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What is an abortion?
Abortion is the voluntary interruption of pregnancy through a
small surgical procedure, most safely performed in a clinic or
hospital. While abortion is presently legal in North America, over
100 000 women die each year from complications of illegal
abortions worldwide. Abortions are most often performed to end an
unwanted pregnancy, but can also be performed to save the life of
the mother, or for the survivors of rape.
How successful are abortions?
Abortions are normally 100% successful. Failures may occur
because of inexperience of the doctor, poor vacuum pressure, an
abnormally shaped uterus or a very early pregnancy.
How is an abortion performed?
Abortions are performed differently according to the length of
pregnancy.
Before 13 weeks of pregnancy
Abortions that are performed relatively early in the pregnancy
usually proceed without any complications. Once the patient has
been admitted, she will be briefed by a nurse on the procedure and
will have a blood test taken. Then the patient will disrobe and
put on a gown. As the procedure begins, the doctor does a pelvic
examination to ascertain the position of the uterus. Clinics will
usually administer some gas to numb the pain of the operation. A
speculum is then inserted in the vagina, and an antiseptic
solution is applied to the vagina and cervix. The cervix has a
clamp placed on it and is then injected with a local anesthetic. A
series of metal rods (each one larger than the one preceding) are
placed in the cervix. This procedure gradually dilates the cervix.
Once the cervix is dilated, a vacurette is passed into the
uterus. A vacurette is a long tube which is attached to a machine
which makes it act like a vaccuum. The suction is turned on and
the doctor moves the vacurette back and forth for several minutes.
This may cause the patient some physical discomfort, and may begin
to cause feelings of uneasiness. When the uterus is empty, the
doctor will turn off the vacurette and (in the case of a dilation
and curettage procedure) proceed to gently scrape the uterus to
make certain that it is empty. The instruments are then removed
and then the patient is left until she feels ready to walk to the
recovery room.
After 13-16 weeks of pregnancy
Dilation and evacuation is often the procedure used after 13
weeks of pregnancy. If this procedure is done after 16 weeks then
it should be done by an experienced physician in a hospital. The
early stages of the procedure are similar to that of an early
abortion (described above). The doctor will usually begin to
dilate the cervix a few hours before the procedure. Sometimes the
doctor will choose to dilate the cervix the day before. Once the
vagina and cervix have been washed with an antiseptic solution,
the fetus is removed from the uterus with forceps. Then a curette
is used to ensure that the uterus is empty.
When an abortion is performed at this stage of the pregnancy,
the recovery is normally longer than the first procedure described
above. The patient is often kept in hospital for several hours
following the procedure.
Inducing labor
Labor can be induced by injecting salt solution and/or hormone
into the uterus. A long needle is placed in the uterus where some
amniotic fluid is removed and is replaced by a salt solution. This
will kill the fetus and induce labor. Oxytocin is administered to
stimulate contraction which are not painful until two hours before
the fetus is aborted. In most cases, labor occurs within 12 hours
and the patient may have to push to remove the fetus. This can be
an especially traumatic procedure because it is very similar to
giving birth.
What are the effects of an abortion on the
physical health of the patient?
Each woman who chooses to have an abortion will have a
different experience. It is difficult to generalize about how a
woman will feel following an abortion, so this guide attempts to
focus on the physical effects of an abortion on a woman. An
abortion is always a stressful decision and we hope to make that
decision a bit more bearable by providing some medical health
information.
An abortion is a safe procedure when done by professional
clinics. It is estimated that 1 woman in 100 000 dies as a result
of an abortion which is performed before the end of the twelfth
week. By comparison, tonsillectomy causes 3 deaths per 100 000 and
apendectomies cause 352 deaths per 100 000.
A properly performed abortion should have little effect on the
menstrual cycle and the fertility of the patient. The menstrual
cycle usually progresses with the first period typically occurring
4 to 8 weeks after the procedure. It is important to know that
during this period in between the abortion and menstruation, a
patient may ovulate which makes her able to conceive. A properly
performed abortion has almost no effect on a woman's ability to
conceive and carry another pregnancy. Physicians are still
debating whether the dilation of the cervix in late abortions will
affect a woman's capacity to carry children, although there are
new methods of dilating the cervix which are thought to be less
risky. Women who have abortions do not have more miscarriages or
more premature births.
A woman should abstain from vaginal penetration for about 7
days after an early abortion or until the discharge stops in the
case of a late abortion. The psychological trauma of the abortion
may cause a lack in sexual desire.
What are the possible complications of an
abortion?
There may be some physical or psychological complications with
an abortion. These may be a factor in your decision to have an
abortion so we have summarized some of the main possible
complications below.
Blood Loss
As with any operation, an abortion may cause some significant
blood loss. A normal abortion performed in the first twelve weeks
of pregnancy will cause very little bleeding. If the patient is
experiencing heavy bleeding for weeks following the abortion then
this is likely due to the incomplete removal of the placenta.
Infection
There may be a problem with infection after the procedure has
been performed. This may be due to contaminated tools, an existing
infection or pieces of placenta which have been mistakenly left in
the uterus. These infections are normally treated with
antibiotics.
Damage to Organs
Physical damage to the interior organs is also a possibility
during the abortion procedure. Any instrument which is used in the
uterus could possibly be passed through the muscle of the uterus.
This normally heals without any further care. The cervix may also
become damaged by the clamp used during abortion. If the clamp
falls off, it may damage the cervix which can be sutured to
correct any difficulty.
Psychological Trauma
How you react after an abortion is influenced by the
circumstance leading to it and the support and kindness of family,
friends and health personnel. Many women are relieved afterwards;
others feel a sense of loss and a need to mourn. Women who have
had mixed feelings leading up to the abortion may need more time
to deal with their decision afterward.
Where can I get help in making my decision?
The infoCenter recommends strongly Planned Parenthood (look in
the white pages of your local phone book for their number) for an
unbiased spectrum of choices and information. This organization is
dedicated to helping a person make the right choices, and is
committed to objectivity and neutrality in making that choice.
There are many different sources of information as well, some of
which may or may not be biased to a given cause or belief. Be sure
to get your information from a variety of sources, but in the end
the decision should rest with no one but you.
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