Abortion Procedures
February 22, 2006
Manual Vacuum Aspiration
► One of three forms of vacuum aspiration:
MVA, EVA (electronic) and D&C
Key Distinction: MVA uses an IPAS manual
syringe
► Used through first 14 weeks after last
period
► Vacuum Aspirations account for 90%
MVA: The Procedure
► Speculum inserted
► Possible injection of numbing medication in/near
cervix
► Dilation:
Increasingly thick rods
Absorbent Dilators- take in fluid/stretch cervix (generally overnight)
Medication
► Tube inserted into uterus via cervix
► Hand-held pump flushes uterus
MVA: Relatively Speaking
► Considered to be one of the safer forms of abortion
► Procedure is 5-15 minutes long (others take longer)
► 99.5% Effective
Procedure is repeated for the 0.5% failures
► Lower Cost
► Quieter than a machine pump
► Can remove full gestational sac
MVA: Side Effects
► Despite being a ‘safer’ method, MVA still
has its side effects:
Abdominal cramping/pain
Bleeding
►Several days of heavy bleeding
►Spotting for up to 6 weeks
Rare, but more severe, complications:
►Uterine/Cervical perforation
►PelvicInfection
►Excess Bleeding
MVA in Moldova
► Moldova is located between Russia and Romania
50 Years of Legal Abortion
NAF funds the improvement of their abortions
► Began the MVA Project in Moldova in 2002
Dilation and Curettage (D&C)
► Curettage: Using a loop-shaped knife to remove
tissue from the uterus
► Common gynecological surgical procedure
Following miscarriages,
To treat excessive mentral flow
► Used for first trimester abortions
► As an independent procedure: May use the knife
to dismember the body, followed by cleaning out
the uterus.
► Often involves dilation followed by suction of the
contents of the uterus
D&C: Why It’s Uncommon
► Considered a relatively risky abortion procedure
► Asherman’s Syndrome: excess tissue seals the
uterus shut
► WHO recommends D&C only if vacuum
aspiration unavailable
► 1972: D&C accounted for 23.4% of abortions
► 2002: D&C accounted for 2.4%
Dilation and Evacuation (D&E)
► Surgical procedure
► Mostcommon second trimester abortion
procedure, 12-24 weeks
Baby doubles in size from weeks 11-13, and
becomes too large to extract with suction
aspiration techniques
D&E: Procedure
► Dilation of cervix (1-2 days)
Conical rods or absorbent dilators
► Forceps inserted, baby dismembered (10-15 mins)
twisting of limbs, spine snapped, skull crushed
► Body may be reassembled outside of uterus to
ensure completion
► Possible ultrasound to confirm that the uterus is
empty
D&E: For the Mother
► Sedatives, painkillers, general anesthesia,
numbing injections to the cervix during
procedure
► Possible Complications:
Perforation of uterus
Cervical laceration
Incomplete removal
Infection
Inability to become pregnant
Hemorrhage
Medical Abortion (RU-486)
► Three steps
► First, either a dose of mifepristone in tablet form or an
injection of methotrexate is given.
Mifepristone blocks the hormone progesterone. Without
progesterone, the lining of the uterus breaks down, ends
pregnancy in the uterus, and causes vaginal bleeding.
Methotrexate stops pregnancy in the uterus. It also stops those
that develop in a fallopian tube — ectopic pregnancies.
► Second, another medication called misoprostol is taken
in tablet form. This causes the uterus to contract and
empty with vaginal bleeding.
► Third, the woman must return to the clinician for follow-
up to make sure the abortion is complete.
► Available first 63 days of pregnancy (9 weeks)
RU-486: How it Works
► Most women who use mifepristone have the abortion
within four hours of taking misoprostol. About 10
percent of women who use mifepristone have the
abortion before they take misoprostol — as early as a
day after taking mifepristone. For others, bleeding
begins within 24 hours of taking misoprostol. The
process usually takes about a week.
► About 50 percent of women who use methotrexate have
the abortion the same day they take misoprostol — as
early as five days after taking the methotrexate. It
happens within a week for another 35–40 percent. The
whole process can take up to 14 days.
► In some cases, bleeding may occur for up to four weeks
RU-486: Side Effects
► Can cause serious birth defects if pregnancy continues
► Bleeding as if a heavy period
► Strong cramps
► Temporary abdominal pain
► Feel uncomfortably warm
► Have fever and chills
► Feel nauseous or vomit
► Diarrhea
Saline Abortions
(Saline Amniocentesis)
►A needle is inserted through the mother’s
abdomen and 50-250 ml (as much as a cup) of
amniotic fluid is replaced with a solution of
concentrated salt.
► The baby breathes and swallows the solution,
and usually dies 1 to 2 hours later from salt
poisoning, dehydration, hemorrhages of the
brain and other organs, and convulsions.
► The baby’s skin is often stripped or burned off
by the salt solution.
► The mother goes into labor about 33 to 35 hours
delivers a dead baby
► Used after 16 weeks
Complications for the Mother
► Hypertonic saline may initiate a condition in
the mother called "consumption
coagulopathy" (uncontrolled blood clotting
throughout the body) with severe
hemorrhaging 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
woman’s vascular system
Partial-Birth Abortion (D&X)
► This form of abortion takes
place in the fifth and sixth
months of pregnancy, or
approximately 20-26 weeks
► With the help of an
ultrasound, the abortion
doctor grabs the baby’s legs
with forceps and repositions
the child in the birth canal in
the breech position, legs
first
Partial-Birth Abortion
► The abortionist delivers
the entire child, except
for the head, which he
purposely leaves in the
canal so the medical
definition of “birth” does
not occur
Partial-Birth Abortion
► With a scissors, the
abortion doctor punctures
the base of the living
baby’s skull and spreads
the scissor blades apart to
widen the hole
Partial-Birth Abortion
► A catheter is inserted into
the resulting hole, and
the contents of the
child’s skull is sucked
out, causing him or her a
brutal, painful death
► The collapsed head is
then removed from the
birth canal
The Tragedy
► When the child is partially delivered, he or she is often
kicking and moving his or her arms, very obviously a
person and very obviously alive
► Like most abortion procedures, partial-birth is only
performed on a child who has serious mental or
physical disabilities about 20% of the time; in at least
80% of cases, the mother simply chooses abortion
because the child is unwanted
► By the time the baby is killed, he or she is only inches
from a medical definition of live birth, and nearly all
victims of partial-birth abortion are viable at the time of
the procedure—adoption would be a perfectly plausible
solution if the mother couldn’t care for the child
Despite What They Say…
► This procedure is NEVER necessary to protect the mother’s health;
in fact, it is likely to be painful and is potentially damaging to her
fertility.
Labor is induced by artificially dilating the cervix over a period of three
days, which could result in the condition known as Incompetent Cervix and
interfere with the woman’s ability to have children in the future
The child is partially-delivered in the breech position, a position undesirable
for safe live births—maneuvering the baby into this position can cause
uterine rupture
Surgical instruments are inserted into the birth canal, increasing risks of
infection or uterine puncture
Regardless of pro-choice claims to the contrary, partial-birth abortion is
definitely not the safest method for the mother
References
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► Reproductive Health Tech. Project:
[Link]
► Planned Parenthood:
[Link]
[Link]#1097785696224::8279011707666963798
► FWHC Services:
[Link]
► National Abortion Foundation:
[Link]
