Descriptions of abortion methods commonly used for each trimester of pregnancy are provided below. A list of references for the information is also included. The methods are listed in alphabetical order. Any of the below mentioned risks or complications can be lessened with good medical care.

• In this type of procedure, the cervix is slowly opened and the fetus, placenta and membranes are scraped from inside the uterus with a sharp instrument.

• Incomplete abortion requiring vacuum aspiration
• Infection of the uterus
• Excessive bleeding
• Torn cervix
• Infection of fallopian tubes
• Punctured uterus
• Blood clots in the uterus
• Reaction to anesthesia
• Infertility

• This is a type of medical abortion with the first medication, Methotrexate, being given by injection into the muscle, followed by vaginal placement of misoprostol.
• The fetus, placenta and membranes are generally expelled the next day. If not, the dosage of misoprostol is repeated.

Possible complications

• Incomplete abortion which may necessitate a surgical abortion
• Allergic reaction to medications
• Prolonged bleeding
• Nausea and vomiting
• Diarrhea
• Abdominal pain and cramping

• This medication can be taken up to 5 weeks after conception.
• The woman is given Mifepristone to be taken by mouth. After a period of time in the doctor’s office, she may return home.
• At 36 – 48 hours after this dose, the woman returns to receive the proper amount of misoprostol.
• The client should then be watched closely by doctors and nurses for a few hours.  The fetus, placenta and membranes are usually expelled during this time. (For further information from the FDA see www.fda.gov)
• The woman should return to the doctor's office on 14th day after taking the medication to assure that there are no problems and that the fetus, placenta and membranes have been fully expelled.

Possible complications

• Incomplete abortion which may necessitate a surgical abortion
• Allergic reaction to medications
• Prolonged bleeding
• Nausea and vomiting
• Diarrhea
• Abdominal pain and cramping

• Incomplete abortion requiring vacuum aspiration
• Infection of the uterus
• Excessive bleeding
• Torn cervix
• Infection of fallopian tubes
• Punctured uterus
• Blood clots in the uterus
• Reaction to anesthesia
• Infertility

• Blood clots in the uterus
• Heavy bleeding
• Cut or torn cervix
• Perforation (puncture) of the wall of the uterus
• Pelvic infection
• Incomplete abortion
• Reaction to the anesthesia
• Infertility

• Retention of pieces of the placenta
• Pelvic infection
• Heavy bleeding
• Ruptured uterus
• Blood clots
• Incomplete abortion
• Reaction to anesthesia
• Infertility

• Retention of pieces of the placenta
• Pelvic infection
• Heavy bleeding
• Ruptured uterus
• Blood clots
• Incomplete abortion
• Reaction to anesthesia
• Infertility

See above

• In this procedure, the physician pulls the fetus feet-first out of the uterus into the birth canal, except for the head which is kept lodged just inside the uterus.
• The base of the fetus’s skull is punctured with a sharp instrument such as a long scissors or pointed metal tube.
•  A catheter is inserted into the wound and removes the fetus’s brain with a powerful suction machine.  This causes the skull to collapse, and allows for the expulsion of the fetus.

• Risks are similar to childbirth
• Uterine infection
• Blood clots to heart, lungs and brain
• Heavy bleeding
• High blood pressure
• Reaction to anesthesia
• Infertility

Amniotic sac: Membrane bag that contains the fetus and fluid before birth.

Cervix: Lowest and narrow end of the uterus; the neck, which extends into the vagina.

Conception: Union of the sperm and egg resulting in fertilization.

Curettage: Scraping of the lining of the uterus with a sharp instrument to remove fetus, placenta and membranes.

Dilatation: Stretching of the mouth of the uterus (cervix) to open wide enough to allow passage of the baby.

Fetus: SDCL 34-23A-1 (2) and SDCL 34-25-1.1 (4) define fetus as "the biological offspring, including the implanted embryo or unborn child, of human parents."

Hypertonic urea: A solution containing a large amount of salts.

Incision: Surgical cut.

Intra-amniotic instillation: Putting liquids that contain large amounts of salts into the amniotic sac.

Local anesthetic: The use of medication to numb a small area of the body.

Membranes: Thin layer of tissue that surrounds the fetus.

Oxytocin: Drugs that cause the uterus to contract.

Placenta: Flattened, round mass of spongy tissue that contains a lot of blood vessels. It attaches to the inside of the inside of the wall of the uterus and carries food and oxygen to the fetus, and carries wastes away from the fetus..

Prostaglandin: Substance present in many body tissues. Used to induce abortions or labor.

Suction catheter: A tube that sucks the fetus, placenta and membranes from the uterus.

Suppositories: A cone-shaped semi-solid substance used to put medication in the vagina.

Systemic: Pertains to the whole body. Involves many organ systems.

Trimester: One of three periods of about 3 months each into which pregnancy is divided.

Vacuum device: A machine that uses suction to remove the fetus, placenta and membranes.

• An adverse drug reaction is any effect not intended by proper use of a medication.
• Reactions also can occur between medications, even non-prescription ones.

• Problems breathing

• Blockage of the air passages of the nose, mouth, or throat may lead to difficulty breathing.
• Heart disease can cause shortness of breath if the heart is not able to pump enough blood to supply oxygen to the body.
• If the brain, muscles, or other body organs do not receive enough oxygen, a sense of breathlessness may occur.
• Sometimes emotional distress, such as feeling anxious can lead to difficulty breathing.

• This condition involves losing blood.
• This can occur internally (when blood leaks from blood vessels inside the body), externally through a natural opening (vagina, mouth or rectum) or externally through a break or wound in the skin.

• Infection

• A disease caused by microorganisms (germs), especially those that release toxins or invade body tissues.

• Excessive bleeding or hemorrhage is defined as the rapid loss of blood of more than 1% of body weight or 10% of total blood volume.
• Rapid loss of more than 1.5 to 2 liters of blood may result in hypovolemic (low blood volume) shock.
• Early symptoms would include pale, clammy skin, decreased urine output, discoloration (turning blue) of lips and nail beds.
• These may be followed closely by feelings of anxiety, restlessness and shortness of breath.

• Infection of the uterus

• Infections of the uterus can be decreased by screening and treating for sexually transmitted diseases before the abortion, by complete emptying of the uterus and by giving antibiotics as a preventative measure when surgical methods have been used.
• Symptoms of infection may include abdominal pain, and or backache, cramping, fever and or chills, foul vaginal discharge, and pelvic discomfort.

• Intrauterine blood clots

• These can occur either right away or as long as 5 days after a surgical abortion.
• Symptoms include severe cramping and pain without bleeding.

• Infection of the fallopian tubes (which can cause scarring and lead to infertility)

• Pelvic inflammatory disease (PID) is one of the major causes of infertility (a woman has difficulty or is unable to conceive a pregnancy), ectopic pregnancy (pregnancy outside of the uterus), and chronic pelvic pain.

• PID can result from microorganisms (germs) transmitted during an abortion.
• Symptoms include lower abdominal pain, fever and chills, nausea and vomiting, unusual vaginal bleeding or foul smelling discharge.

• Puncture (perforation) of the uterus, or damage to the cervix (rare)

• Puncture of the uterus and tearing of the cervix are complications of surgical abortion.
• Depending on their severity, these complications may require attention ranging from simple observation to hysterectomy (removal of the uterus).

• Prolonged bleeding

• Bleeding following a medical abortion may last for 30 days or more.
• Rarely, excessive bleeding may require a D & C (scraping of the lining of the uterus) or blood transfusion.

• Incomplete abortion necessitating a surgical abortion

• Some parts of the fetus, placenta or membranes may be retained resulting in the need for a follow-up curettage.

• Nausea or Vomiting

• According to FDA trials, nausea occurred in 61% of women after taking Mifepristone and Misoprostol, whereas vomiting occurred in 26%.

• Diarrhea

• According to FDA trials, diarrhea occurred in 20% of women after taking Mifepristone and Misoprostol.

• Abdominal pain and cramping

• According to FDA trials, abdominal pain and cramping occurred in 96% of women after taking Mifepristone and Misoprostol.

• Infertility

• Difficulty or inability to conceive.
• Generally results from damage to the fallopian tubes, uterus or cervix either directly by surgical procedure or as the result of infection.

• With any surgical procedure, blood clots may form or break loose, and travel to the heart, lungs or brain. Heart attack, pulmonary emboli, or stroke may result.

Most women who undergo surgical abortions done in appropriate medical facilities recover without physical complications.

Any significant emotional and psychological issues should be considered and addressed before and after a chosen abortion.

Findings from some studies suggest that the unborn child may feel physical pain.

Taber’s Cyclopedic Medical Dictionary, Edition 19
F. A. Davis Company
Philadelphia, PA
Published 2001

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