Abortion (pregnancy termination)

An abortion is ending a pregnancy before it can result in a live baby. An abortion is performed using a medical or surgical technique, and in developed countries is legal and safe.

Legal abortions are generally available up to 12 weeks, but only in certain circumstances after this.

Medical abortion

A medical abortion is performed using what’s known as an abortifacient, which is a pharmaceutical-grade drug that interrupts the pregnancy, causing the foetus to be expelled in a premature labour^​1,2​. 

There are several drugs that do this safely, and the success rate is about 98 per cent^​3​. If the abortion is incomplete (part or all of the foetus remains inside the uterus), a surgical abortion will be necessary to complete the procedure.

In a nutshell, you can take a pill and the pregnancy ends, causing you to miscarry. The time it takes to happen depends entirely on the drug used. Some countries prefer medical abortions over surgical abortions (Britain, France, Switzerland, Netherlands), while the USA uses mostly surgical abortions.

• Methotrexate – 24-48 hours (the same day you take the misoprostol), but can take up to a week, sometimes up to two weeks
• Mifepristone – 12-24 hours, but can also take up to a week

A medical abortion can be performed up to the second trimester, but the drugs used may differ in early abortions compared to later abortions. (Learn about safe, mail-order medical abortions using misoprostol by searching online for Women on Waves.)^​4​

Surgical abortion

Surgical abortions involve the use of medical tools to forcibly remove the foetus from the uterus.^​5​ The procedures differ depending on the size of the foetus.

Up to 15 weeks

Up to 15 weeks an aspiration and curettage (A & C) may be used – aspiration is suction, and can be used with or without the curettage (metal spoon to scrape the uterus of tissue). It may include forcing the cervix open to fit a plastic tube through.

Manual vacuum aspiration (MVA), which removes the contents of the uterus using a syringe, while the electric version (EVA) uses an electric pump. This sort of procedure is known as a menstrual extraction^​6​.

No dilation of the cervix is necessary, however the pregnancy must be quite early, since the foetus may otherwise be too large to fit through the undilated cervix.

Dilation and curettages (D & C) are used very commonly as a surgical method of abortion. Dilation (the opening up of), and curettage (scraping with a tool to clean the uterine lining of tissue)^​7​.

D & C’s are not just used for abortions, but also for scraping out the uterine lining as a sample to find abnormalities or cancers, and to check out the cause of abnormal bleeding.

From 15 – 26 weeks

From 15-26 weeks dilation and evacuation (D & E) is used. The cervix is opened (dilated) and the foetus and all pregnancy tissue is removed using surgical tools and suction.

Premature labour may be induced using hormones (prostaglandins), which causes the body to expel the material, which is not intact.

After 16 weeks and third-trimester abortions

After 16 weeks, and for third-trimester abortions an intact dilation and extraction (IDX) may be performed. This leaves the foetus more or less intact, but the skull is altered in a partial-birth abortion. This procedure is banned in the USA.

It is sometimes used in late-term abortions where the removal of a foetus is required, and premature labour is not the best option.

Removal of a foetus can also be done by hysterotomy abortions, which are similar to a caesarean section but with a smaller incision, and involves opening up the abdomen to remove the foetus and pregnancy tissue.

A spontaneous abortion is the medical term for what we usually call a miscarriage, whereas a deliberate miscarriage is called an induced abortion.

‘Bringing on’ a period – menstrual extractions

It can be tempting to try to find a way to ‘bring on your period’ if it’s ‘late’ at home by trying a menstrual extraction. Menstrual extractions are used by some as a matter of course, sometimes every month, to gently suck out the entire endometrium (blood and tissue) at ‘period time’.

This of course also means removing any fertilised eggs that may be clinging to the sides, but other reasons include to resolve problematic periods or other discomfort.

There is no reason you (and a kind friend or two to help) can’t explore this possibility, but do your homework! The gear you will need is simple, and you can buy it online, or in fact you can make a device at home by yourself. For more information, look for instructions online.

Herbal abortions

Before attempting any non-medical pregnancy terminations, if you have safe surgical or medical abortions available, these are by far the best and safest option.

Attempting a termination at home can be very time-consuming, may be completely ineffective (resulting in a surgical abortion anyway) and at worst, unsafe.

Herbal abortions are possible, but are somewhat more hit and miss than doing a very early menstrual extraction. Natural does not mean safe. ^​8​

Some herbs are known as abortifacients and exert other hormonal effects that can be used in an attempt to expel the contents of your uterus, but it is a particular procedure that according to some sources only works about half the time.

Those odds aren’t great, but again, some people do not have easy access to abortions and alternatives must be sought. Look for help to establish how far along you are, what that means biologically, and what options may be available herbally.

Earlier is far better when it comes to menstrual extractions and herbal abortions, with anything after six weeks, according to some sources, not really worth it.

Safety of abortion

Safe abortions are legal abortions, since proper standards are in place and laws must be adhered to. Those who get safe terminations have very low rates of damage.

Abortion is considered one of the safest procedures performed. That’s pretty amazing considering unsafe pregnancy terminations cost almost 50,000 lives each year and millions more in damage.

A safe, properly performed abortion leaves no marks or scars, and once healed, nobody can tell you have had one.

Post-abortion emotions

There is good evidence to suggest that the majority of those who choose a pregnancy termination most often feel nothing but relief afterwards.^​9​ Grief may also be felt. Abortion may be a hard decision to make, but there are many elements at play for each person.

See a counsellor or speak to a trusted confidant if you feel affected by the pregnancy termination negatively.

Should I get an abortion?.

Birth control

Birth control should be carefully considered after an unwanted pregnancy – it fails from time to time, we mess up, and mistakes happen for lots of reasons.

It’s easy to get pregnant accidentally, so make sure you understand what your body is doing and when by charting your cycles (use a cycle/period tracking app at minimum).

Know when you ovulate so you can have some control over your body. Check out the contraception page so you see what is available, and what options might suit you the best.

References^​10,11​

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