Surgical
Abortion
SURGICAL ABORTION
Every woman should be fully informed before making a decision to terminate
At Genesis, we have witnessed firsthand for many years, the devastation that can result when information about abortion procedures or fetal development is learned after the event. This is your body, your pregnancy and your future. Accurate information is the safest way to come to your decision. Avoidance will not remove the reality of the experience afterwards so it is best faced now before your choice is made.
1st Trimester: up to 12 weeks gestation
- Commonly known as Vacuum or Aspiration or Suction Termination of Pregnancy. [VTOP, STOP or D&C(T)]
- It can be performed from 5 weeks although doctors prefer the pregnancy to be at least 7-9 weeks so that the complete expulsion of the fetus is more easily discerned.
- It can be done under a general anaesthetic, nitrous oxide, or a local anaesthesia either injected directly into the cervix or intravenously.
- The cervix is dilated by a series of rods of progressively larger sizes being inserted.
- A tube with suction applied is then introduced through the cervix into the uterus and the fetus and placenta are suctioned out.
- The lining of the uterus is then scraped (curettage) to ensure that all the contents have been removed.
- All parts of the fetus and placenta must then be visually examined and accounted for to avoid any possible risk of infection from unremoved tissue.
Relevant fetal development (www.medicinenet.com)
2nd Trimester : 13-27 weeks gestation
The same procedure as 1st trimester is basically used up to around 18 weeks of pregnancy
- As gestation increases, greater cervical dilation is needed. This is achieved using Misoprostol which softens and dilates the cervix to allow for a larger catheter (suction tube).
Dilation and Evacuation : D&E
- This method is used for pregnancies up to 27 weeks.
Day 1
- The cervix is first dilated with several doses of Misoprostol.
- Potassium chloride is injected into the heart or amniotic fluid or umbilical cord to stop the heartbeat (this step is not always included depending on gestation).
- Laminaria (a seaweed product and osmotic dialator) is inserted into the cervix.
- The woman goes home with a vaginal pack in place.
Day 2
- Further dose/s of Misoprostol are given.
- A general anaesthetic is given and, if adequate dilation of the cervix has been achieved, grasping forceps are used to remove the fetus and placenta.
- As the fetus is larger at this stage of the pregnancy and is not usually able to be removed intact, it is removed in pieces.
- At later stages ( >23 weeks) labour is induced by intravenous drip using synthetic oxytocin and the fetus removed via dismemberment.
Relevant fetal development (www.medicinenet.com)
Intact Dilation & Extraction : D&X
A variant of dilation and evacuation can be performed when sufficient cervical dilation is present. In these cases,
- the fetus is delivered via breech extraction.
- If the fetus is not in the breech presentation, internal manipulation may be used to adjust the position.
- after delivery of the body, the fetal head will become lodged in the cervix.
- Decompression of the skull is performed with suction to complete the abortion.
This procedure is illegal in the United States. It is not illegal in Australia.
There is no published data regarding the frequency or complication rate of this procedure.
We know this can be such a difficult decision to make
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