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| » 2nd Trimester Abortion-Dilation and Evacuation |
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First Trimester Abortion: Vacuum Aspiration (4.5—12 weeks)
The vacuum aspiration procedure is a one-day outpatient procedure. It is used to terminate pregnancy through the 12th menstrual week (12 weeks from the first day of your last period). You may choose to be either awake or asleep for a first-trimester abortion.
When you arrive at the clinic, the receptionist will ask you to complete paperwork and read through an informational notebook. When you are finished, you will have an ultrasound. This shows how far along you are in your pregnancy. The ultrasound does not hurt. You will then be asked to leave a urine sample for a pregnancy test. A patient coordinator will then check your blood pressure, temperature, height and weight. You will have a finger-poke to check your Rh type (the positive or negative part of your blood) and iron level.
Next, you will meet privately with a patient coordinator who will review your medical history. The patient coordinator will explain the procedure to you in detail and answer any questions you may have.
You will be taken to a dressing area and asked to change into a patient gown. You may place your belongings in a locker. You will then be called into the procedure room, where you will be introduced to the doctor. Our doctors are board-certified obstetrician-gynecologists, and are experienced in performing abortions.
To begin the procedure, the doctor will put an instrument called a speculum into your vagina. He or she will then use a series of round, smooth, dilating rods to gently open your cervix (the opening to your uterus). The doctor will gently remove the contents of your uterus. The abortion procedure takes less than 10 minutes.
Your anesthesia will be administered according to your preference as discussed when making your appointment. Family Planning Specialists offers the following options:
• Local Anesthesia (Awake): If you choose local anesthesia, you will be fully awake during the abortion. You will be given the option of taking a pain medication and a muscle relaxer prior to the procedure. Both medications are optional. The muscle relaxer we use also helps to prevent nausea. The doctor will inject Lidocaine (a numbing agent) into and around your cervix before completing the abortion. While the medications help to make you more comfortable, you may still experience some cramping during the procedure, which typically lasts less than ten minutes. An abortion with local anesthesia feels differently to different women; therefore some women feel only mild discomfort while others feel intense cramping. After the procedure, you will spend 30 minutes in the recovery room for observation and rest. If you take the muscle relaxer, you MUST have someone come to the clinic to drive you home.
• Conscious Sedation (Drowsy): If you choose conscious sedation, you may be drowsy and relaxed during the procedure. An abortion with conscious sedation feels differently to different women. Some women may feel only slightly drowsy while others feel extremely relaxed; some women feel only mild discomfort while others feel intense cramping. You MUST NOT eat, drink, chew or smoke anything for four hours prior to your appointment. Before the doctor begins your procedure, he will give you medications by IV. The doctor will also inject Lidocaine (a numbing agent) into and around your cervix. You will feel the effects in less than one minute. The abortion procedure usually takes less than 10 minutes. You will need to spend a half hour in the recovery room for observation and rest. Before you are allowed to leave the recovery room, our staff will confirm that your ride is in the lobby to drive you home. Under no circumstances will you be allowed to leave without a ride home. You must have someone pick you up. You may not take public transportation, take a taxi alone, or drive yourself home.
• General Anesthesia (Asleep): If you choose general anesthesia, you will be asleep during the entire procedure. This means that you will not feel anything at all and have no awareness during the procedure. You must not eat, drink, chew or smoke anything after midnight on the night prior to your appointment. Before the doctor begins your procedure, an anesthesiologist or nurse anesthetist will give you anesthesia by IV. You will fall asleep in less than one minute. The abortion procedure usually takes less than 10 minutes. You will need to spend one hour in the recovery room for observation and rest. Before you are allowed to leave the recovery room, our staff will confirm that your ride is in the lobby to drive you home. Under no circumstances will you be allowed to leave without a ride home. You must have someone pick you up. You may not take public transportation, take a taxi alone, or drive yourself home.
First Trimester Abortion: Abortion Pill (“Medical Abortion” or “RU 486”)
The abortion pill (Mifepristone) or medical abortion (sometimes referred to as RU 486) is an alternative to surgical abortion within the first nine weeks of pregnancy. Taking a combination of two medications (mifepristone and misoprostol) will induce the abortion. These medications, when taken as directed, will stop the development of the pregnancy and then cause the uterus to expel the pregnancy, similar to an early miscarriage.
When you arrive at the clinic, the receptionist will ask you to fill out paperwork and read through an informational notebook. When you are finished, you will have an ultrasound. This will show how far along you are in your pregnancy. The ultrasound does not hurt. You will then be asked to leave a urine sample for a pregnancy test. A patient coordinator will then check your blood pressure, temperature, height and weight. You will have a finger-poke to check your Rh type (the positive or negative part of your blood) and iron level.
Next, you will meet privately with a patient coordinator who will review your medical history. The patient coordinator will explain the procedure to you in detail and answer any questions you may have. If you are further along in your pregnancy than expected or have any other reason why you are not an appropriate candidate for medical abortion, the patient coordinator will discuss with you the possibility of surgical abortion.
You will then see a clinician for a pelvic exam. After the exam, you will be given one pill of Mifepristone to take orally in the office. This is the beginning of your abortion process. You will then be given four tablets of misoprostol to take home with you to use 24-48 hours later. You will hold these pills in your mouth (between your cheeks and gums) for 30 minutes before swallowing any remaining pill fragments.
Most women start to bleed and cramp within 1-8 hours after using misoprostol. The bleeding may be like a heavy period and you may pass some large blood clots. You may also see pregnancy tissue. Cramping can be very intense for a few hours. Other symptoms may include nausea, diarrhea, feeling tired, dizzy, or feverish. Pain and discomfort can vary widely among individual women. Some say the experience is like having a difficult period with mild to moderate cramping, while others say the pain is so intense that it resembles labor pains.
Finally you will need to return to the clinic approximately 14 days after your initial visit. At this time you will have another pregnancy test and ultrasound. This appointment will confirm the completion of your abortion. If your abortion has not been completed, you may need to have a surgical abortion.
Day 1: Appointment at Family Planning Specialists. Take mifepristone orally in clinic. Receive misoprostol pills to take home.
Day 2: (24-48 hours after taking mifepristone) Hold the 4 misoprostol pills between your cheeks and gums for 30 minutes, then swallow any remaining pill fragments.
Day 14: Return to Family Planning Specialists to confirm your abortion is complete.
Second Trimester Abortion: Dilation and Evacuation (12—21.6 weeks)
The dilation and evacuation (D&E) abortion is a 2-day outpatient procedure. It is used to terminate pregnancies beyond the 12th week. It is recognized to be the safest procedure for the termination of pregnancies in the second trimester.
On the first day, you will complete some paperwork and read through an informational notebook. When you are finished, you will have an ultrasound. This shows how far along you are in your pregnancy. The ultrasound does not hurt. You will then be asked to leave a urine sample. A patient coordinator will then check your blood pressure, temperature, height and weight. You will have a finger-poke to check your Rh type (the positive or negative part of your blood) and iron level.
Next, you will meet privately with a patient coordinator who will review your medical history. The patient coordinator will explain the procedure to you in detail and answer any questions you may have.
You will then be examined by a clinician who will insert laminaria into your cervix. Laminaria are slim sticks of sterile seaweed, which are inserted into the cervical opening and remain in place overnight. The laminaria swell by absorbing the natural fluids of the cervix, thereby slowly dilating the cervical opening. During the insertion of the laminaria, you may feel some cramping similar to menstrual cramps. The insertion of the laminaria is the first part of the D&E procedure. Once the procedure has begun, you must return to the clinic on the second day for the completion of your abortion. If you do not return to the clinic, serious complications could occur. To prepare for your surgery appointment, it is very important that you do not eat, drink, chew or smoke anything after midnight.
When you return to the clinic, you will be given general anesthesia by an anesthesiologist or nurse anesthetist. Once you are asleep, the doctor, who is a board-certified obstetrician-gynecologist, will perform your abortion. The contents of the uterus are removed by a combination of methods: the use of specially designed instruments and vacuum aspiration (gentle suction). You will be asleep during the entire procedure, which usually takes approximately 15 minutes.
You will be required to spend from an hour to an hour and a half in our recovery for observation and rest. Before you are released, our staff will confirm that your ride is in the lobby to drive you home. Under no circumstances will you be allowed to leave without a ride home. You must have someone pick you up. You may not take public transportation, take a taxi alone, or drive yourself home.
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