Therapeutic abortion

Alternative names

Abortion - elective or therapeutic; Elective abortion

Definition

Elective or therapeutic abortion is the deliberate termination of a pregnancy.

Causes, incidence, and risk factors

Elective abortions are those initiated by personal choice. Therapeutic abortions are those recommended by the health care provider to protect the mother's physical or mental health. In the United States, one legal abortion occurs for every four live births.

Symptoms

Early pregnancy symptoms include:

• Breast tenderness
  
• Breast swelling
  
• Discoloration of breast areola
  
• Nausea
  
• Light-headedness or dizziness
  
• Missed periods
  

Signs and tests

A pelvic examination is performed to confirm pregnancy and estimate the weeks of gestation. A serum HCG blood test may be performed to confirm pregnancy. A vaginal or abdominal ultrasound may be used to determine gestational age and location.

Treatment

Most elective abortions take place between 8 and 12 weeks of gestation. The traditional procedure consists of dilating the cervix and removing the contents of the uterus by suctioning the inner walls of the uterus.

Recently, medications have become available to terminate an early pregnancy (prior to 7 weeks of gestation). These medications include mifepristone, methotrexate, misoprostol, or a combination of these medications. Most women who use medication do so because of a desire to avoid anesthesia and surgery if at all possible.

Side effects of medication may include nausea, vomiting, diarrhea, warmth or chills, headache, more visits to the doctor's office, prolonged vaginal bleeding, and more aware of cramping than with surgical abortion. With medication, passage of the products of conception most likely will occur at home, but some women may still require surgical evacuation (D and E) to complete the abortion. The success rate has been shown to be around 95%.

Expectations (prognosis)

Legally performed abortions are relatively safe. Complications rarely occur. A first trimester legal abortion is physically safer for a woman than giving birth.

Complications

Excessive loss of blood, uterine perforation and infection, and an incomplete abortion are the most frequent complications. These complications are rare when the procedure is performed by a competent provider in an adequate facility.