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CONSIDERING ABORTION?


Perhaps now is not the best time to find out you’re pregnant. At Choices, we care about you and your abortion decision. The first step is to confirm that you’re really pregnant. Our medical staff will provide you with a free pregnancy test and a free limited ultrasound exam. Since 1 out of every 5 pregnancies ends in natural miscarriage, it’s important to confirm that you have a viable pregnancy. You may not need an abortion.


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ABORTION PROCEDURES


If you’re thinking about getting an abortion you probably have a lot of questions. Get all of the facts before you decide. There are many risks associated with the procedure including physical, emotional & psychological.


There are two types of abortion procedures: Surgical and Medical


Surgical Abortion – Surgical instruments are used to extract the fetus from the uterus.


Medical Abortion (link to RU486) – Drugs are administered to the pregnant woman that stop the fetus from developing and ultimately expel the fetus from the uterus.

One of the factors that determine the method of abortion is how far along the woman is in her pregnancy.

The gestational age of the pregnancy is determined by the woman’s last menstrual period (LMP).



What Happens During an Abortion?


One of the most frequently asked questions by women considering abortion is “What will the doctor do to me during an abortion?”

The answer to this question depends upon what point you are in your pregnancy. Doctors divide a typical nine-month pregnancy into three-month long periods called trimesters and date your pregnancy from the beginning of your last menstrual period (LMP).


First Trimester (1st, 2nd and 3rd Month of Pregnancy)


During the first three months of pregnancy, the three most common types of abortion are Suction Aspiration (after 7 weeks of LMP), Medical Abortion or RU486 (4 to 7 weeks after LMP), or Dilation & Curettage (D&C) (6 to 14 weeks after LMP) may be used.


Suction Aspiration Abortion (within 7 weeks after LMP)

This surgical abortion is done early in the pregnancy, up until 7 weeks after the beginning of your last menstrual period (LMP). The cervix (the opening of the womb) must be stretched wide enough to allow the abortion instruments to pass into the uterus. This is difficult to do because, until natural childbirth, the muscles of the cervix are closed tight and are hard. Sometimes the abortionist uses dilators or long cylindrical rods. Starting with the rod of the smallest diameter, he inserts them into the cervical opening, stretching it open with rods of increasing diameter.


When the cervix is open wide enough, the doctor will put a cannula (a hollow plastic tube) with a knife-like edge on its tip, through your cervix and into your uterus. With a manual vacuum aspiration abortion, a hand held syringe is attached to the tube. The fetus is torn from the uterine wall and suctioned out into a collection bottle. With an electric vacuum-aspiration abortion, the suction created by the electric vacuum attached to the tube is 29 times more powerful than a home vacuum cleaner. It tears the fetus into pieces and sucks it through the tube into the collection bottle. The knife edge is used to cut the deeply rooted placenta from the uterine wall. After the procedure, all of the parts (limbs and head) of the fetus must be accounted for to avoid infection.


What you experience: You may have the procedure explained to you and be required to sign consent forms. You may be awake or given medicine to make you drowsy. The doctor performs the painful procedure. Throughout the procedure you will hear the noise from the powerful suction machine used. Afterward, you may be given medications to prevent infection. You will experience cramping, bleeding.


Dilation & Curettage (D&C) (within 6 to 14 weeks after LMP)

For this surgical abortion, the doctor opens the cervix with dilators (metal rods) or laminaria (thin sticks inserted several hours before the procedure that absorb body moisture and swell, pushing open the cervix). The doctor then inserts a curette (a loop shaped steel knife) into the uterus. He cuts the fetus into pieces and scrapes the pieces into a basin. The placenta is also scraped off the uterine wall with the knife. This usually causes a lot of bleeding.


Second Trimester (4th 5th & 6th Month of Pregnancy)


Dilation and Evacuation (D&E) (within 13 to 24 weeks after LMP)

This surgical abortion is done during the second trimester of pregnancy. Because the developing fetus doubles in size between the eleventh and twelfth weeks of pregnancy, the baby’s body is too large to be broken up by suction and will not pass through the suction tubing. In this procedure, the cervix (opening to your uterus) must be opened wider than in a first trimester abortion. This is done by inserting laminaria a day or two before the abortion. The laminaria are sticks made of a highly absorbent material about the thickness of a pencil lead, but as they absorb moisture from your body, they swell and force the cervix open. When you return to the office, the doctor will insert forceps (a long pliers-like instrument) into the uterus. Because the baby is too large to fit through the cervix, the forceps are used to grab hold of the baby’s leg or arm and twist it until it is torn from the baby’s body. That part is then pulled through the cervix. This grabbing and twisting is repeated, limb by limb, until the baby has been totally torn apart and pulled from your body. The baby’s spine must also be snapped, and its skull crushed in order to remove them from the uterus. At this point in the pregnancy, the bones in the baby’s skull are hard enough that they could cut the cervix during removal. The nurse’s job is to lay out all the body parts to make sure the entire baby has been removed from the uterus. If all parts haven’t been removed, you will develop an infection (see Abortion Risks for more information)


Digoxin Induction: (20 to 32 weeks after LMP)

Involves injecting a lethal chemical directly into the heart of the fetus followed by labor induction with prostaglandin.


Third Trimester (7th, 8th, & 9th Month of Pregnancy)


There are only 4 doctors in the United States that perform 3rd trimester abortions and the procedure is only legal in three states.


Abortion Risks and Complications


What you need to know about abortion risks and complications


Some side effects may occur with induced abortion. These include abdominal pain, cramping, nausea, vomiting and diarrhea. However, complications may happen in as many as 1 out of every 100 early abortions (4-7 weeks) and in about 1 out of every 50 later abortions (8 weeks and beyond). Such complications may include:


Heavy Bleeding

Some bleeding after abortion is normal. Large clots may also be passed. There is, however, a risk of hemorrhage, especially if the uterine artery is torn. When this happens, a blood transfusion may be required.


Infection

Bacteria may cause an infection if the abortion doctor does not completely remove all parts of the baby. A serious infection may lead to persistent fever over several days, extended hospitalization and even death.


Incomplete Abortion

Some of the baby’s body parts may not be removed by the abortion. Bleeding and infection may occur. RU486 fails in up to 1 out of every 20 cases. Another abortion may be required to remove the remaining body parts.


Allergic Reaction to Drugs

An allergic reaction to anesthesia used during abortion surgery may result in convulsions, heart attack and, in some cases, death.


Tearing of the Cervix

The cervix may be cut or torn by abortion instruments, which may cause problems with future pregnancies.


Scarring of the Uterine Lining

Suction tubing, curettes, and other abortion instruments may cause permanent scarring of the uterine lining, resulting in infertility up to 14% of patients.


Perforation of the Uterus

The uterus may be punctured or torn by abortion instruments. The risk of this complication increases with the length of the pregnancy. If this occurs, major surgery may be required to repair the damage. In some cases the damage is so great that a hysterectomy (complete removal of the uterus) may be required.


Damage to Internal Organs

When the uterus is punctured or torn, there is also a risk that damage will occur to nearby organs, such as the intestines, bladder, kidneys and ureters (the tubes connecting the kidneys to the bladder). In some cases, the bowel is so damaged a colostomy is required. (In a colostomy, a piece of the colon is diverted to an artificial opening in the abdominal wall to bypass the damaged part of the colon)


Death

In some cases, other physical complications from abortion, including excessive bleeding, infection, organ damage, perforated uterus, and bad reactions to anesthesia may lead to death.


Effect on Future Pregnancy

Uterine scarring, damage to the cervix or other injury during an abortion may prevent you from becoming pregnant when you do decide to have children, or put your future pregnancies at risk. The risk of miscarriage is greater for women who abort their first pregnancy.


Emotional Impact

Women experience strong negative emotions after abortion. Some of these feelings are masked or compounded by changing hormone levels. Sometimes this occurs within days and sometimes it happens after many years. This psychological response is known as Post-Abortion Stress (PAS). Several factors affect the likelihood of Post-Abortion Stress, including: your age, the circumstances under which your abortion occurred, the stage of pregnancy at which the abortion occurs, and your religious beliefs. The symptoms of Post-Abortion Stress include:



Before you decide, let us help walk you through all of your alternatives. Learning as much as you can about your options is the best way to make a decision that’s right for you. We’re here to help you sort through your emotions, fears and concerns. We don’t judge – we listen.


We care about you.


Call us today to schedule a free and confidential appointment (732) 516-0911


Choices, Options for Women’s Health Does not Refer or Perform Abortions.