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Surgical Abortion Procedure
This Page Outlines the Clinics Surgical Abortion Process
The surgical abortion generally takes about 10 minutes to complete and there are NO sharp instruments.
Please be Sure to Check the Following Additional Resources:
Understanding the Surgical Procedure Process
First, you’ll be draped with a sheet from the waist down. You may have a Support Person in the room with you.
The doctor will give you a pain medication directly into a vein in your arm that relaxes you and helps with any strong cramping you may feel.
Then the doctor does a pelvic exam to determine the size and position of your uterus. For those who have never had a pelvic exam, the doctor puts on a latex glove, inserts 2 fingers gently into the vagina, and presses firmly on your abdomen with his other hand. This takes a few seconds.
The doctor will insert the speculum, the same instrument used during a routine pap smear, into the vagina, so he can view the cervix. If you’ve never had a pap smear it is not a problem. It just feels a little uncomfortable, but will NOT hurt.
The cervix is then numbed with a local anesthetic, and in a few minutes it will take effect. From there the doctor dilates, (or opens) the cervix about the width of your little finger. This only takes about one minute.
You may feel uncomfortable cramping, so do slow deep breathing at this time. The doctor completes the abortion by slipping a small plastic tube into the opened cervix and connects it to a small machine called “the aspirator.” When you hear the sound of the aspirator, YOU’LL KNOW YOU ARE ALMOST FINISHED.
The aspirator quickly and easily removes the pregnancy by means of a gentle suction. Continue your slow deep breathing. Your nurse will then take you to the recovery room.
Here you’ll have a seat in a comfortable recliner. You’ll be in the recovery room for 30 minutes to an hour. You will have a blood pressure monitor checking your pulse and blood pressure every ten minutes for the next 30 minutes. The nurse will ask you to go to the restroom and check your bleeding. If she feels that your bleeding is normal and that the medication has worn off she will then discharge you.
You will be given your antibiotics and birth control with instructions on taking them. Any other medications or prescriptions that the doctor ordered will be also given and explained to you at that time.
Once the nurse discharges you from the recovery room, feel free to leave and get something to eat. Most patients are hungry and ready to go home.
The doctor will give you a pain medication directly into a vein in your arm that relaxes you and helps with any strong cramping you may feel.
Then the doctor does a pelvic exam to determine the size and position of your uterus. For those who have never had a pelvic exam, the doctor puts on a latex glove, inserts 2 fingers gently into the vagina, and presses firmly on your abdomen with his other hand. This takes a few seconds.
The doctor will insert the speculum, the same instrument used during a routine pap smear, into the vagina, so he can view the cervix. If you’ve never had a pap smear it is not a problem. It just feels a little uncomfortable, but will NOT hurt.
The cervix is then numbed with a local anesthetic, and in a few minutes it will take effect. From there the doctor dilates, (or opens) the cervix about the width of your little finger. This only takes about one minute.
You may feel uncomfortable cramping, so do slow deep breathing at this time. The doctor completes the abortion by slipping a small plastic tube into the opened cervix and connects it to a small machine called “the aspirator.” When you hear the sound of the aspirator, YOU’LL KNOW YOU ARE ALMOST FINISHED.
The aspirator quickly and easily removes the pregnancy by means of a gentle suction. Continue your slow deep breathing. Your nurse will then take you to the recovery room.
Here you’ll have a seat in a comfortable recliner. You’ll be in the recovery room for 30 minutes to an hour. You will have a blood pressure monitor checking your pulse and blood pressure every ten minutes for the next 30 minutes. The nurse will ask you to go to the restroom and check your bleeding. If she feels that your bleeding is normal and that the medication has worn off she will then discharge you.
You will be given your antibiotics and birth control with instructions on taking them. Any other medications or prescriptions that the doctor ordered will be also given and explained to you at that time.
Once the nurse discharges you from the recovery room, feel free to leave and get something to eat. Most patients are hungry and ready to go home.
Possible Complications and Aftercare:
One possible complication is infection. To help prevent an infection, you will receive antibiotics. Avoid sexual intercourse, douching, and using tampons for 3 weeks.
Another possible risk is incomplete abortion. This means tissue from the pregnancy is still inside the uterus after the abortion. Signs would be heavy bleeding, severe cramping, and bleeding past 3 weeks.
A missed abortion happens in less than 1% of cases. The three week checkup is important so that you and the doctor know that you are no longer pregnant.
Another possible complication is a tear in the uterus or cervix, bowel, or bladder. The possibility is less than a 1% chance, but it could require removing the uterus, which means you could not have children in the future. You can help keep this complication rare by lying still during the procedure, which most women are able to do.
Other possible, rare complications are covered on the consent form.
Normal bleeding and cramping varies from person to person. Bleeding 1 to 5 days is common, but it could continue lightly for up to 3 weeks. You may experience cramping for up to 5 days following the abortion, and some patients experience no cramping at all.
Another possible risk is incomplete abortion. This means tissue from the pregnancy is still inside the uterus after the abortion. Signs would be heavy bleeding, severe cramping, and bleeding past 3 weeks.
A missed abortion happens in less than 1% of cases. The three week checkup is important so that you and the doctor know that you are no longer pregnant.
Another possible complication is a tear in the uterus or cervix, bowel, or bladder. The possibility is less than a 1% chance, but it could require removing the uterus, which means you could not have children in the future. You can help keep this complication rare by lying still during the procedure, which most women are able to do.
Other possible, rare complications are covered on the consent form.
Normal bleeding and cramping varies from person to person. Bleeding 1 to 5 days is common, but it could continue lightly for up to 3 weeks. You may experience cramping for up to 5 days following the abortion, and some patients experience no cramping at all.
Remember, Complications after an Abortion are Possible, not Probable.
A first trimester surgical abortion is more than 10 times safer than childbirth. Most women leave the clinic feeling fine, return to their normal, physical activities the next day, and have their first period in 4 to 6 weeks.
Midtrimester Abortion by Dilation and Evacuation
The decision when to perform the two day procedure will be determined by the physician based on several factors, previous pregnancies, and/or patient’s age, gestation ages ranging 17-20 weeks, and other factors will be taken in consideration in making the decision.
The D & E procedure consists of two parts: Dilation and Evacuation. Dilation means to gradually dilate the cervix which is the opening of the uterus. Laminaria is inserted that will gradually swell in size and this process gently opens the cervix. The laminaria remains in the cervix overnight and will be removed by the physician prior to emptying the uterus. Evacuation is the removal of the contents of the uterus. The emptying of the uterus is performed using surgical instruments and suction aspiration.
After waiting the State 24 hour required time period you will return on day 2 for the insertion of the laminaria. It is important to know that once the laminaria is inserted the abortion procedure has begun.
After the laminaria is inserted, the patient and driver are required to spend the night at a nearby hotel. Patients receive information on overnight care instructions, the emergency number to the clinic, instructions for taking medications, and the time to return for the completion of the procedure for the next day. The D & E procedure are performed on two consecutive days.
Completion of the Procedure - Day 2
Upon arriving at the clinic and signing in, the patient is taken to the exam room. IV Sedation of Demerol and phenergan will be administered by the physician.
The physician performing all abortions at West Alabama Women’s Center is Board Certified OB/GYN Physician with years of experience in performing abortions.
Recovery Room
Following the completion of the procedure the patient is taken to the Recovery Room where vitals signs and bleeding will be carefully monitored for 30 minutes or until stable.
The discharge nurse will review your post-operative instructions, how to take your medications, and use of birth control pills if you have chosen this option. You will have an emergency number on post-op instructions where a physician is on call 24 hours a day.
Follow up appointments are scheduled for three weeks unless specified by the physician.
IV Sedation
At West Alabama Women’s Center we offer IV sedation during all surgical abortion procedures; since the majority of patients want sedation, it is already included in the listed fees. The sedation we use is a simple injection mixture of two different medicines: Demerol (meperidine hydrochloride) and Phenergan (promethazine hydrochloride). The technical descriptions of these medications are:
"Meperidine hydrochloride is a narcotic analgesic with multiple actions…the most prominent of these involve the central nervous system and organs composed of smooth muscle. The principle therapeutic actions are analgesia and sedation." Physicians Desk Reference (PDR)
"Promethazine hydrochloride is a phenothiazine derivative that has several different pharmacologic properties including antihistaminic, sedative and antiemetic actions and anticholinergic effects. The major side effect is sedation. Promethazine hydrochloride is specifically indicated for sedation and relief of apprehension." Physicians Desk Reference (PDR)
Translated into normal language this means that the medicines work together to: decrease any pain you might feel; decrease feelings of nausea; decrease cramping of the uterus (which is a ‘smooth muscle’); decrease feelings of nervousness; make you feel sleepy.
"IV" is the abbreviation for Intravenous. This means that the medications are given with a thin needle into a vein, usually in the crease inside the bend of the elbow. Because the medication is given in a vein, it goes directly into the patient’s bloodstream and the sedation works very rapidly. Patients who receive the IV sedation must have a driver to take them home because it is not safe to drive after taking sedatives.
Some women chose not to use the IV sedation; they cannot find a driver; or don’t want anyone to come with them to the clinic, or simply prefer not to take sedatives. Anyone can decide to have their procedures without IV sedation, these women are given oral (pills to swallow) medications that don’t cause drowsiness but are still effective at controlling cramps. These patients do find that after the procedure and resting they can drive themselves home. In fact, there are many abortion clinics where IV sedatives are not used at all.
To Book An Appointment or for additional information please feel free to Contact us at anytime at 1-800-616-2383 or 205-556-2026
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