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Methods of Abortion

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There are many different ways an abortion can be performed. Different methods are used under different circumstances and after different developments of the embryo or fetus. No method of abortion is 100% safe, and no method is 100% successful. (See Side Effects)

 

Methotrexate Injection: Performed in the early first trimester. Methotrexate is injected and begins to attack the cells surrounding the embryo.1 The embryo is deprived of food and oxygen, and eventually dies. Several days later, misoprostol is injected to trigger the expulsion of the embryo. This expulsion may not occur for as long as eight weeks2, and the woman may bleed heavily3. The actual expulsion may occur at any moment and in any place 4. In about 4% of cases, expulsion does not occur and surgery is required 2.
This is not a common form of abortion because Methotrexate is toxic and has many common side-effects, such as nausea, pain, diarrhea, and increased chance of cancer, anemia, and lung disease5.

 

Suction Aspiration (vacuum curettage): The most common (98%) form of first trimester abortion6. The cervix is dilated, and a powerful vacuum tube with a sharp cutting edge is inserted. The suction rips apart the body of the baby, and sucks out blood, amniotic fluid, tissue, and body parts7.
The most frequent post-abortion complication occurs with this method. If any fetal or placental tissue is left behind in the uterus, infection can develop.

 

Dilatation and Curettage (D&C): Generally performed in the first or early second trimester. The cervix is dilated or stretched to permit the insertion of a loop shaped steel knife. The body of the fetus is cut up and removed from the placenta7.
Blood loss and likelihood of uterine perforation are relatively high in this form of abortion8.

 

Dilation and Evacuation (D&E): Generally performed in the second trimester, this is similar to D&C. Forceps are used to rip away pieces of the developing body and remove them from the womb. Because the skull has often hardened by this time, it may have to be crushed for removal.
Bone fragments from the crushed skull can easily puncture the cervix, causing high blood loss9.

 

Prostaglandins Injection: Performed during the second trimester. Prostaglandins, naturally occurring birthing hormones, are injected to prematurely induce labor. Oftentimes the baby is delivered alive10.
Permanent placental, cervical, and cardiovascular side-effects are common. Even death is possible11.

 

Saline Amniocentesis (Salt Poisoning): This method, first used in Nazi concentration camps and now common in America, is performed during the second or early third trimester. A needle is injected into the abdomen, and 50-250ml of amniotic liquid is removed12. This is replaced by a concentrated salt that burns away and deteriorates the baby's skin13. Within three days the mother goes into labor and delivers a dead, burned baby14.
This concentrated salt may cause severe hemmorage, cervical injuries, or side effects to the nervous system such as seizures or coma15.

 

Urea Injection: Performed during the second or early third trimester. This is performed just like Salt Poisoning, however it is not as strong.
Though not as dangerous as Salt Poisoning, Urea Injection increases the chance of a failed abortion, which usually results in surgery. Almost 2% of Urea Injection patients must be hospitalized for side-effects16.

 

Hysterotomy: Performed during the third trimester, this is usually performed if other forms of abortion are unsuccessful. Incisions are made in the abdomen, and the baby, placenta, and amniotic sac are removed. Babies are often removed alive during the operation7.
The risk to the mother's health is greatest in this form of abortion, and the chance of complications during later pregnancies is greatly increased8.

 

Partial Birth Abortion: Performed during the late second or third trimester. Using ultrasound, the abortionist grasps the baby's leg with forceps, and partially forcefully delivers all but the head. Scissors are then jammed into the back of the babies skull, and the wound is pryed open. A powerful vacuum tube is inserted and sucks out the baby's brain.

 

Dilatation and evacuation, for example, where fetal tissue is progressively punctured, ripped, and crushed, and which is done after 13 weeks when the fetus certainly responds to noxious stimuli, would cause organic pain in the fetus. Saline amnioinfusion, where a highly concentrated salt solution burns away the outer skin of the fetus, also qualifies as a noxious stimulus [pain]."

-T. Sullivan, M.D., FAAP,
Amer. Academy of Neurosurgeons

Sources

 

1. Mitchell D. Creinin, M.D., "Methotrexate for abortion at 42 days gestation"
Contraception, Vol. 48, No. 6 (December, 1993), p. 519.
2. Eric A Schaff, M.D., et al, "Combined Methtrexate and Misoprostol for Early
Induced Abortion," Archives of Family Medicine, Vol. 4. 1995, p. 2.
3. Richard U. Hausknecht, M.D., "Methotrexate and Misoprostol to Terminate
Early Pregnancy," New England Journal of Medicine, Vol. 33, No. 9 (August 31,
1995), p.538.
4. Conversation between Richard U. Hausknecht, M.D., and Phil Donahue, "An
Abortion Pill by Prescription Without Surgery," The Phil Donahue Show,
September 26, 1995; Journal Graphics, Transcript #4346, pp. 2-4.
5. Physicians' Desk Reference (PDR), 47th edition (Montvale, NJ: Medical
Economics Data, 1993)., p. 1245.
6. U.S. Centers for Disease Control (CDC). "Abortion Surveillance: Preliminary
Data -- United States, 1991, " Morbidity and Mortality Weekly Report, Vol. 43,
No. 3, 1994, p. 43.
7. U.S. Senate Report of the Committee on the Judiciary, Human Life
Federalism Amendment, Senate Joint Resolution 3, 98th Congress, 1st Session,
legislative day June 6, 1983, p. 36.
8. F. Gary Cunningham, M.D., et al, Williams Obstetrics, 19th ed. (Norwalk,
CT: Appleton & Lang, 1993), p.683.
9. Warren M. Hern, M.D., Abortion Practice (Philadelphia: J.B. Lipincott
Company, 1984), pp. 153-154.
10. Nancy K. Rhoden, "The New Neonatal Dilemma: Live Births from Late
Abortions," The Georgetown Law Journal, Vol. 72 (1984), p. 1458.
11. Willard Cates, M.D. and H.V.F. Jordaan, "Sudden Collapse and Death of
Women Obtaining Abortion Induced by Prostaglandin F2 Alpha," American
Journal of Obstetrics and Gynecology, Vol. 133 (February 15, 1979), pp.
398-400.
12. Thomas D. Kerenyi, "Hypertonic Saline Instillation," in Second Trimester
Abortion, cited above, p. 81.
13. Jeff Lyon, "Abortion paradox: A live baby," York Daily Record (York,
Pennsylvania), August 21, 1982. 
14. Stephen L. Corson., M.D., et al, Fertility Control (Boston, MA: Little,
Brown, and Company, 1985), pp. 82-83.
15. James R. Scott, M.D., et al, Danforth's Obstetrics and Gynecology, 6th
ed. (Philadephia: J.B. Lippincott, 1990), p. 726.
16. Ibid., pp. 115-116.
17. Martin Haskell, M.D., "Dilation and Extraction for Late Second Trimester
Abortion," in "Second Trimester Abortion: From Every Angle," Fall Risk
Management Seminar, September 13-14, 1992, Dallas, Texas, National Abortion
Federation.

 

 

 

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