Types of Abortion

I) Medical Abortion/Abortion Pill/RU-486/ Mifeprex

Gestational Age: within 10 weeks of last menstrual period

Cost: $275-$700

Procedure:

The FDA approved regimen 1 for Mifiprex (RU-486) is a two-visit process using two different drugs. Mifepristone is given orally during the first office visit (200 mg). Mifepristone blocks progesterone from sustaining the pregnancy, thereby ending the pregnancy. Misoprostol tablets are given orally (800 -1600mcg) 48 hours later. The misoprostol will cause contractions to expel the remains. The misoprostol is taken at home. A follow-up occurs with  the healthcare provider about 7-14 days later to ensure the abortion is complete and that there are no immediate complications.

Risks and Side Effects:

The abortion pill is not advised for women who have anemia, bleeding disorders, liver or kidney disease, seizure disorder, acute inflammatory bowel disease, use an intrauterine device (IUD), or are unable to return for the follow-up visit.

  • Risk: unsuccessful abortion. The procedure is unsuccessful <3.2% of the time prior to 57 days, 6.5 % from 57-63 days and 7.2% from 63-70 days gestation. 2
  • Risk: medical emergency requiring an emergency room visit. Major adverse events requiring going to the emergency room occur for about 3.7% (about 1 in 25) of the patients between 47-63 days and 4.6% (about 1 in 20) of the patients between 64-70 days gestation. 3
  • Side Effects: Cramping, abdominal pain, nausea, vomiting, diarrhea, heavy bleeding, headaches, dizziness, infection and in rare cases, death.

II) Suction or Vacuum Aspiration

 Gestational Age: Up to 14 weeks after last menstrual period

Cost Estimate: $600-$1000

Procedure

Patient lies on her back with feet in stirrups and a speculum is inserted to open the vagina. A local anesthetic is administered to her cervix. Then, a tenaculum (a slender sharp pointed hook attached to a handle, mainly used in surgery for seizing and holding parts) is used to hold the cervix in place for the cervix to be dilated by cone shaped rods. When the cervix is wide enough, a cannula (a long plastic tube connected to a suction device) is inserted into the uterus to suction out the baby and placenta. The procedure usually lasts 10-15 minutes, but recovery may require staying at the clinic for a few hours.

Risks and Side Effects

  • Cramping, nausea, sweating, and feeling faint.
  • Less frequent side effects include possible heavy or prolonged bleeding, blood clots, damage to the cervix, Rh sensitization and perforation of the uterus.
  • Infection due to retained remains of the baby and related tissues, an STD, or bacteria being introduced to the uterus, can cause fever, pain, abdominal tenderness, scarring, infertility and in some cases, death.

III. D&E: Dilation & Evacuation

Gestational Age: 15 weeks and up after last menstrual period

Cost: $1500-$2100

Procedure

In most cases, 24 hours prior to the actual procedure, the abortion provider will insert laminaria or a synthetic dilator inside the cervix. Cone-shaped rods of increasing size are used to continue the dilation process. The cannula is inserted to begin removing tissue away from the lining. Then using a curette, the lining is scraped to remove any residual tissue. If needed, forceps may be used to remove larger parts. The procedure normally takes about 30 minutes.

Risks and Side Effects

-incomplete abortion with retained tissue, heavy bleeding, reactions to anesthesia, infection, and organ damage

 Most D&E procedures are performed in a hospital setting due to the increased risks of severe complications. The risk of complications increases with the duration of pregnancy. Although rare, additional risks related to D&E are damage to the uterine lining or cervix, perforation of the uterus, infertility, infection, and blood clots.

Sources

  1. S. Food and Drug Administration (2016). Mifeprex Medication Guide. Retrieved June 2021 from http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088643.pdf
  2. Mifeprex Label (2016), Table 4
  3. Winikoff, B., Dzuba, I.G., Chong, E., Goldberg, A.B., Lichtenberg, E.S., Ball, C., et al (2012). Extending outpatient medical abortion services through 70 days of gestational age. Obstet Gynecol; 120(5): 1070-1076.

 

No cost pre-abortion consultation

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