Legal Methods Of Abortion

The definition of abortion is the ending of a pregnancy before the time of birth. The National Abortion Federation defines abortion as the removal of a fetus from the uterus before it is mature enough to live on its own.

90% of abortions are done in the first trimester (the first three months of life.)

Medical Abortion
In the first seven weeks of pregnancy a medical abortion is most commonly done. One of two drugs is given by a doctor to the mother to induce the abortion. Methotrexate or Mifepristone were originally approved by the Food and Drug Administration for cancer but were found to also end a pregnancy.

After an injection of Methotrexate, the fetal cells stop dividing and growing. Mifepristone also known as RU486 blocks the hormone progesterone. Without this hormone the pregnancy cannot continue. Progesterone keeps the uterus walls intact. When there is no progesterone the healthy blood vessels that are fed breakdown and the fetus detaches from the wall. The cervix then softens and the uterine muscles contract.

Commonly after a few days have passed, and after having taken either one of these drugs, a second drug named Misoprostol is administered. It is a pill that can be taken orally or inserted into the vagina area, which starts the uterus to contract and then expels what is left of the fetus. This method can cause pain, nausea, vomiting, headaches, very heavy bleeding, and diarrhea.

Chemical Abortion
The "morning after pill" is a high dosage of the well known birth control pill. It is used after sexual intercourse, over a 72 hour period, to either prevent or terminate an early pregnancy. No thorough testing has been done to confirm the safety of this practice, or the safety of repeatedly using this practice.

The "morning after pill" works in one of three ways: 1. The egg is not released (stops ovulation) 2. The menstrual cycle is altered (delayed ovulation) 3. The fetus is unable to attach itself to the uterus; therefore, this emergency contraception is called a chemical abortion.

10% of abortions are done in the second and third trimeters (between thirteen to forty weeks).

Surgical Abortion
The most common kind of abortion in the first trimester is a surgical abortion. There are three different types. These are done within thirteen to fifteen weeks since the woman's last menstrual period.

The most widely used of the three during the first trimester is the vacuum abortion. A local anesthetic is used to numb the cervix and then the opening to the cervix is dilated. A sharp-edged plastic tube from a suction machine is inserted into the uterus. The suction machine sucks out pieces of the fetus and the placenta. A sharp spoon-shaped instrument, known as a curette, is used by the doctor to remove remaining parts of placenta or fetus. It takes five to ten minutes to perform and the woman can have infections as well as uterus damage.

The second type of surgical abortion is called a dilation and evacuation (D&E). Most of the time, this procedure is done in an outpatient clinic but also is done in a hospital. It is performed in the early stage of the second trimester under general anesthesia. The cervix is enlarged in order to remove the body because the fetus is larger now. Many times the head must be crushed to remove the body.

Suction alone does not remove all parts and placenta so surgical forceps are used. This process twists and tears the fetus' skin and bones. The curette is used to remove anything that remains. The woman now is at greater risk of infection and complications. In most, all of these procedures drugs and/or anesthesia are given to the mother but nothing is given to the fetus.

In the later part of the second trimester, a third surgical method is used. This is called the instillation or induction method. For this procedure, the woman goes to a hospital and general anesthesia is used.

The doctor injects prostaglandin or urea medication and saline (salt water) solution, which are very strong chemicals, into the uterus through the abdomen. The fetus breathes and swallows the saline solution, burning and poisoning the fetus. Many times it causes the fetus to convulse. It takes over an hour to complete the procedure. The mother must still deliver the dead fetus which can take up to 48 hours of labor. Babies aborted in this manner are called "candy apple" babies because the burning of the skin causes the whole body to turn red.

There are even higher risks to the mother. Pain and infections are greater and the stay in the hospital is longer. There can be many complications including blood clots. Surgical punctures or tears, and in some cases legs, arms and other body parts are left inside the uterus. This is called an incomplete abortion, which requires a second abortion. The ultimate risk can be death for the mother.

Partial Birth Abortion
During this procedure, the doctor turns the fetus so that the feet will come out first and the fetus will be pointed down. The doctor pulls out the fetus' feet first until all but the fetus' head and neck are delivered. With the fetus usually kicking, moving, and sometimes crying, the doctor places his index and ring fingers over the baby's shoulders.

Finding the base of the fetus' skull the doctor uses a blunt-tipped scissors to jam into the skull. He opens the scissors so that it makes a large opening. The doctor removes the scissors, inserts a suction catheter to the wound, and sucks out the brain. When this is done the skull collapses and it is now small enough to remove from the mother's body. Next, the placenta is removed with forceps and the uterine walls are scraped.

Prostaglandin Abortion
Prostaglandin abortion is done by injecting prostaglandin hormones into the amniotic sac, which induces strong labor and causes the fetus to be born so prematurely that most do not survive. Urea or saline are injected repeatedly into the amniotic sac before the prostaglandin is injected. This is done to make labor less stressful for the mother and doctor, but the fetus remains alive longer.

Hysterotomy Abortion
Hysterotomy abortions are performed the same as a cesarean delivery. This is a preferred method when a tubal ligation (sterilization) is wanted at the same time.

D&X Abortions or Late Term Abortions
In the third trimester, abortions are called D & X or late-term abortions. They are performed after twenty-three weeks.This kind of abortion can be done all the way up to the due date. Usually an ultrasound is done to find the feet of the unborn baby then the doctor inserts a forceps through the cervix into the uterus and grabs a leg or foot. The fetus is pulled and scraped until it is removed from the uterus. If the baby comes out alive, it is left to die. Usually, the baby comes out in pieces.