Abortion Procedures – Frequently Asked Questions
First Trimester Surgical Abortion 7-12 Weeks
What Is A First Trimester Surgical Abortion?
The first trimester of pregnancy is defined as the first day of the last period through the 14th week of pregnancy. Thus a first trimester surgical abortion can be performed at any point during this time period.
Technically, pregnancy is defined as the point in time when the fertilized egg implants into the Uterus. This normally happens 7 to 10 days after ovulation. This is normally day 21 to 24 of the woman’s menstrual cycle.
This means that the earliest a surgical abortion can be performed is between the third and fourth week of the woman’s last menstrual period
Over 90% of abortions are performed in the first trimester of pregnancy. The medical term for a surgical abortion in the first trimester is a suction curettage or suction dilation and curettage.
What Are The Steps That Occur Prior To Having The First Trimester Suction Curettage Performed?
On arrival to the Medical Facility, a medical history form and other pertinent paperwork is filled out. Women are sent to the lab to have blood a urine test. A pregnancy Sonogram (Ultrasound) is performed on all women to determine the number of weeks pregnant.
A counseling session will take place where the benefits and risks of the surgical procedure vs other methods of terminating pregnancy will be discussed. Short and long term methods of birth control to help prevent an unwanted pregnancy will also be explained.
First Trimester Cervical Preparation May Be Required:
If it is determined prior to beginning the surgical abortion procedure that cervical preparation is required after meeting the Doctor, then this will be done first.
Cervical preparation is used to soften and dilate (open) the cervix (entrance to the womb). It reduces the chance of cervical lacerations or tears, uterine perforation (puncture of hole into the uterus), bladder and bowel damage, retained pregnancy tissue, heavy vaginal bleeding and infection.
Cervical preparation is usually done by using one of two methods. At times, they are combined:
- Laminaria- This is sterile seaweed that is in the shape of a matchstick. When inserted in the cervix, it absorbs water which causes it to slowly expand like a sponge.
- Misoprostol (Cytotec) – These are tablets that can be inserted vaginally or placed between the cheek and gum (buccally) or underneath the tongue (sublingually). This causes Uterine contractions which in turn leads to softening and dilation of the cervix.
In many cases, within a 3 to 4 hour time period, there is no need or only a minimal requirement to use surgical instruments to dilate the cervix.
How Is A First Trimester Surgical Abortion Performed?
Women are escorted to the Procedure Room and placed in the same position as having a Pap Smear.
If the Patient has chosen to have IV sedation, a small needle is placed. This allows most women not to have any discomfort, pain or recall the procedure.
A pelvic exam is performed followed by placement of a speculum inside the Vagina. Its purpose is to hold the vaginal walls open so the cervix can be visualized (seen).
The vagina and cervix are gently cleansed with gauze that has been soaked in sterile soap.
The cervix is anesthetized (numbed) using 1% Lidocaine if no history of allergy. This helps to alleviate the cramping sensation of the next step.
The opening of the cervix is gently stretched open with metal or plastic serial dilators.
After adequate dilation that is required to remove the pregnancy tissue, a sterile plastic non-reusable curette is inserted inside the cervix.
A manual or electric suction is attached to the curette and the pregnancy tissue is gently removed.
Near the end of the procedure, some women may experience mild to moderate cramping. This is due to the uterus shrinking back to its normal size.
This process normally takes only 3 to 5 minutes to perform.
Recovery After First Trimester Abortion:
Women are given a pad and escorted to the recovery room. A Medical staff person will be with patients at all times.
Vital signs will be monitored along with other measures to assure that they are recovering appropriately without any problems.
Patients should expect mild cramping, and some may experience mild dizziness, and nausea.
The amount of bleeding is evaluated by examining the amount of blood that has accumulated on their pad every 15 to 20 mins.
Patients are discharged when they are fully awake and their vital signs are normal and not experiencing abnormal vaginal bleeding.
Women who are 6 weeks or less and had no IV sedation can go back to work or school the same day. They may even participate in sport activities and have intercourse on the same day of the procedure if they choose to do so.
When To Follow-Up After First Trimester Surgical Abortion Procedure?
Patients are given verbal and written instructions that includes a 24 hour emergency number to call when or if they experience any complications or problems.
This includes but not limited to heavy bleeding (greater than 2 pads an hour for 2 hours in a row), severe abdominal pain that is not alleviated by pain medications or a temperature greater than 100.4.
Patients are encouraged to return to the office in 3 to 4 weeks or make an appointment with their personal Physician. This is to assure their pregnancy test is negative and they are not experiencing any problems related to the abortion process.
What Complications Can Occur With Having A First Trimester Surgical Abortion?
The chance of a complication occurring after a surgical abortion is less than 0.1%.
The risk of dying in having a full term birth is 14 times greater than having a first trimester abortion.
The risk of complications include the following:
- Heavy vaginal bleeding
- Infection
- Incomplete abortions
These are all rare events and are associated with reasons to call the medical office as described on the discharge instruction shit. Patients are asked to return to the office for immediate evaluation and treatment when required.
A patient may request an exclusive or private appointment by contacting by Email at: 24hourabortion@gmail.com or call directly at 407-245-7999. Same day appointments may be arranged.
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