. In U.S. trials conducted in 1995, one woman is known to have nearly died after losing half her blood and requiring emergency surgery.

There are reasons to believe that RU 486 could affect not only a womans current pregnancy, but her future pregnancies as well, potentially inducing miscarriages or causing severe malformations in later children.


Methotrexate Injection


The procedure is similar to the RU 486, except it is administered by an intramuscular injection instead of a pill.

Originally designed to attack fast growing cells such as cancers by neutralizing the B vitamin folic acid necessary for cell division, methotrexate attacks the fast growing cells of the trophoblast as well. This is the tissue surronding the embryo that eventually grows the placenta. The trophoblast not only functions as the life support system for the developing child by drawing oxygen and nutrients from the mothers blood supply and disposing of carbon dioxide and waste products, but also produces the hCG (human chorionic gonadotropin) hormone which signals the corpus luteum to continue the production of progesterone necessary to prevent breakdown of the uterine lining that causes the death of the baby. Methotrexate initiaties the disintengration of that sustaining, protective, and nourishing environment. Deprived of the food, oxygen, and fluids, the baby dies.

Three to seven days later a suppository of misoprostol (the same prostaglandin used with RU 486) is inserted into a womans vagina to trigger expulsion of the tiny body of the child from the womans uterus. Sometimes this occurs within the next few hours, but often a second dose of the prostaglandin is required, making the time lapse between the initial administration of methotrexate and the completion of the abortion take as long as several weeks. A woman may bleed for weeks days, even heavily, and may abort anywhere without notice. Those found to still be pregnant in later visits are given surgical abortions

Some abortion doctors are reluctant to prescribe methotrexate because of its high toxicity and unpredictable side effects. Those side effects commonly include nausea, pain, diarrhea, as well as less visible but more serious effects such as bone marrow depression, severe anemia, liver damage and methotrexate-induced lung disease.



Second & Third Trimester / Late-Term Abortion Procedures



Dilatation (Dilation) and Evacuation (D&E)


This technique is used to abort unborn children as old as 24 weeks, and s similar to the D&C. The difference is that forceps with sharp metal jaws are used to grasp parts of the developing baby, which are then twisted and torn away. This continues until the childs entire body is removed from the womb. Because the babys skull has often hardened by this time, the skull must sometimes be compressed or crushed to allow removal. If not carefully removed, sharp edges of the bones may cause cervical laceration. Bleeding from the procedure may be extreme.


Salt Poisoning Instillation


Otherwise known as saline amniocentesis, salting out, or a hypertonic saline abortion, this technique is used after 16 weeks of pregnancy, when enough fluid has accumulated in the amniotic fluid sac surrounding the baby.< /p>

A needle is inserted through the mothers abdomen and 50-250 ml of amniotic fluid is withdrawn and replaced with a solution of concentrated salt. The baby is poisoned by breathing in and swallowing the salt. The chemical solution also causes painful burning and deterioration of the babys skin. Usually, after about an hour, the child dies. The mother goes into labor about 33 to 35 hours after instillation within 72 hours the mother delivers a dead, burned, and shriveled baby.

Hypertonic saline can casue the mother to expereience consumption coagulopathy (uncontrolled blood clotting throughout the body) with severe hemorrhage as well as other serious side effects on the central nervous system. Seizures, coma, or death may also result from saline inadvertently injected into the womans vascular system.


Urea Instillation


Because of the dangers associated with saline methods, other instillation methods such as hypersomolar urea may be used by abortion doctors. These are less effective and usually are supplemented with oxytocin or a prostaglandin in order to achieve the desired result. Incomplete or failed abortion casued by this method adds the additional risk of surgery.

As with other instillation techniques, gastrointestinal side effects such as nausea or vomiting are frequent, but the most common problem with second trimester techniques is cervical injuries, which range from small lacerations to complete detachments of the anterior or posterior cervix. 1-2% of patients using urea must be hospitalized for treatment of endometritis, an infection of the lining oft he uterus.


Prostaglandins Instillation


Prostaglandins are naturally produced chemicals which assist in the birthing process. The injection of concentrations of artificial prostaglandins prematurely into the amniotic sac, induces violent labor and a baby is born too that is young to survive. Often salt or another toxin is first injected to ensure that the baby will be delivered dead, since some babies have survived the trauma of a prostaglandin birth and been born alive.

In addition to risks of retained placenta, cervical trauma, infection, hemorrhage, hyperthermia, bronchoconstriction, tachycardia, more serious side effects and complications from the use of artificial prostaglandins, including cardiac arrest and rupture of the uterus, can be unpredictable and very severe. Even death is a possibility


Partial-Birth Abortion


Abortion doctors may call this method Dilation and Extraction (D&X) or Intact D&E (IDE) to hide the truth about what this type of abortion really is. This procedure is used to abort women who are 20 to 32 weeks pregnant, or even later into pregnancy. Using ultrasound as a guide, the abortionist enters into the uterus, grabs the leg of the unborn baby leg with forceps, pulls the baby into the birth canal, except for the head, which is deliberately kept just inside the womb. At this point the baby is alive. Then the abortionist jams scissors into the back of the skull of the baby and spreads the tips of the scissors apart to inflict maximum destruction. After removing the scissors, a suction catheter is inserted into the skull and the brains are sucked out. The collapsed head is then removed from the uterus.


Hysterotomy


Similar to the Caesarean Section, this method is generally used if chemical methods such as salt poisoning or prostaglandins fail to work. Incisions are made in the abdomen and uterus and then he baby, placenta, and amniotic sac are removed. Babies are sometimes born alive during this procedure, raising questions as to how and when these infants are murdered.This method offers the highest risk to the health of the mother, because the risk of rupture during subsequent pregnancies is high.