What are the different types of abortion?

Women's Health

There are a number of types of abortion, and options depend on the duration of the pregnancy.

An abortion is a medical means of ending a pregnancy.

Worldwide, around half of all reported unintended pregnancies end in abortion. Abortion is legal throughout the majority of the United States and in many other countries.

In this article, we describe the different types of abortion, when and where they are available, and what they involve. We also look into advantages and disadvantages, recovery, and potential risks.

 

When can a woman have an abortion?

Where abortion is legal in the U.S., doctors usually perform them in the first trimester or the early part of the second trimester.

The first trimester lasts from conception to week 12 of pregnancy. The second trimester is from week 13 to week 28. Some states allow abortion in the latter part of the second trimester.

In 2015, two-thirds (65.4%) of reported abortions in the country took place when the pregnancy had lasted fewer than 8 weeks, according to the Centers for Disease Control and Prevention (CDC).

In the same year, almost all of the reported abortions (91.1%) took place when the pregnancy had lasted fewer than 13 weeks.

In the first trimester, options for abortion commonly include:

  • medical abortion
  • vacuum aspiration

A woman can usually access medical abortion until about 10 weeks after her last period. It involves taking two types of medication.

Surgical options, such as vacuum aspiration and dilation and evacuation, are more common after 10 weeks.

In the second trimester, a woman may undergo:

  • dilation and evacuation
  • labor induction abortion

Abortion is rare during the third trimester, but a doctor may perform it after 29 weeks of pregnancy if a woman’s life is in danger. They may use the same methods that are used during the second trimester.

 

Medical abortion

A medical abortion requires a woman to take pills at separate times.

How it works

Woman taking a pill with a glass of water.
A medical abortion involves taking two medications that stop the pregnancy from developing.

This type of abortion involves taking two medications, mifepristone and misoprostol.

A doctor or nurse will advise about the timing, but a woman should take the second medication, misoprostol, no more than 48 hours after taking the first, mifepristone.

Mifepristone stops the pregnancy from developing. Misoprostol triggers the uterus to empty, which will begin 1–4 hours after taking the pill.

A woman will experience cramping and bleeding as the uterus empties, which may feel like having an unusually heavy period. Some women feel more severe cramping than others.

Within around 4–5 hours, the pregnancy tissue will likely have passed from the body, but it can take longer.

Advantages

Some advantages of a medical abortion are:

  • It does not involve surgery.
  • It is available in the first trimester.
  • It does not require an anesthetic.

Disadvantages

Some disadvantages of a medical abortion are:

  • It is not available in the second trimester.
  • Only part of the treatment takes place in a clinic.
  • It may cause painful cramping.
  • Rarely, it is not effective.

It may be a good idea to have a partner or friend close by for support while the tissue is passing.

Recovery

Recovery from a medical abortion involves:

  • some bleeding and spotting that may last for several weeks
  • a check-up with the doctor to monitor recovery

Risks

Some women experience side effects of the medications. These can include:

 

Vacuum aspiration

Vacuum aspiration is a type of surgical abortion that involves using gentle suction to end a pregnancy. Doctors typically recommend this during the first trimester.

How it works

A doctor begins the vacuum aspiration procedure by inserting a speculum into the woman’s vagina. They then apply medication or use an injection to numb the area.

Next, they use thin rods called dilators to open the cervix, then insert a tube into the uterus. Then, they use either a manual or mechanic suction device to empty the uterus.

Advantages

The advantages of vacuum aspiration are:

  • It is available in the first 12 weeks of pregnancy.
  • It is quick, with the procedure only taking 5–10 minutes.
  • It is relatively pain-free, though some women experience cramping, sweating, nausea, or a combination.
  • It does not require a general anesthetic.

Disadvantages

The main disadvantage of vacuum aspiration is that it is not available in the second trimester.

Recovery

Recovery from vacuum aspiration involves:

  • resting for up to 1 hour after treatment
  • taking antibiotics to prevent infection
  • avoiding sex for 1 week after treatment

Also, some women experience cramping for a few days following the procedure, and irregular bleeding or spotting can occur for several weeks.

Risks

The potential complications of vacuum aspiration include bleeding and infection. However, the risk of these complications is low.

Speak to the doctor right away if signs of bleeding or new symptoms occur.


Dilation and evacuation

Dilation and evacuation is a type of surgical abortion that doctors commonly use during the second trimester.

How it works

A doctor may give a general anesthetic before performing a dilation and evacuation. This type of anesthetic ensures that a person does not feel anything during the procedure.

The doctor begins by inserting a speculum into the woman’s vagina. Then, they use dilators to open the cervix.

Next, they remove the pregnancy tissue with small forceps. Finally, they use suction to remove any remaining tissue.

Advantages

The advantages of dilation and evacuation are:

  • It is available in the second trimester.
  • It is a safe and effective way to end a pregnancy.

Disadvantages

The disadvantage of dilation and evacuation is that it can require a general anesthetic.

Recovery

Recovery from dilation and evacuation involves resting.

Mild pain and cramping can occur for a few days after the procedure, and there may be some bleeding for up to 2 weeks.

Risks

Potential complications of dilation and evacuation include:

  • infection
  • heavy bleeding
  • injury to the uterus

The risk of injury to the uterus or other organs during a second-trimester abortion is less than 1 in 1,000, according to The American College of Obstetricians and Gynecologists.

 

Labor induction abortion

Labor induction abortion is a late-term method of ending a pregnancy in the second or third trimester.

This type of abortion is rare, and a doctor may recommend it if a woman’s life is in danger.

How it works

Labor induction involves using medications to start labor, which causes the uterus to empty over a period of around 12–24 hours. A woman can take these medications by mouth or the doctor may place them into the vagina or inject them into the uterus.

Doctors usually also administer pain relief medication or a local anesthetic, as intense cramping occurs during this type of abortion.

Recovery

After the abortion is complete, a woman tends to remain in the clinic or hospital for anywhere from a few hours to 1–2 days, depending on health and other factors.

The doctor can help determine the length of the stay, and they may be able to estimate it before the abortion.

Risks

The medications that induce labor can cause side effects, such as:

  • nausea and vomiting
  • fever
  • diarrhea

Complications are rare but can include:

  • hemorrhage
  • cervical injury
  • infection
  • rupture of the uterus
  • incomplete release of the pregnancy tissue

 

Are abortions legal?

female patient listening to female doctor
Women can speak with their healthcare provider for advice about access to abortion services in their area.

Abortions are legal in most U.S. states and in many countries.

However, the state of Alabama banned abortions in 2019, and the following U.S. states strictly limit access:

  • Georgia
  • Kentucky
  • Louisiana
  • Missouri
  • Mississippi

These types of restrictions require some women to travel to a different state or country to have an abortion. Speak to a healthcare provider for advice about access.

 

Summary

An abortion is a medical means of ending a pregnancy. There are various types of abortion, including:

  • medical abortion
  • vacuum aspiration
  • dilation and extraction
  • labor induction

A healthcare professional will recommend a type, depending on the stage of pregnancy.

In many countries access to abortion is legal, as it is in most U.S. states.

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