Types of Abortions- Advantages, Disadvantages, Recovery, Risks

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In this article, we will discuss about the various types of abortions in detail.

Introduction

1/5th of the total pregnancies conceived in a year, end in abortion. The WHO regards reproductive health as total well-being in all aspects of reproduction: physical, emotional, behavioral, and social. After time immemorial, women finally get to make their decisions for themselves.

Thus, it becomes exceedingly important for a woman to be aware of the types of abortions there are and their health risks. Abortions are generally the safest in the first trimester (each trimester is 3 months long), and although second and third-trimester abortions are performed, they are riskier.

Abortions are legal throughout the United States, but the laws and restrictions vary from state to state. The various types of abortions, in order of the timeline in which they are performed, are:

1. Medical Abortions

Done by taking medication in pill form, this is the safest type of abortion. The two drugs in the pill are mifepristone and misoprostol. Mifepristone blocks the action of progesterone or the pregnancy hormone while misoprostol, taken after mifepristone, induces the uterine muscles to contract, thereby causing bleeding. This results in the displacement and exit of the implanted fetus in the uterus.

Done in the first trimester up to 10 weeks, so medical abortions are the safest option.

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Apart from mifepristone and misoprostol, three more pills are available in case of side effects like nausea (Zofran/Ondansetron), cramps (Flexon MR), and heavy bleeding (Ethamysylate), with a prescription from your physician.

Advantages:

  • Extremely safe, and pills are easily accessible
  • Does not require any anesthesia
  • Cost-effective

Disadvantages:

  • Cannot be performed in case of ectopic pregnancies, where the fetus is generally implanted in the fallopian tube outside the uterus
  • Cannot be performed if you have pre-existing health conditions affecting the liver, kidney, and lungs
  • Unsafe if you have an Intra-Uterine Device (IUD)
  • Unsafe if you are on steroids

Recovery:

Bleeding begins after 4-5 hours of taking the pills. You lose the pregnancy usually within 2 days of taking the medication and your regular menstrual cycle should begin again within the next 4-6 weeks once the bleeding ceases.
Severe cramping has been observed in some cases, which is mitigated to a great extent by taking normal over-the-counter (OTC) analgesics.

Risks:

  • Diarrhea and nausea persist for quite some time
  • You might feel fatigued throughout the day
  • Might induce migraines for those who suffer from it

2. Vacuum Aspiration

It is an invasive surgical type of abortion procedure performed up to 16 weeks (early 2nd trimester).

A speculum and dilator are used in this process, and manual or mechanic suction force is applied. This method can also be used in the very rare chance a medical abortion fails. The embryo or fetus is removed via the cervix.

Vasopressin or some similar medicine that slows uterine bleeding may be mixed with the local anesthetic to reduce blood loss. After the suctioning is complete, a cannula (thin tube-like structure) is inserted into the cervical canal to scoop out any leftover debris or tissue.

Advantages:

  • Can be done in a matter of minutes
  • Relatively pain-free because of the administration of a local anesthetic

Disadvantages:

  • Can cost almost 1000$ when performed by an expert obstetrician/gynecologist

Recovery:

It becomes essential to refrain from sexual intercourse for at least a week and rest under the physician’s observation in a hospital ward for a day or two. Your normal menstrual cycle will restart in 4-6 weeks.

Avoid strenuous exercise for the first fortnight.

Risks:

  • Engaging in coitus can lead to vaginal infections
  • Profuse bleeding is common along with cramping and clotting
  • Uterine perforations can occur if vacuum aspiration is not done with precision

3. Dilation & Evacuation (D & E)

This is another surgical type of abortion procedure performed between 14 and 24 weeks (end of 2nd trimester) also involving the use of a speculum and dilator. The process involves using vacuum aspiration, forceps, and dilation and curettage (D & C) to scrape out the uterine lining.

This method is generally for those expecting mothers who have delayed getting an abortion or want to abort the fetus because of a chromosomal anomaly found during amniocentesis.

Advantages:

  • Relatively safe and quite effective
  • Takes about half an hour
  • Painless due to the application of general anesthesia, which numbs you from the waist down
  • Unlikely to affect future pregnancies

Disadvantages:

  • Hefty charge of over 1500$
  • Can lead to uterine or bowel puncture, although it is an extremely rare complication

Recovery:

Irregular bleeding and spotting constitute the first two weeks of a normal recovery. Avoid tampons and menstrual cups in this duration, and stick to sanitary pads. Avoid engaging in sexual activity.

Cramps may last for a week until the uterus shrinks back to its original size pre-pregnancy. Pelvic rest is advised during this period.

Risks:

  • The procedure can cause hemorrhaging
  • Chances of contracting an STI or venereal infection if the female has sex with a male partner
  • Increment in the possibility of suffering from Asherman Syndrome, in which bands of scar tissue form in the uterine cavity. Occurs mostly in women who have previously had a miscarriage.

4. Labor Induction Abortion

Only done when all other options have been exhausted. Of all types of abortions this is considered as the most dangerous and precarious type as it poses a health hazard for the female, therefore only done when the fetus poses a life risk for the expectant mother. It constitutes less than 0.01% of all abortions in the United States.

As the name implies, this method involves inducing the uterus to contract and expel the pregnancy before the onset of spontaneous labor. The intensity of the cramping keeps on increasing with every wave of contractions.

Efficacious sedatives are given and if need be, even an epidural may also be provided by your physician. It can take more than a day for the completion of the procedure.

Labor Induction abortions are only performed after the 2nd trimester (24 weeks).

Advantages:

  • 100% effective
  • Safe in most cases

Disadvantages:

  • Can result in rupture of the uterus
  • A major health hazard for the mother, can cause permanent damage to organs if not done with expertise

Recovery:

The doctor shall ask you to spend a few days under observation and in the care of nurses. Two weeks of complete bed rest is advisable. Strong analgesics have to be administered to manage the pain levels or it will get unbearable. Avoid sex for the next month to allow your body to properly heal from this traumatic experience.

Risks:

  • Cervical incompetence in future pregnancies resulting in an inability to conceive or frequent miscarriages
  • Blood clots larger than a lemon are observed after labor induction abortions are done
  • Persistent high fever and chills for a week with recurring nausea and acute fatigue
  • Permanent laceration or perforation of the uterus

Types of Abortions : Wrap Up

In conclusion abortion is not an easy thing to go through. Seek professional help if you feel overwhelmed at any point during the process. Reach out to other women who have had similar experiences and de-stigmatize this issue because you aren’t alone. Your body will heal over due course of time, give it ample rest and nutrition.

To avoid unwanted pregnancies in the future, refer to this useful blog post regarding birth control: Birth Control Myths And Facts: Everything You Need To Know