Approximately 1.3 million women in the United States have an abortion to terminate a pregnancy, according to the American Congress of Obstetricians and Gynecologists. The abortion pill, also referred to as RU-486, is a combination of two medications, mifepristone and misoprostol. Women take the two drugs separately under a physician's care to induce expulsion of the fetus prior to the ninth week of pregnancy. There are a number of medical and surgical abortion alternatives to the abortion pill.
Methotrexate and Misoprostol
MTX is a medical abortion procedure commonly used up to the seventh week of pregnancy. Physicians commonly prescribe methotrexate to treat rheumatoid arthritis, but when the medication is used off-label during an abortion, it causes the fetus and placenta to separate from the lining of the uterus. The Food and Drug Administration has not approved methotrexate for the use of abortion.
During the initial office visit, a physician will give the woman methotrexate either by mouth or injection. The woman will take misoprostol either orally or via vaginal suppository at a second office visit five to seven days later. After a woman returns home, the misoprostol should trigger contractions and expel the fetus. The physician will schedule a follow-up examination seven days later to ensure that the procedure has completed with no complications.
Misoprostol Alone
Vaginal misoprostol is another alternative medical abortion and must be performed within the first eight weeks of pregnancy. The method uses only misoprostol given as a vaginal suppository. The American Congress of Obstetricians and Gynecologists explains that this method is often less effective and the side effects are often worse.
Suction Aspiration
A suction aspiration procedure, also known as a suction curettage or vacuum aspiration, is a surgical abortion used between the first six to 12 weeks of gestation, according to the American Pregnancy Association. The procedure takes approximately ten to 15 minutes, but patients often stay at the clinic for a few hours for recovery. Women often receive medications to help dilate the cervix as well as pain medication. The woman will lie on the table with her legs in stirrups, and when the cervix is wide enough, a long plastic tube attached to a suction device is inserted into the uterus to suction out the fetus and placenta.
Dilation and Curettage
A dilation and curettage, also known as a D&C, is an abortion procedure often performed during the 12th to 15th weeks of gestation. A dilation and curettage works similar to a suction aspiration procedure, according to the American Pregnancy Association. Once the initial suction aspiration is complete, the physician introduces a long loop-shaped instrument known as a curette to scrape the lining of the uterus to ensure that all fetal tissue and placenta is removed. In some cases, a second suctioning may occur to remove the new tissue.
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