Dilation & Evacuation (D&E) About 13 to 24 weeks after LMP
The majority of second trimester abortions are performed using this method. The cervix must me opened wider than in the first trimester abortion because the fetus is larger. This is done by inserting numerous thin rods made of seaweed a day or two before the abortion and/or giving other oral or vaginal medications to further soften the cervix. Up to about 16 weeks gestation, the procedure is identical to the first trimester one (mentioned above). After the cervix is stretched open and the uterine contents suctioned out, any remaining fetal parts are removed with a grasping tool (forceps). A curette (a loop- shaped tool ) may also be used to scrape out any remaining tissue.
After 16 weeks, much of the procedure is done with the forceps to pull fetal parts out through the cervical opening, as suction alone will not work due to the fetus’ size. The doctor keeps track of what fetal parts have been removed so that none are left inside as this can potentially cause infection. Lastly, a curette, and/or the suction machine are used to remove any remaining tissue or blood clots, which if left behind could cause infection or bleeding (4).
Medication Methods for Second Trimester Induced Abortion
This technique induces abortion by using medicines to cause labor and eventually delivery of fetus and placenta. Like labor at term, this procedure typically involves 10-24 hours in a hospital’s labor and delivery unit. Digoxin or potassium chloride is injected into the amniotic fluid, umbilical cord or fetal heart prior to labor to avoid the delivery of a live fetus. The cervix is softened with the use of seaweed sticks and/or medications. Next, oral mifepristone and oral or vaginal misoprostol are used to induce labor. In most cases, these drugs result in the delivery of the dead fetus or placenta. The patient may receive oral or intravenous pain medications. Occasionally, scraping of the uterus is needed to remove the placenta. Potential complications include hemorrhage and the need for blood transfusion, retained placenta and possible uterine rupture (splits open) (4). Costs and prices for this abortion vary.
It’s important to know that Alternaterm does not offer, preform or refer for abortions.