In the first fifteen weeks, suction-aspiration or vacuum abortion is the most common method. Manual vacuum aspiration, or MVA abortion, consists of removing the fetus or embryo by suction using a manual syringe, while the Electric vacuum aspiration or EVA abortion method uses an electric pump. These techniques are equivalent, differing only in the mechanism use to apply suction. They are sometimes referred to as STOP: 'Suction (or surgical) Termination of Pregnancy'. From the fifteenth week up until around the twenty-sixth week, a surgical dilation and evacuation (D & E) is used. D & E consists of opening the cervix of the uterus and emptying it using surgical instruments and suction.
Dilation and curettage (D & C) is a standard gynaecological procedure performed for a variety of reasons, including examination of the uterine lining for possible malignancy, investigation of abnormal bleeding, and abortion. Curettage refers to the cleaning of the walls of the uterus with a curette. The World Health Organization recommends this sort of procedure, also called Sharp Curettage, only when MVA is unavailable. Sharp curettage only accounted for 2.4% of abortion procedures in the US in 2002. The term "D and C", or perhaps suction curette, etc, is sometimes used as a euphemism to refer to the first trimester abortion procedure, irrespective of the method used to perform the procedure. |
Other techniques must be used to induce abortion in the third trimester. Premature delivery can be induced with prostaglandin; this can be coupled with injecting the amniotic fluid with caustic solutions containing saline or urea. Very late abortions can be brought about by intact dilation and extraction (intact D & X) (also called Intrauterine cranial decompression), which requires the surgical decompression of the fetus's head before evacuation, and is sometimes termed "partial-birth abortion." A hysterotomy abortion, similar to a caesarian section but resulting in a terminated fetus, can also be used at late stages of pregnancy. It can be performed vaginally, with an incision just above the cervix, in the late mid-trimester.
From somewhere between the 20th to 23rd week of gestation, an injection to stop the fetal heart can be used as the first phase of the surgical abortion procedure.
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