Types of Abortion Procedures
You have the right to know all of the facts regarding the potential physical or psychological risks of abortion
Abortion as an option in pregnancy carries potential risks both physically and emotionally. It is important for you to take the time to become fully informed if this is the option you choose.
The reasons why some women choose abortion are varied. Some fear the loss of a relationship; others fear the disapproval or pressure from family. Some women don’t feel the timing of the pregnancy is right or believe having a baby will negatively affect their career.
Others feel they will be unable to handle any additional financial strain a child may bring. Whatever the reason may be, abortion is final and it is vitally important to process all the options before you make a decision.
For more info on RU 486
Types of Abortions
There are two types of abortions: medical (or chemical) and surgical.
Medical (or Chemical) Abortions
MIFEGYMISO (mifepristone tablet/misoprostol tablets)
What is Mifegymiso?
Mifegymiso is a combination of two drugs, mifepristone (also known as RU-486) and misoprostol. Mifegymiso is a medication that induces abortion (induced termination of a pregnancy).
Where is Mifegymiso used?
Mifegymiso (mifepristone tablet/misoprostol tablets) is indicated for medical termination of a developing intrauterine pregnancy with a gestational age up to 63 days as measured from the first day of the Last Menstrual Period (LMP) in a presumed 28 day cycle.1
What are some unwanted effects related to Mifegymiso?
- Serious bacterial infections and sepsis can occur without fever, bacteremia or significant findings on pelvic examination.2
- At least two deaths have been reported.3,4
- Prolonged heavy vaginal bleeding could be a sign of incomplete abortion or other complications and may require immediate medical or surgical intervention.1
- If you take Mifegymiso, in order to prevent possible birth defects you must not become pregnant again before your next period.5
Before a patient is able to access Mifegymiso:
- If gestational age is unknown, more than nine weeks, or an ectopic pregnancy is suspected an ultrasound is recommended . Under these conditions the drug may not successfully terminate the pregnancy,may damage the fetus,and can result in serious health risks to the pregnant woman. The use of Mifegymiso could mask a ruptured ectopic pregnancy as the symptoms associated with both maybe similar.
- Ensure that patients have access to emergency medical care in the 14 days following administration of mifepristone.
- Counsel patients about the adverse effects including: bleeding, infection, an incomplete abortion and how to access the treatment centre by telephone or local access.1
Research is ongoing to reverse the effects of RU486. Dr. Matthew Harrison, a pioneer in the field, has an open invitation for Canadian physicians to learn more about his work in this area. Interested physicians can call (619) 577-0997 or email apreversal@gmailcom. You can also call the emergency HOTLINE (877) 558-0333 or visit www.abortionpillreversal.com.
References:
- Linepharma International Limited. MIFEGYMISO product monograph. Health Canada Drug Product Database. 2016. https://pdf.hres.ca/dpd_pm/00036826.PDF.
- Danco Laboratories. Mifeprex® (mifepristone) oral tablet prescribing information. New York, NY: 2005.
- Mifepristone – New safety information. Essential Medicines and Health Products Information Portal. 2002. http://apps.who.int/medicinedocs/en/d/Js4942e/2.5.html
- Food and Drug Administration. Mifeprex (mifepristone) information (April 10, 2006 update). Rockville, MD: 2006 Apr 10. https://www.fda.gov/.
- Food and Drug Administration. FDA Public Health Advisory: Sepsis and Medical Abortion Update. Rockville, MD: 2006 Mar 17. https://www.fda.gov/.
Surgical Abortions:
Manual Vacuum Aspiration (MVA)
This is the most common method of abortion and it can only be performed during the first trimester. Most women will require cervical dilation which can be done using dilators or medications prior to the procedure or metal rods during the procedure. Local anesthetic or medication may be used to reduce pain and the risk of blood loss or infection. A long thin tube is inserted through the cervix and into the uterus. Suction is used to separate the tissues from the uterine wall and empty the contents of the uterus which include the embryo or fetus and pregnancy tissue.
References:
Davis, Victoria. (2006, November). Induced Abortion Guidelines. SOGC Clinical Practice Guidelines. Retrieved Oct. 28, 2009, from https://sogc.org/wp-content/uploads/2013/01/gui184E0611.pdf.
Healthwise. Vacuum Aspiration for Abortion: Surgery Overview. MyHealth.Alberta.Ca. 2017. https://myhealth.alberta.ca/health/Pages/conditions.aspx?hwid=tw1078.
Dilation and Curettage (D&C)
This method can be used up to 12 weeks of pregnancy. After dilation of the cervix, a curette, or looped shaped knife is used to scrape out the contents of the uterus (embryo or fetus and pregnancy tissue). This procedure may also be used as a follow-up to incomplete abortions after other procedures.
References:
Abortion. Online Care. Retrieved Nov. 20, 2009, from http://www.onlinecare.ca/optionabortion.aspx
Dilation and Evacuation (D&E)
This second trimester abortion is rarer than MVA or D&C simply because earlier abortions carry fewer risks than mid or late-term abortions. The cervix is dilated the day before the procedure using osmotic dilators or medications. Local anesthetic or medications are given to reduce pain and the risk of blood loss or infection. Medical instruments and suction are used to separate the contents of the uterus (fetus and pregnancy tissue) and ensure the pieces are small enough to safely extract. Additional products of conception (e.g. placenta) are removed with forceps.
References:
Healthwise. Dilation and Evacuation: Surgery Overview. MyHealth.Alberta.Ca. 2017.
https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=tw2462
Davis, Victoria. Op Cit. p1022.
Dilation and Extraction (D&X)
Late-term abortions take place in Canada, although they are rare. This method uses medications injected into the vagina or amniotic sac to induce labour. Prior to complete delivery, the skull of the fetus is decompressed to allow delivery of the head. This procedure is not available in all provinces.
References:
Abortion. Online Care. Retrieved Nov. 20, 2009, from http://www.onlinecare.ca/optionabortion.aspx
Canadian abortion statistics can be accessed at https://www.cihi.ca/en/search?query=abortion&Search+Submit
Hysterotomy Abortion
This method of abortion is extremely rare. The abdomen and the womb are opened surgically like in a caesarean section. A small incision is made and the contents of the womb (fetus and pregnancy tissue) are removed. As it is major abdominal surgery, this procedure is only used when other procedures have failed or are medically unadvisable.
Reference:
Davis, Victoria. Op Cit. p1024
More information on abortion procedures can be accessed at http://abortionincanada.ca/methods/