South Avenue Women’s Services provides surgical and medical abortion procedures from our clinic in Rochester, NY. Choosing the elective procedure that is right for you is a difficult decision, and our professionals are here to help by providing all of the necessary information and advice you need.
For Pregnancies Up to 15 Weeks Gestation
With pregnancy up to 15 weeks gestation, the procedure will be performed by suction aspiration or vacuum aspiration. This elective procedure is considered to be one of the safest procedures in common medical practices, and complications are very rare.
For Pregnancies Beyond 15 Weeks Gestation
For pregnancy beyond 15 weeks gestation, other techniques must be used due to the requirement of cervical dilation. Dilation and evacuation involve opening the cervix of the uterus and clearing it through surgical and suction methods. This process does require more healing time since dilation is induced, but the procedure itself is relatively brief. For information on recovery and healing instructions, please refer below.
Before the procedure, you’ll have the opportunity to ask any questions and be required to sign a consent form. Once you have consented and arrived for your appointment, here is what you can expect:
- You will begin by lying on the exam table with your feet in stirrups and hips at the end of the table. The doctor will perform a bimanual exam, in which two fingers of the same hand are inserted in the vagina to feel the uterus and the other hand is placed on the abdomen. The speculum is then placed in the vagina to expose the cervix, which will then be swabbed with a cleansing solution.
- A small amount of local anesthetic is injected into the cervix, after which an instrument is used to grasp it. Then, the paracervical nerve block is placed to minimize pain felt during the procedure. Most women don’t feel much more than a sense of pressure while the block is being administered, a process that takes no more than a few seconds.
- After the block is in place, the cervix is dilated (opened) with tapered plastic rods called dilators, each a little bigger than the last. The doctor will dilate only as far as necessary, to be determined by the gestational age of the pregnancy and the size of the uterus. Women usually feel cramping during the dilation phase of the procedure, which typically lasts a minute or less.
In some circumstances, such as a very early pregnancy, dilating the cervix is not necessary. In others, a medication called misoprostol can be given before the procedure to stimulate dilation with cramping and the softening of the cervix.
- Once the cervix is fully dilated as necessary, the doctor will insert a plastic tube called a suction catheter or suction curette into the uterus that is attached to a suction machine. The size of the catheter will be determined by the gestational age of the pregnancy. After insertion, the doctor will rotate the suction catheter in the uterus several times and then withdraw it. This process will be repeated until the uterus is empty.
Most women feel cramping during this phase of the procedure. This cramping may increase in intensity as the procedure comes to an end, indicating that the uterus is empty. In some cases, the doctor may check the uterus with a metal curette to make sure it has been fully evacuated.
- A sponge may be used to clean up the vagina and then all instruments are removed. You may rest until you feel ready to get up and dress. In some cases, an antibiotic pill is given by mouth at the time of the procedure and for one dose afterwards. A plan for contraception is usually discussed before you leave. A follow-up appointment is recommended within the next two weeks.
Advantages of Surgical Abortion
In most cases, the surgical abortion procedure can be accomplished right at the first visit. Once it’s over, it’s over. Even if you’re further along in your pregnancy and require laminaria, the whole thing is over in 24 hours.
High Success Rate
Surgical abortion is almost always successful. With the skilled specialists we have at South Avenue Women’s Services, the chances of an unsuccessful procedure are very small.
Surgical abortion has been developed and refined for over 30+ years, and is now one of the safest elective procedures that a woman can have. Minor complications are uncommon and major complications are very rare.
You can be confident that the procedure will almost always go well, and that recovery and aftercare will be quick and minimal. You will leave your appointment and be able to get back to your normal life within the next few days. Surgical abortion does NOT affect your ability to have children in the future.
Disadvantages of Surgical Abortion
There are few disadvantages to surgical abortion. The procedure may cause some pain and cramping. If IV sedation is selected, the patient will be drowsy or “woozy” for a time afterwards and will require a ride home. Risk of complications is minimal.
No procedure in medicine is completely free from the possibility of complications. Potential complications from surgical abortion may include:
Complications from Anesthesia
Some patients may experience an allergic reaction to certain drugs used during the procedure. Others may experience dizziness, ringing in the ears, and a taste in the mouth due to high levels of the local anesthetic drug in the bloodstream. These effects are fairly common, only last for a few minutes, and are not a threat to your health or safety.
You may feel nauseated during or after the procedure.
Perforation, when a hole poked in the uterus by one of the instruments, is the most serious complication of the procedure itself. Should perforation occur, patients may be hospitalized or have to undergo additional surgery for repair. Perforation is very rare.
Excessive bleeding may occur during or after the procedure. Various medications are usually effective in controlling this complication.
Leftover Uterine Tissue
Infrequently, the surgical abortion procedure may not initially remove all the tissue from the uterus. The doctor may suspect this at the time of the procedure and perform an ultrasound to monitor progression. If tissue is retained, the procedure must be repeated.
Infection is a potential complication of most medical procedures and is usually diagnosed if, in the days following your appointment, you develop a fever or experience pain in your lower abdomen and pelvis. Antibiotics usually treat infection successfully.
Restricted Access to Cervix
Rarely, the doctor is unable to perform the procedure, either because the cervix is too tight, tumors prevent access to the uterus, or for some other reason. There are various strategies to deal with this situation that may be considered.
Tubal or Ectopic Pregnancy
While this is not, strictly speaking, a complication of surgical abortion itself, if a tubal or ectopic pregnancy is discovered during the procedure, prompt action is required to preserve your health and safety. About one in a hundred pregnancies may be a tubal pregnancy. Tubal pregnancies may be treated with medicine or surgery. You may be sent back to your regular gynecologist, referred to a suitable gynecologist clinic, or treated by the doctors in our Rochester practice.
Some women may feel depressed or guilty after an abortion. This is completely normal. Counseling before and after an abortion can help prevent and manage these feelings if they occur.
Late complications, or problems that arise later in life from surgical abortion, are rare. Though some studies have observed the occurrence of infertility, premature labor, and other pregnancy problems, none of these effects have been proven to be a result of a previous abortion.
Recently, the news media reported a higher incidence of breast cancer in women who have had an abortion. This announcement was made by a staunch anti-abortionist, whose scientific method is highly suspect. In general, women who have had an abortion have been able to have all the children that they wish when they decide they are ready.
Overall, although the potential for complications may be scary, they occur very rarely. Minor complications occur less than one percent of the time. Significant complications—those severe enough to require hospitalization—occur in less than one in a thousand cases.
Death from abortion is exceedingly rare, occurring in less than one in one hundred thousand cases nationwide. Most of these reported deaths are associated with either general anesthesia or late (second trimester) abortion. South Avenue Women’s Services has never experienced death as a result of surgical abortion.