Surgical Abortion

Depending on how far along the pregnancy is, there are TWO types of Surgical Abortion offered at Heritage Clinic for Women.

I. SUCTION CURETTAGE Surgical Abortion

Heritage Clinic for Women offers the suction curettage surgical abortion procedure if your pregnancy length is between 5-13 weeks LMP. Suction Curettage abortion procedure is the most common method of abortions performed in the United States.

Procedure

You will be accompanied into the exam room by a member of our medical staff, who will remain with you as support during the abortion and as an assistant to the physician.

It is normal to experience cramping with an abortion, which may be less than or greater than your normal menstrual cramps. To help maximize comfort, we provide a narcotic before the procedure called Fentanyl that acts as a pain reliever. Additionally, an anti-anxiety medication called Midazolam is provided to help you to feel more relaxed and less anxious.

Once you have received these medications and our physician has performed a basic pelvic exam, the cervix is numbed with a local anesthetic. A series of increasingly larger dilating rods will be inserted into the cervical canal, which will open or dilate the cervix. Once the cervix is dilated, the physician will insert a small, sterile, plastic aspirating tube into the uterus that provides suction and removes the pregnancy. The entire Suction Curettage procedure takes approximately three to five minutes to complete.

Considerations, Side Effects and Risks

First trimester abortions are considered the safest way a pregnancy can end. Every woman is different, but most women experience some cramping and bleeding after an abortion. You will receive thorough instructions regarding restrictions, recovery and aftercare to minimize the risk of problems.

More than 97% of all first trimester abortions take place without any complications. Of the remaining percentage, 2.5% experience minor complications such as infection, retained tissue, and heavier bleeding which, if addressed promptly, can be handled with medication or a return visit to the clinic.

Continuing pregnancy is possible after a very early suction curettage abortion and could be due to multiple pregnancies, a double uterus, or an ectopic pregnancy; however, due to a routine ultrasound prior to every abortion, these conditions are normally discovered and addressed before the abortion even occurs.

More major complications such as perforation of the uterus, prolonged infection, or prolonged hemorrhage might require additional medical support. Although, the need for hospitalization or surgery is less than .005%. It is extremely rare that anyone would have a complication, or require treatment for a complication, that is severe enough to cause damage to the reproductive system, damage a woman’s health, or threaten her life. These risks are possible regardless of how the pregnancy ends: miscarriage, abortion, C-section or vaginal delivery.

Statistically speaking, first trimester abortions are the safest way a pregnancy can end. Our counseling and medical staff provide thorough aftercare instructions, and existing clients have emergency access to our physician 24 hours a day.

Items to bring with you at the time of your appointment.

II. DILATION & EVACUATION (D&E) Surgical Abortion

Heritage Clinic for Women offers the Dilation and Evacuation (D&E) abortion procedure for pregnancy 14-22 weeks LMP.

D&E abortions constitute approximately 10% of all abortions performed in the United States with less that 1% performed after 20 weeks.

Procedure

The D&E procedure is performed in two steps. Since the cervix needs to be opened farther in the second trimester, slower dilation is necessary to minimize the risk of cervical harm. The length of pregnancy determines what the first step of procedure will be.

Between 14-17 weeks LMP, the first step involves placing a medication called Misoprostol under the tongue to dissolve. This works to soften the cervix over a 2-3 hour time period, and is provided after a pelvic exam is performed. At this length of pregnancy, both steps are provided in one day.

Between 18-22 weeks LMP, the first step involves inserting a dilating substance called Laminaria into the cervical opening during a pelvic exam. The Laminaria remains in the cervix overnight as it absorbs moisture and swells, pressing the cervix open. At 21-22 weeks LMP, it may be necessary to have more Laminaria inserted on day 2 and return to the office on day 3 for the second step.

During the second step, the physician removes the pregnancy with sterile instruments (such as a curette and forceps) and suction aspiration. A combination of a pain-relieving narcotic called Fentanyl with an anti-anxiety medication called Midazolam is administered during the second step for physical and emotional comfort. This step of the procedure usually takes between ten and fifteen minutes.

Considerations, Side Effects and Risks

More than 97% of all second trimester abortions take place without any complications. Of the remaining percentage, 2.5% experience minor complications such as infection, retained tissue, and heavier bleeding which, if addressed promptly, can be handled with medication or a return visit to the clinic.

The risk of more major complications, such as perforation or laceration of the uterus or cervix or prolonged infection or hemorrhage, all of which might require additional medical support, is slightly higher than in the first trimester. Although, the need for hospitalization or surgery is still less than 1%.

It is extremely rare that anyone would have a complication, or require treatment for a complication, that is severe enough to cause damage to the reproductive system, damage a woman’s health, or threaten her life. These risks are possible regardless of how the pregnancy ends: miscarriage, abortion, C-section or vaginal delivery.

Statistically speaking, a second trimester abortion does not carry any risks higher than carrying a pregnancy full term.

Our counseling and medical staff provide thorough aftercare instructions, and patients have emergency access to our physician 24 hours a day.