Clients' and clinicians' experiences

How a pregnant person experiences a later abortion can vary significantly based on their own circumstances, the reasons for their abortion and their beliefs and feelings about the process. Medical providers have their own thoughts and feelings about providing abortion care that also result from their professional experiences personal beliefs. Many clients and medical providers choose to share their stories in order to destigmatize the process of obtaining a later abortion. Information about the later abortion procedure and a selection of these stories are below.

 

What happens during a later abortion?

This information is a general overview of what a client can expect when having a later abortion. Most clinics that offer the procedure have detailed information on their websites about the specific protocols at that clinic.

Later abortions are usually performed by a process called “Dilation and Evacuation” (D & E) or “Dilation and Extraction” (D & X).

At the first appointment, the client is given an ultrasound, counseling and a medical examination. Cervical dilation is begun with the use of osmotic dilators. Osmotic dilators that are used most commonly may be either sterile sticks of compressed seaweed (called laminaria) and/or a synthetic get (Dilapan) that upon insertion will gradually swell in size. This process gently opens (dilates) the cervix. The number of osmotic dilators used and the time required for dilatation will depend upon the duration of the pregnancy and the individual pregnant person's body. Usually it takes 24-48 hours for the cervix to sufficiently open. During this time, some clinics offer counseling and/or support groups.

For the procedure itself, medicines are used for pain control and sedation. Most commonly, anesthesia medicines are administered intravenously in the arm, and local anesthesia is done by an injection into the cervix. The physician then removes the pregnancy through the cervix with a combination of suction aspiration and grasping instruments. The abortion itself generally takes about 10-30 minutes.

In other cases, clinics or hospitals may offer labor induction as the way to end a pregnancy. In most cases, after an ultrasound, counseling and a medical assessment, an injection is used to stop the fetal heartbeat. After that, the client receives medications that cause labor to begin and delivers the pregnancy tissue vaginally. This process may take anywhere from several hours to several days. Sometimes, the body is primed for labor with mifepristone (the “abortion” pill) a few days before labor is induced with misprostol.

For labor induction terminations, the client may be offered any type of pain control that would be used for a vaginal delivery. This may include intravenous or intramuscular pain and anti-anxiety medicines, or epidural anesthesia.

Most later abortion procedures present less risk than carrying a pregnancy to term and delivering a live infant.

Clients' stories

Why doctors provide later abortions

Photography:

Jose Luis Pelaez, Inc/Blend Images/Getty Images