Dilation And Evacuation (D&E) Abortion | What To Expect

Dilation and Evacuation (D&E) abortions are one of the most common types of abortions. This type of abortion is done during the second trimester, between 13 and 24 weeks.

D&E abortions are usually performed because a fetus has an anomaly that is incompatible with life or because the health of the mother is in danger.

In this article, we will explain how a Dilation and Evacuation abortion is performed, why it may be recommended, what patients can expect during the procedure, and what the recovery process involves. 

Counselling Before An Abortion

Counselling Before An Abortion is mandatory in some states, but not all. You will likely meet with your doctor or a counsellor to discuss your decision and go over the risks and benefits of the procedure.

You will also be asked about your medical history and given a physical examination. If you are Rh-negative, you will be given a shot of RhoGAM to prevent problems with future pregnancies.

Ultrasound

Before undergoing a Dilation and Evacuation (D&E) abortion, an ultrasound will typically be performed to confirm how far along you are in your pregnancy, assess the position of the pregnancy, and evaluate the uterus.

The ultrasound may also help identify certain fetal abnormalities, although a detailed fetal anatomy assessment is not routinely required for every abortion procedure.

These preliminary evaluations help ensure that the D&E procedure is planned according to your individual medical needs, with an emphasis on safety, comfort, and appropriate care.

Dilation And Evacuation Procedure

Before the procedure, you will be given medication to help you relax. This is optional, but it can help make the experience more bearable.

During a D&E abortion, the cervix is dilated and the uterus is emptied. This procedure is usually done in a hospital or clinic.

The first step is to dilate the cervix. This is done by inserting thin rods of varying sizes into the cervix. The rods are slowly increased in size over a period of several hours depending on the individual case.

Once the cervix is dilated, a suction device is used to remove the contents of the uterus. The suction device may be attached to a handheld syringe or an electric vacuum pump.

After the contents of the uterus have been removed, forceps are used to remove any remaining tissue. The forceps are inserted through the dilated cervix and into the uterus.

The D&E procedure is usually completed within 30 minutes to an hour.

After the D&E Procedure

After the D&E procedure, you will be asked to rest in a recovery room for a few hours. You will be monitored for any complications during this time.

You may experience cramping and bleeding after the procedure. This is normal and should resolve itself within a few days. You may also have spotting or light bleeding for up to four weeks after the procedure.

It is important to avoid sex, tampons, douching, or using vaginal medicines for two weeks after the procedure to reduce your risk of infection.

You should make an appointment for a follow-up visit with your doctor within two weeks of the procedure.

Complications

Although most D&E procedures are completed without serious complications, the following problems can occasionally occur:

• Heavy Bleeding (Hemorrhage): Some vaginal bleeding is expected following a D&E procedure. However, excessive bleeding may require additional medical treatment and, rarely, a blood transfusion.

• Infection: An infection of the uterus or surrounding reproductive organs can develop following the procedure. Symptoms may include fever, worsening pelvic pain, or unusual vaginal discharge. Infections are generally treatable with antibiotics when identified promptly.

• Incomplete Abortion: Occasionally, pregnancy tissue may remain inside the uterus after the procedure. This may require additional medication or a repeat surgical procedure known as re-aspiration.

• Uterine Perforation: In rare cases, a surgical instrument may injure the uterine wall. Depending on the severity, further medical evaluation or surgical treatment may be necessary.

• Cervical Injury: The cervix may occasionally be injured during dilation or the surgical procedure. Careful cervical preparation helps reduce this risk.

• Injury to Surrounding Organs: Damage to nearby organs, including the bladder or bowel, is extremely rare but may require additional surgery.

• Anesthesia-Related Complications: Patients receiving IV sedation or general anesthesia may experience side effects such as nausea, dizziness, or allergic reactions. Serious anesthesia complications are uncommon.

Conclusion

Dilation and Evacuation (D&E) is a well-established surgical abortion procedure with a low risk of serious complications when performed by qualified healthcare professionals.

Most patients experience a smooth recovery without significant medical complications.

However, understanding the possible side effects, following post-procedure care instructions, and recognizing warning signs are essential for ensuring a safe and healthy recovery.

If you have questions about D&E abortion complications, recovery, or aftercare, contact us.

Dr James S Pendergraft | Orlando Women’s Center | Abortion Pill Clinic | Articles On Abortion