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Abortion Information

While there are many abortion procedures available, before saying yes to any of them, it’s imperative that you understand the methods and risks involved. The client advocates at safe abortion jhb Women’s Clinic will give you the guidance and support you to need to make an informed decision about your pregnancy.

There are several common abortion methods depending on how far along you are in your pregnancy. You can learn more about the fetal development during each of these trimesters by clicking here.

First Trimester

Medical Abortion

A medical abortion uses drugs or chemicals to end the life of the developing baby during the early stages of human growth. Currently, 3 chemicals are used to perform a medical abortion methotrexate, misoprotol and mifepristone (RU-486).

The following chemicals are often used in combination:

• Methotrexate is a chemical that prevents the developing baby and placenta from properly using folic acid. Without the normal use of folic acid, the fetus cannot make, repair or replicate DNA in order to survive.
• Misoprotol (cyotec) is a chemical that resembles a prostaglandin in its action. It causes very intense uterine contractions to expel the developing fetus and placenta.
• Mifepristone (RU-486/Abortion Pill/Mifeprex) is a chemical that blocks the action of the hormone progesterone. Progesterone is needed to continue the pregnancy by maintaining the lining of the uterus; this is necessary for normal implantation as well as normal placental attachment and development.
• RU-486 causes the lining to die and separate from the uterine wall. When this happens, the fetus’ blood supply (carrying nutrients and oxygen) is cut off. Both the placenta and the fetus eventually fall from the uterine wall attachment site.

Surgical Abortion

Surgical abortion procedures involve the use of a suction or vacuum aspirator to remove the developing fetus from the uterus. Suction aspiration is the most common first trimester technique. It is used to terminate a pregnancy up to 14 weeks old.

Second Trimester

Dilation and Evacuation

Dilation and evacuation is the most common surgical technique used in the second trimester. Generally, it is performed when the pregnancy is between 12 – 24 weeks gestational age. This is because the developing fetus is bigger at this stage and bone calcification has occurred.

The cervix must be opened wider (than that required in a D&C or Suction Aspiration) to allow entry of forceps. Forceps refers to the surgical instrument resembling pliers with teeth used to grab and extract the contents of the pregnancy. Intravenous sedation or general anesthesia may be required.

Saline (or other toxic level chemical) Injection

Saline (or other toxic level chemical) injection is performed when a pregnancy is 16 weeks and beyond (when enough amniotic fluid is present to surround the fetus). A long needle is inserted through the mother’s abdomen (belly) into the amniotic sac. Amniotic fluid is removed from the sac and is replaced by a very strong salt solution meant to terminate the pregnancy. By the fourth month of pregnancy, the fetus has been drinking and breathing in amniotic fluid to help the organs develop properly.

However, when the salt solution is substituted for the normal amniotic fluid, it causes severe burning of the skin, eyes, mouth and lungs. Labor may begin within 24 hours of the saline injection resulting in the delivery of the remnants of your pregnancy. There is a chance that the fetus could survive this procedure, but would not live long thereafter.

Third Trimester

Dilation and Extraction

Dilation and Extraction is a surgical abortion procedure used to terminate a pregnancy after 21 weeks of gestation. This procedure is also known as D & X, Intact D & X, Intrauterine Cranial Decompression and Partial Birth Abortion. When this procedure is used on full term-sized fetuses, it is in effect, intentionally rearranging the fetus’ in-uterus position from head down to feet and legs down for a breech delivery. The body of the fetus, except the head, is pulled through the cervical opening.

The doctor makes an incision (cut) at the base of the skull and inserts a catheter (tube) to suck out the brain, causing the skull to collapse. The fetus is then removed completely from the uterus.

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