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
► http://www.optionline.org/abortion.html
► http://www.absoluteastronomy.com/reference/dilation_and_curetta
ge
► http://www.thedoctorslounge.net/gynecology/diseases/abortion.htm
► http://www.answers.com/topic/dilation-and-curettage
► http://www.nrlc.org/abortion/ASMF/asmf5.html
► http://www.webmd.com/hw/womens_conditions/tw1469.asp
► http://en.wikipedia.org/wiki/Dilation_and_evacuation
► Reproductive Health Tech. Project:
 http://www.rhtp.org/abortion/mva/default.asp

► Planned Parenthood:
 http://plannedparenthood.com/pp2/portal/files/portal/medicalinfo/abortion/pub-a
bortion-surgical.xml#1097785696224::8279011707666963798
► FWHC Services:
 http://www.fwhc.org/abortion/ab-procedures.htm
► National Abortion Foundation:
 http://www.prochoice.org/international/training/moldova.html