METHODS OF ABORTION

There are three main methods of abortion. By far the commonest is the invasion of the womb from below, the other two methods are the use of a drug to cause premature labour (the drug may include a poison which kills the baby also) and the removal of the baby from the uterus by abdominal surgery.

The method used depends on how long you have been pregnant, the number of days since the first day of your last period.

FIRST TRIMESTER (1-12 weeks, the first three months of pregnancy)

Menstrual Extraction or Manual Vacuum Aspiration (MVA)
It is used in the very early stages of pregnancy. It can be done as soon as you know you are pregnant. It is the emptying of the uterus with gentle suction of a manual syringe. However, if all the fetal remains are not removed, infection results, requiring full dilation of the cervix and a scraping of the uterus.

The Abortion Pill (5-7 weeks)
RU486 is also known as Mifepristone or Mifegyne (originally labeled 2K95.890, but now classified as Roussell-Uclaf 38486 or RU486 in short) It is an anti-hormone, anti-progesterone. The work of progesterone is to signal the uterus to become receptive to the fertilized egg. Once the anti-hormone has occupied the progesterone receptors, the blastocyst is denied attachment and simply starves for want of nutrients and oxygen and is expelled after several days. This mechanism of action works to kill preborn children in the first seven weeks of pregnancy. At least three clinic visits are made: one for the RU486 tablets, another 2 days later for the prostaglandin and a third 8-12 days later to check whether the abortion is complete. Between visits, women are left to bleed at home.

Methotrexate(5-9 weeks)
A Methotrexate injection kills the unborn child by interfering with the growth process (cell division). Several days later, the woman is treated with prostaglandin (misoprostol) to expel the fetus and the woman aborts at home. Requires three visits to the doctor to complete the process.

Suction Abortion, Suction Aspiration or Vacuum Aspiration
Abortionists use this method most in the first trimester and can also use it up to 16 weeks. This is the most commonly used technique in developed countries. The day before the scheduled abortion, dry laminaria (a sea weed) is inserted into the cervix; it absorbs water and swells, gradually pushing open the cervix in the process. The next day when the woman comes for the abortion her cervix is already partially dilated. The abortionist, under anesthesia, further dilates the cervix with a set of dilators of increasing size. He does all this in a matter of thirty to sixty seconds. He then attaches a suction curette via a hollow plastic tube to a powerful suction pump. The suction curette is inserted into the uterus and the suction pump is turned on. The suction curette is moved inside the uterus and the suction created by the vacuum pump pulls the unborn baby's body apart and detaches the placenta from the wall of the uterus, sucking the fetal parts and placenta into a collection bottle and checked to see whether the abortion is complete.

Dilatation and Curettage (D&C)
This method is not as common anymore because it requires more dilation and more time and is considered less safe than suction abortion. After the cervix has been dilated sufficiently as in the procedure used for suction abortion, here it is dilated even further up to ten to twelve millimeters and takes more time. Once the cervix is open wide enough, a loop-shaped steel knife called curette is inserted into the cavity of the uterus to cut apart the unborn baby into pieces and scrape the uterine lining to detach the placenta from the wall of the uterus. Finally, all body parts and membranes are scraped out through the cervix and checked to see whether the abortion is complete. Bleeding is usually profuse. Possible complications include infection, cervical laceration and uterine perforation.
Note: This abortion method should not be confused with a therapeutic D&C done for reasons other than pregnancy. Many doctors assert that ultrasound testing should precede any D&C, or the woman risks having an unintentional surgical abortion.

SECOND TRIMESTER (13-24 weeks, second three months of pregnancy)

Dilatation and Evacuation (D&E) (13-20 weeks)
At this point in pregnancy, the unborn baby's body is too large to be broken up by suction and curette, besides, the cervix must be much more widely opened than in the D&C method. A sharp plier-like instrument is used to tear the unborn baby from limb to limb. The skull is crushed, as it is too large and too firm to be pulled out intact, and the spine is broken and all body parts pulled out in pieces, stacked on the table and reassembled to check if the abortion is complete. Bleeding is profuse. Possible complications include infection, cervical laceration and uterine perforation.

Saline Injection or Salt Poisoning
Used after 16 weeks, when enough amniotic fluid has accumulated. A long needle injects a concentrated salt solution through the mother's abdomen into the amniotic fluid, which surrounds the unborn baby. The fetus swallows and absorbs this solution causing burning of the outer layer of skin, haemorrhage of internal organs, edema, shock, dehydration, convulsions and eventually death. It normally takes somewhat over an hour for the baby to die from this. Within 24 hrs, labour will usually set in and the mother will give birth to a dead or dying baby. (There have been many cases of these babies being born alive. They are usually left unattended, to die. However, a few have survived and later been adopted.)

Urea Abortion
They are similar to Saline Abortions, but are not as effective. They are thought to have fewer complications. Urea infusion is more commonly combined with later term D&E abortions to soften fetal tissues for easier, safer and less painful removal of fetal parts.

Prostaglandin Abortion (16-38 weeks)
Prostaglandin is a hormone also called Misoprostol. This chemical induces premature labor. About 8ccs of Prostaglandin hormone is injected into the uterine muscle, which contracts to expel the baby in an artificially induced and extremely violent premature labor that takes about 20 hours. Live births are common. Hazards for mother include convulsions, vomiting and cardiac arrest.

Intercardiac Injection Abortion
At about 16 weeks, ultrasound imagery is used to pin point the location of the baby so that a long needle may be guided into its heart. The abortionist injects potassium chloride or some other fluid into the heart of the unborn through the mother's abdominal wall into her uterus, the heart is viewed on the ultrasound screen until it stops beating. After a period of days, the dead fetus is delivered naturally, or the process can be accelerated with cervical dilation followed by Prostaglandin injections. This method is most commonly used for "pregnancy reduction" abortions, also called selective abortion.

THIRD TRIMESTER (24 - 26 weeks, the third three months of pregnancy)

Hysterotomy
A hysterotomy is actually a Cesarean section done during the third trimester of pregnancy when other types of abortion may be too dangerous to the mother. The mother's uterus is surgically opened and the baby is lifted out. The helpless baby is then either left to die or is killed by the abortionist or his staff.

Dilatation and Extraction (D&X) or Partial Birth Abortion
This method was originated by abortionist Marvin Haskell. Most surgeons find dismemberment at twenty weeks and beyond to be difficult, due to the toughness of fetal tissues at this stage of development. This method takes three days to complete. In the first two days, the mother's cervix is dilated with laminaria in two or more sessions, with medication given for cramping. On the day of the procedure, the laminaria is removed and the patient is injected with Pitocin to induce contraction. The abortionist next determines the fetus orientation in the uterus through ultra sound and locates the legs. Grasping the legs with a large forceps, he then pulls the legs into the vagina and delivers the baby (live) up to the baby's head with his hands. Next the abortionist slides his hands up the baby's back and hooks his fingers over the shoulder of the baby. Then a pair of scissors are inserted into the base of the skull to create an opening and the scissors are then opened to enlarge the hole. The scissors are removed and a suction catheter is inserted. The baby's brains are then sucked out. Minus its brain, the skull collapses, and is easy to remove. Finally the abortionist removes the placenta with the help of forceps and scrapes the uterine walls with a suction curette.