Induced abortion

Alternative names

Abortion; Suction curettage; Surgical abortion; Medical abortion

Definition

An abortion is a procedure, either surgical or medical, to end a pregnancy by removing the fetus and placenta from the uterus.

Description

A surgical abortion that is performed between 6 and 12 weeks into a pregnancy may be done while the woman is awake. She is given the option of being sedated by medications, or having her cervix numbed with an injection of anesthesia so that she is basically pain-free.

A surgical abortion for a pregnancy over 12 weeks is usually done while the woman is sedated, although it can also be performed while the woman is awake. The cervical canal is enlarged (dilated) and a hollow tube is inserted into the uterus.

A vacuum (suction) machine is used to remove the tissues (fetus and placenta) from the uterus. Medicines such as oxytocin are sometimes given to cause the uterine muscles to contract and reduce bleeding.

An abortion can be performed non-surgically for a pregnancy less than 7 weeks from the first day of the last menstrual period using a combination of medications. The current regimen approved by the FDA includes administration of one dose of Mifepristone (RU486), an antiprogestin, followed by one dose of Misoprostol, a prostaglandin analogue two days later. These medications may be given in the doctor's office, after a thorough history and physical is performed.

Indications

There are several reasons an abortion might be considered:

• The woman may not wish to be pregnant (elective termination)
  
• The woman's health is endangered by pregnancy (therapeutic abortion)
  
• There is a chance of an abnormality in the developing fetus (birth defect, genetic abnormality)
  

The decision to have an abortion is an intensely personal one. Most health care providers recommend competent counseling before making this decision.

Because abortion is a controversial issue in the United States, many women who make such a decision feel as if they cannot share that information with others. Therefore, it is important for women who are contemplating an abortion to examine their existing support system and identify those people who may be capable of helping them through what may be a difficult time.

It is also important that they choose a reputable provider or clinic that advocates choice for women, and is a safe environment in which they can obtain adequate counseling regarding all options for pregnancy resolution, have the procedure performed, and obtain the support and follow-up care that may be necessary after the abortion.