Surgical Abortion Care
“Reproductive freedom – a fundamental liberty.”
First Trimester Abortion
A first trimester surgical abortion can be completed up to 12 weeks in a pregnancy. The surgical method we use is called vacuum aspiration, which is a quiet, safe and gentle suctioning of the uterus. The cervix, or opening to the uterus, is dilated, or opened, and a small tube attached to the suctioning device is inserted into the uterus to remove the pregnancy. The entire procedure takes between 5 and 15 minutes in duration, and your visit to our Center will last between 3 and 4 hours.
When you arrive at our Center, you will be checked in by our front-desk staff and asked to complete intake forms. You will then meet with a nurse or counselor who will review your medical history, answer any questions you may have and obtain your consent for the procedure. You will also have an ultrasound and laboratory work (urine pregnancy test and blood draw). You may be given a drug called Misoprostol to help soften the cervix and make dilation easier. In a private room, the physician will do a pelvic exam to determine the size of your pregnancy. He will then perform the aspiration procedure. At all times during the pelvic exam and procedure a nurse or medical assistant will also be in the room with you and the physician. You may experience some discomfort and menstrual-like cramping during the procedure and options are available for anesthesia. After surgery, you will be monitored in our Recovery Room by our medical staff until you are medically cleared to return home. You may have some menstrual-like cramping and bleeding after the procedure, which is normal. If you are having anesthesia, you will not be able to drive yourself home and will need to make arrangements for someone to pick you up. We can also assist you with taxi arrangements. Before leaving our Center, you will be given detailed after-care instructions.
Click here to download a printer-friendly PDF of pre-surgical instructions for first trimester abortion.
Second Trimester Abortion
After an evaluation by our medical team, a second trimester surgical abortion can be completed through 21 weeks 6 days in a pregnancy. A second trimester abortion is done using the same method as with a first trimester abortion with gentle suctioning, or aspiration, of the uterus. With a second trimester procedure, though, the step where the cervix (opening to the uterus) is dilated, or opened, takes more time. A gradual dilation of the cervix is done to make the procedure safer and easier for you. Depending on the results of ultrasound and pelvic exam, a second trimester procedure can be done at our Center on the same day in about 4 to 5 hours or may require a two- or three-day procedure. Generally if your pregnancy is 15 weeks or more, you will not be able to have a same day procedure.
The pre-operative process is the same for both same day second trimester abortion or two-day second trimester abortion. When you arrive at our Center, you will be checked in by our front-desk staff and asked to complete intake forms. You will then meet with a nurse or counselor who will review your medical history, answer any questions you may have and obtain your consent for the procedure. You will also have an ultrasound and laboratory work ( urine pregnancy test and blood draw ). In a private room, the physician will do a pelvic exam which will help him determine the appropriate treatment for you. The physician may insert one or several cervical dilators which will enlarge the opening of the cervix. He may decide to use a drug called Misoprostol to soften the cervix. Often times, both treatments are necessary.
When you arrive at our Center, you will be checked in by our front-desk staff and asked to complete intake forms. You will then meet with a nurse or counselor who will review your medical history, answer any questions you may have and obtain your consent for the procedure. You will also have an ultrasound and pelvic exam to determine the size of the pregnancy and laboratory work (urine pregnancy test and blood draw). In a private room, the physician will do a pelvic exam and insert one or several cervical dilators to enlarge the opening of the cervix. You may also be given a drug called Misoprostol to soften the cervix. You will go home after the dilators are inserted and will return the next day for the completion of the procedure.
If a cervical dilator is inserted, this will take about 5 minutes. Most women over 15 weeks will need a cervical dilator. To make insertion of the dilator more comfortable, the physician will first numb your cervix with an injection of lidocaine (similar to novocaine used for dental procedures). You may feel a pinch during the injection and some pulling and cramping during the insertion of the cervical dilator, but need to be awake for this part of the procedure. Once inserted, the dilator swells like a tampon, slowly opening the cervix. You may have some cramping during this process. It is important to understand that once the cervical dilator is inserted, the abortion process has begun and can’t be stopped.
Once the cervix is opened, the physician will complete the procedure to empty the uterus during which time you will not be awake. At all times during the pelvic exam and surgical process a nurse or medical assistant will also be in the room with you and the physician. After surgery, you will be monitored in our Recovery Room by our medical staff until you are medically cleared to return home. You may have some menstrual-like cramping and bleeding after the procedure, which is normal. You will not be able to drive yourself home because you will be having anesthesia, and will need to make arrangements for someone to pick you up. We can also assist you with taxi arrangements. Before leaving our Center, you will be given after-care instructions.
Click here to download a printer-friendly PDF of pre-surgical instructions for same-day second trimester abortion.
Click here to download a printer-friendly PDF of pre-surgical instructions for two-day second trimester abortion.
Anesthesia Options
Depending on your individual situation and needs, first and second trimester abortions can be performed with different types of anesthesia. Our medical staff will work with you to determine the best type of anesthesia to ensure your comfort and protect your safety, depending on your individual situation and needs. If your pregnancy is 12 weeks or more, you will have to have general anesthesia. Anesthesia options include:
- Local anesthesia – Where the physician injects a numbing agent called lidocaine (similar to novocaine used for dental procedures) into your cervix. This will lessen discomfort but you may experience some cramping and discomfort during the procedure. Because you are alert during the procedure, you will be able to drive yourself home. Our medical staff assists you during the procedure with breathing and relaxation exercises to help reduce discomfort.
- Local anesthesia with relaxation* – To increase relaxation with a local anesthetic, you may request an anti-anxiety drug.
- Intravenous (IV) sedation* – Often called twilight sleep, an IV needle is inserted into your hand or arm through which medication is injected into your body. You go into a light sleep where you may hear or feel sensation but you will not remember anything after the drug wears off.
- General anesthesia* – You are totally asleep with this type of anesthesia and will not hear or feel anything during the procedure.
*You will need to make arrangements to have someone pick you up if you have local anesthesia with relaxation, IV sedation or general anesthesia. We can also assist you with taxi arrangements.
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