Surgical abortion is a common surgical procedure performed to end a pregnancy. Surgical abortions usually are performed only during the first trimester of pregnancy, but may be performed at any time throughout a pregnancy if medical emergencies arise that threaten the mother's life. The most common type of surgical abortion is a suction aspiration abortion, and unless performed under extreme medical circumstances in a later pregnancy, this is the method most likely to be used.
Vaginal Exam
The woman will lie down on a hospital bed flat on her back and then must place her feet in stirrups like those used for a Pap smear exam. However, unlike the stirrups used for a Pap smear exam, the ones used in the abortion have metal leg rests extending up to the bed that the legs are placed on. Her legs will be strapped to the leg rests to prevent accidental internal organ damage in case she moves during the procedure, which is rare. A speculum is inserted to open the vaginal canal and to allow the physician to see the cervix.
Internal Ultrasound
Although most physicians have performed an ultrasound before the surgical abortion, most will perform another one at this time. This is to ensure that the pregnancy is in the uterus and not in the fallopian tubes or abdominal cavity, which can be life-threatening if not detected.
Administration of Pain Medication
The physician will then rub an anesthetic to the outside of the cervix to alleviate pain that may be caused during the procedure. Many clinics also offer IV pain medications and nitrous oxide, (laughing gas), which will also be administered at this time if opted for.
Dilitation of Cervix
The physician will clamp an instrument called a tenaculum to the cervix to prevent it from moving during the procedure, which could result in cervical damage. The doctor then will start manually dilating the cervix by placing cone shaped rods into the cervical opening. Several different rods are used to open the cervix and each one is progressively larger in size. He will continue this process until the cervix is dilated enough to complete the procedure.
Aspiration of Uterus Contents
Once the cervix is adequately dilated, the physician will insert a hollow plastic tube called a cannula into the cervical opening and slightly into the uterus. He will attach the other end of the cannula to a suction machine. The physician will start suctioning out the contents of the uterus, which include the fetus, placenta and other products of pregnancy. During more advanced pregnancies a tool may also be used to scrape additional contents from the uterine wall. He will perform another ultrasound exam to ensure that he removed all of the products of conception from the uterus.
Recovery
The woman will remain in a small waiting room for a few hours after the procedure so that the clinic staff can monitor her medical condition. She will wear an absorbent pad after the surgical abortion and her bleeding, blood pressure, and heart rate will be monitored before before she is allowed to go home. She may be given additional pain medication, antibiotics and drugs to help return her uterus to its pre-dilated state. The physician should provide with a 24-hour phone number to call for any medical questions or emergencies. In fact, a woman should only have the procedure done by a physician who offers this 24-hour service.
