From the Guidelines
Abortion can be performed through nine main methods, including medication abortion, vacuum aspiration, dilation and curettage (D&C), dilation and evacuation (D&E), induction abortion, intact dilation and extraction, hysterotomy, hysterectomy, and self-induced abortion, with the choice of method depending on the stage of pregnancy and individual circumstances. The primary types of abortion procedures are:
- Medication abortion, which uses drugs like mifepristone (200mg orally) followed by misoprostol (800mcg buccally or vaginally) to end early pregnancies up to 10-12 weeks 1.
- Vacuum aspiration, which uses gentle suction to remove pregnancy tissue through the cervix, typically performed up to 14-16 weeks.
- Dilation and curettage (D&C), which involves dilating the cervix and using a curette to remove uterine contents, often used for first-trimester abortions.
- Dilation and evacuation (D&E), which combines vacuum aspiration with surgical instruments for second-trimester procedures (13-24 weeks) and is considered the safest procedure in both the first and second trimesters 1.
- Induction abortion, which uses medications to induce labor and delivery, typically for later pregnancies.
- Intact dilation and extraction, sometimes called D&X, used in rare, late-term cases.
- Hysterotomy, a surgical incision into the uterus similar to a cesarean section, used only in rare circumstances.
- Hysterectomy, the complete removal of the uterus, almost never used specifically for abortion except when other serious uterine conditions exist.
- Self-induced abortion, which refers to attempts to end pregnancy without medical supervision, and is not recommended due to the risks involved 1. It's essential to note that the method of abortion should be chosen based on the individual's specific situation and medical history, and that access to safe and sustainable abortion services is crucial, particularly for women with complex pre-existing conditions or difficult social circumstances 1.
From the Research
Types of Abortion
There are several types of abortion, including:
- Medical abortion: a non-surgical abortion that uses medication to terminate a pregnancy 2, 3, 4, 5, 6
- Surgical abortion: a procedure that uses surgical instruments to terminate a pregnancy 3
- Vacuum aspiration: a type of surgical abortion that uses a vacuum to remove the fetus and placenta from the uterus
- Dilation and evacuation (D&E): a type of surgical abortion that uses instruments to dilate the cervix and remove the fetus and placenta from the uterus 3
- Induction abortion: a type of abortion that uses medication to induce labor and deliver the fetus
- Partial-birth abortion: a type of abortion that involves partially delivering the fetus before terminating the pregnancy
- Intact dilation and extraction (D&X): a type of abortion that involves dilating the cervix and removing the fetus intact
- Menstrual extraction: a type of abortion that uses a vacuum to remove the fetus and placenta from the uterus during the early stages of pregnancy
- Hysterotomy: a type of abortion that involves making an incision in the uterus to remove the fetus
Medical Abortion Regimens
Medical abortion regimens can vary, but common regimens include:
- Mifepristone and misoprostol: a combination of medications that can be used to terminate a pregnancy up to 70 days gestation 2, 4, 5, 6
- Mifepristone and buccal misoprostol: a combination of medications that can be used to terminate a pregnancy up to 63 days gestation 4, 6
- Mifepristone and vaginal misoprostol: a combination of medications that can be used to terminate a pregnancy up to 70 days gestation 5
Efficacy and Safety of Medical Abortion
Studies have shown that medical abortion regimens using mifepristone and misoprostol are highly effective and safe for terminating pregnancies up to 70 days gestation 2, 4, 5, 6. The efficacy of these regimens can vary depending on the gestational age and the specific regimen used. Adverse events, such as infection and transfusion, are rare 4, 5, 6.