There are many ways to perform abortion procedures. Each Physician has his or her preference for using one or a combination of methods to successfully carry out the procedure. There are 3 procedures used to perform late term and third trimester abortion procedures.
Late Term Abortion Methods
Induction of preterm labor after performing a procedure causing fetal death in-utero is commonly performed for second trimester and third trimester abortions. This is due to the fact that less physicians are being trained in Ob/Gyn residency programs to perform surgical procedures. The medical literature from around the world show that induction of labor is efficient, safe, and has minimal complications. On the first day of the office visit, the patient is sedated with medications such as a narcotic and antianxiety agent like Valium so that she will not remember or feel any discomfort. These medications cross the placenta and causes the fetus to go to sleep. Medications are then instilled into the intrauterine cavity or directly into the fetus that stop the heart beat. Laminaria (sterile seaweed) are inserted inside the cervix allowing for gradual opening to occur overnight. They cause a decrease in complications that can occur from tears of the cervix to retained gestational products. In addition, it allows a faster delivery which reduces overall maternal side effects. The patient returns to the facility the following morning and labor is initiated. This requires the use of medications such as prostaglandins that lead to labor. Patients are given medications to alleviate discomfort as required.
Dilatation and Extraction
The fetal heart is stopped as described above. Laminaria are then placed into the cervix to allow the cervix to gradually open overnight. The following morning, the patient is given medication that leads to further dilation and softening of the cervix. Serial dilators may be used if the physician decides that a surgical procedure can be performed. After sufficient dilatation is achieved, the fetus is then gently extracted with the use of special forceps. This procedure only takes approximately 10 to 30 minutes up to a few hours to complete. The mother is given intravenous anesthesia prior to the surgical procedure is performed so she will not experience any pain.
This is a procedure that is similar to a Caesarean Section. For this procedure epidural anesthesia is given which numbs the patient's lower part of the body. An abdominal incision is made into the uterus. After making a sufficient opening, the surgeon removes the fetus. The placenta and umbilical cord will also be removed. Once assured the gestational tissue has been removed from the uterus; the incision is then closed and dressed to promote healing of the skin. This method is rarely used as it is associated with the highest maternal morbidity and mortality compared to the other methods discussed above.
Other Late Term Abortion Clinic Services
Most clinics are not limited to performing only abortion procedures. Many also offer medical and emotional support for those mothers who have undergone abortion procedures. They also provide consultation and counseling regarding appropriate abortion practices. Other clinics also offer the use of fetal intracardiac medications for those patients whose pregnancies pose severe defects deemed incompatible with life. After injection of the above described medications, a mother can elect to have a third trimester abortion in the Late Term Abortion clinic or go to her private gynecologist or physician to have the necessary final phase of abortion procedure completed.