Abortion is a medical procedure used to terminate a pregnancy. Almost half of all reported unplanned pregnancies in the world result in abortion. There are various types of abortion, and the options vary depending on the duration of the pregnancy. These consist of vacuum aspiration, dilation and evacuation, labour induction, and medical abortion.
If you’re thinking about having an abortion, it’s a good idea to educate yourself on the various abortion methods so you can choose the best and most accessible option for you. There are two types of abortion techniques – medical and surgical abortion. They are both incredibly safe ways of abortion and effective too. But, one may be better depending on how long you’ve been pregnant, where you live, your budget, and a few other criteria.
- First-trimester termination – Medical abortion or vacuum aspiration is a common type of abortion option in the first trimester. A person can normally access a medical abortion until about 7-9 weeks after their last period. It includes taking two different forms of medication. Between 6 and 14 weeks of pregnancy, surgical options such as vacuum aspiration and dilation and evacuation are more common.
- Second and third-semester termination – A pregnant woman may have dilation and evacuation (D&E) during the second trimester. It is generally done between weeks 12 and 24. An abortion via labour induction is an option for pregnant women in the third trimester. However, this is quite rare.
Classification of abortion:
Let’s try to understand all the different types of abortion:
1. Medical abortion –
How to take abortion pills?
A medical abortion involves a pregnant woman taking pills at different times. This form of abortion requires taking two medications: mifepristone and misoprostol. Generally, the person will take mifepristone first. They should not take the second medication, misoprostol, for at least 24 hours after taking mifepristone. A doctor may advise them to take the medication orally by swallowing, placing it between the gums and cheeks or under the tongue or vaginally.
Mifepristone prevents pregnancy from developing, whereas misoprostol causes the uterus to contract and expel the pregnancy, which occurs 2-24 hours after taking the pill. As the uterus empties, a person may experience cramping and bleeding, which may feel like having a heavy period. Some people could be having more intense cramps when compared to others. But, it should not be severe; anything that seems concerning or unbearable is a reason to contact a doctor.
Advantages:
The advantages of a medical abortion are:
- It does not require surgery.
- It is available in the first trimester.
- An anesthetic is not necessary.
- You don’t have to take any further treatments.
Disadvantages:
The disadvantages of a medical abortion are:
- It is unavailable in the second trimester.
- It may cause painful cramping.
- Rarely, it is not effective.
It is helpful for you to have someone around for support when the uterine tissue is passing.
Side effects:
The side effects of abortion pills are:
- Nausea
- Heavy vaginal bleeding
- Dizziness
- Fatigue
- Diarrhea
- Mild fever
Complications :
The complications of medical abortion are:
- The termination fails.
- Some pregnancy material does not expel, which can result in excessive bleeding and the need for surgery to clean the uterus.
- A hemorrhage can occur, resulting in severe bleeding that can be fatal.
- Infection in the uterus can arise, needing antibiotics and having severe consequences if doctors do not diagnose it early.
2. Surgical abortion or In-clinic abortion –
A surgical abortion is a procedure by a skilled medical professional in a clinical setting, like a hospital. Vacuum aspiration and dilation and evacuation are the two basic kinds of surgical abortion (D&E). Vacuum aspiration is generally used up to 16 weeks after your last period, while D&E is used up to 24 weeks.
Vacuum aspiration – It is a type of surgical abortion used to terminate a pregnancy through a mild suction. Doctors usually advise this method during the first trimester.
- A doctor begins the vacuum aspiration process by placing a speculum into the vagina.
- They then apply medication or inject the region to numb it.
- They next open the cervix with thin rods called dilators before inserting a tube into the uterus.
- They then empty the uterus using either a manual or mechanical suction technique.
Advantages:
The advantages of vacuum aspiration are:
- It could be performed in the first 12 weeks of pregnancy.
- It is a quick procedure taking around 5-10 minutes.
- It is relatively pain-free, though some people experience cramps, sweating, nausea or both.
- It does not require a general anesthetic.
Disadvantages:
The disadvantage of vacuum aspiration is that this abortion procedure is not available during the second trimester. Recovery from vacuum aspiration involves taking antibiotics to prevent infection for up to 1 hour after treatment and avoiding sex for one week after treatment. Also, some people have cramps for a few days after the procedure. They may also have irregular bleeding or spotting for several weeks.
Side effects:
Bleeding and infection are two side effects of vacuum aspiration. The risk of these problems, however, is low. If someone notices signs of bleeding or new symptoms, they should contact their doctor immediately.
Dilation and evacuation (D&E) –
It is a type of surgical abortion that is usually performed during the second trimester.
- Before performing a dilation and evacuation, a doctor may give general anaesthesia. This anaesthetic ensures that the patient feels nothing during the procedure.
- To begin, the doctor inserts a speculum into the vagina.
- Then, use dilators to open the cervix.
- They proceed to use little forceps to remove the pregnant tissue.
- Finally, suction is used to remove any remaining tissue.
Advantages:
D&E has the advantage of being available in the second trimester of pregnancy. It is also a safe and effective procedure to end a pregnancy.
Disadvantages:
The disadvantage of dilation and evacuation is that you may need general anaesthesia. Rest is necessary for recovery from dilatation and evacuation. Minor pain and cramping may occur for a few days after the operation, and some bleeding may persist for up to two weeks.
Side effects:
Dilation and evacuation may cause infection, heavy bleeding and injury to the uterus. According to The American College of Obstetricians and Gynecologists, the risk of the uterus or other organ injury after a second-trimester abortion is less than 1 in 1,000.
3. Labour induction abortion –
Labour induction abortion is a late-term abortion method used to end a pregnancy in the second or third trimester. This type of abortion is uncommon. However, it may be recommended by a doctor if a pregnant woman’s life is in danger.
Labour induction involves using medications to induce labour, causing the uterus to empty over a period of 12-24 hours. You can take these medicines orally. Also, the doctor may inject them into the uterus or put them in the vagina. Due to the extreme cramping during this type of abortion, doctors frequently also prescribe pain-relieving medicine or a local anaesthetic.
Recovery:
After an abortion, a woman may stay in the clinic or hospital for a few hours to 1-2 days, depending on her health and other conditions. The doctor can help figure out the length of the stay, which they may be able to estimate before the abortion.
Side effects:
The side effects caused due to medications that induce labour include:
- Nausea and vomiting
- Fever
- Diarrhea
Complications are uncommon, however, they can include:
- Hemorrhage
- Cervical injury
- Infection
- Rupture of the uterus
- Incomplete release of the pregnancy tissue 1 2
4. Self-induced abortions –
Self-induced abortions occur when a person attempts to end their pregnancy without medical assistance or in unsafe conditions. They may be driven by various factors, including limited access to safe abortion services, legal restrictions, financial constraints, fear of judgment or prosecution, or lack of awareness about available options.
Self-induced abortions pose significant health risks. Without medical supervision, the methods used can be unsafe and lead to severe complications such as infection, hemorrhage, damage to reproductive organs, or incomplete abortion. In some cases, they can be life-threatening. Recovery from a self-induced abortion can vary, but it may involve physical discomfort, heavy bleeding, infection, or damage to the reproductive organs. Hence, seeking safe and legal abortion services from trained doctors is essential for ensuring the well-being and safety of individuals. 3
Miscarriage –
A miscarriage, often referred to as a spontaneous abortion, is the unanticipated ending of a pregnancy occurring during the initial 20 weeks of pregnancy. The term “miscarriage” does not mean that you did anything wrong in carrying the pregnancy. Most miscarriages are beyond your control and occur when the fetus stops growing.
What are different types of miscarriages?
The different types of miscarriage are listed below –
- Missed miscarriage – You’ve lost the pregnancy but are not yet aware of it. Although there are no signs of miscarriage, an ultrasound indicates that the fetus has no heartbeat.
- Complete miscarriage – It occurs when you lose your pregnancy, and the uterus is empty. You’ve been bleeding and passing fetal tissue. An ultrasound can confirm a total miscarriage for you.
- Recurrent miscarriage – If you’ve had three miscarriages in a row. It affects approximately 1% of all couples.
- Threatened miscarriage – Your cervix remains closed, but you’re bleeding and having pelvic cramps. The pregnancy usually continues without issue. Your doctor may closely monitor you throughout the rest of your pregnancy.
- Inevitable miscarriage – You’re bleeding, cramping and your cervix is beginning to open (dilate). You could be leaking amniotic fluid. A total miscarriage is most likely. 4
What is the most common cause of abortion in the first trimester?
The fetus’s chromosomes are frequently the source of first trimester miscarriages. 5
What is the difference between spontaneous abortion and threatened abortion?
Pregnancy loss that occurs before 20 weeks gestation is referred to as spontaneous abortion. A threatened abortion, on the other hand, refers to vaginal bleeding during early pregnancy that may or may not lead to the loss of the pregnancy. 6
Which sleeping position can cause miscarriage?
Doctors recommend sleeping on your side – either right or left to ensure optimal blood flow for you and the baby. You might also try using pillow props to get into the most comfortable position for you. Several doctors recommend that pregnant women sleep on their left side. Prior research has connected back and right-side sleeping to an increased risk of stillbirth, poor fetal growth, low birth weight, and preeclampsia, a potentially fatal high blood pressure disorder affecting the mother. 7
Can abortion cause kidney failure?
Acute renal failure is a potentially fatal consequence of septic abortion. The recorded death rate ranges from 30% to 65%. The patient’s initial treatment for this problem is resuscitation, which should be performed in an intensive care unit. 8
What causes missed abortion?
The causes of missed abortions are not fully understood. Around half of all miscarriages occur because the embryo has an incorrect chromosomal number. In some cases, a uterine problem, like scarring, can be a contributing factor in causing a miscarriage. If you have an endocrine or autoimmune problem or smoke often, you may be at a higher risk of miscarriage. Physical trauma might sometimes result in a missed miscarriage.
If you have a missed miscarriage, your doctor will most likely be unable to pinpoint the cause. The embryo stops developing in the case of a missed miscarriage, and there is generally no evident cause. Miscarriage is not caused by stress, exercise, sex, or travel, so don’t blame yourself. 9
