- Author James Pendergraft
- Published March 19, 2012
- Word count 513
An abortion is defined as termination of pregnancy where there is not the intent to induce a live birth or remove a dead fetus. Abortions can be spontaneous as a miscarriage, or it can be induced surgically by Dilatation and Curettage (D&C) which is performed up to 15 to 16 weeks gestation where the cervix is dilated and a sterile curette is introduced into the uterus and the pregnancy tissue is gently removed or Dilatation and Extraction (D&E) which is performed from 17 to 28 weeks where the cervix is dilated and the gestational tissue is manually extracted with forceps and a sterile curette is later used to remove remaining gestational tissue, or medically with uterotonic medications such as Cytotec (Misoprostol), Oxytocin (Pitocin), Prostaglandin F2 alpha, or intra-amniotic instillation of hypertonic urea or saline.
Abortions are performed in approximately 35 to 40 percent of pregnancies. There are over 6 million pregnancies that occur in the United States every year with almost half of them unwanted. The only way to reduce the incidence of unwanted pregnancy is abstinence and birth control. There are not enough places for people to go and receive birth control. Access to family planning facilities is the key to reducing unwanted pregnancies.
Early medical and surgical abortions can be performed as early as 3.5 weeks. Medical abortions using RU 486 (Mifeprex) and Cytotec can be performed up to 14 from the last menstrual period. Vaginal ultrasounds can determine a intrauterine pregnancy as early as 3.5 weeks from the last period. It is very difficult to see a intrauterine pregnancy earlier than 3.5 weeks gestation.
Pre-operative instructions used to be very strict where patients could not eat or drink prior to coming to the office if they were going to receive sedation or general anesthesia. From studies done over the past several years, it has been found that an empty stomach does not prevent aspiration, and if patients drink clear fluids (no milk or solid foods) 2 to 3 hours before undergoing surgery, there was no difference in the complication rate. If it is known that surgery will not occur for more than 4 hours, then patients are encouraged to eat a regular meal which diminishes patient anxiety when waiting for a while.
Patients are told to wear warm clothes and that it can take 4 to 6 hours in the office before they are discharged home. Patients are given antibiotics to prevent pelvic infections and pain medications in case they have discomfort. The chance of developing any kind of infection is extremely low. Patients are given a 24 hour emergency instruction sheet that describes what patients can do after the surgical procedure is completed. It also discusses when a patient should call the office for problems which includes heavy vaginal bleeding (using more than 2 pads an hour), having severe lower abdominal pain not relieved by Motrin or Tylenol, or a temperature greater than 100.4.
The earlier in gestation women undergo abortion procedures, generally the less side effects occur. Women who have an unwanted pregnancy should call an abortion facility as soon as she finds out that she is pregnant in order to have the abortion procedure performed.