From the Guidelines
There are several types of abortion procedures available, including medication abortion, aspiration abortion, dilation and evacuation (D&E), and induction abortion, with the choice of procedure depending on gestational age and medical circumstances. The different types of abortion procedures can be broken down as follows:
- Medication abortion, which can be used up to 7 weeks gestation, involves the use of mifepristone, a medication that blocks progesterone and causes uterine contractions to expel the pregnancy 1.
- Aspiration abortion, also known as vacuum or suction abortion, is typically performed up to 14 weeks and involves dilating the cervix and using gentle suction to remove pregnancy tissue.
- Dilation and evacuation (D&E) is considered the safest procedure in both the first and second trimesters, and combines vacuum aspiration with surgical instruments to remove tissue 1.
- Induction abortion, which involves medications to induce labor and delivery, can be used in later pregnancies, but may have more risks and side effects, such as lowering systemic vascular resistance and blood pressure, and increasing heart rate 1. It's worth noting that some procedures, such as saline abortion, should be avoided due to the risk of expansion of the intravascular volume, heart failure, and clotting abnormalities 1. In addition, the method of termination of pregnancy should be considered on an individual basis, taking into account the need for anesthesia and the risk of post-abortal endometritis, which can be prevented with antibiotic prophylaxis 1. Overall, the choice of abortion procedure should be based on the safest and most effective option for the individual patient, taking into account their medical history, gestational age, and local regulations.
From the FDA Drug Label
WARNING: TERMINATION OF PREGNANCY Mifepristone is a potent antagonist of progesterone and cortisol via the progesterone and glucocorticoid (GR-II) receptors, respectively. The antiprogestational effects will result in the termination of pregnancy. The FDA drug label does not answer the question.
From the Research
Types of Abortion
There are different types of abortion, including:
- Medical abortion: This type of abortion uses medications to terminate a pregnancy. Studies have shown that the combination of mifepristone and misoprostol is effective for medical abortion in the first trimester of pregnancy 2, 3, 4, 5.
- Surgical abortion: This type of abortion involves a surgical procedure to terminate a pregnancy.
- Self-managed medical abortion: This type of abortion involves the use of medications to terminate a pregnancy without the direct supervision of a healthcare provider. Studies have shown that self-managed medical abortion with mifepristone and misoprostol is safe and effective 6.
Medical Abortion Regimens
Different medical abortion regimens have been studied, including:
- Mifepristone and buccal misoprostol: This regimen has been shown to be effective and safe for medical abortion through 63 days of gestation 4, 5.
- Mifepristone and vaginal misoprostol: This regimen has been shown to be effective and safe for medical abortion through 70 days of gestation 3.
- Mifepristone and sublingual misoprostol: This regimen has been shown to be effective and safe for medical abortion, but more studies are needed to determine its efficacy and safety compared to other regimens 2.
Gestational Age and Abortion
The gestational age of the pregnancy can affect the type of abortion and the regimen used. Studies have shown that: