Second Trimester Abortion at CHOICES
(between 12 and 24 weeks)
CHOICES is one of the relatively few clinics that provides safe abortion services up to 24 weeks of pregnancy. Although over 90 percent of all abortions in the U.S. are done in the first trimester, many women need abortions beyond that.
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There are many different reasons why women need later abortions, including:
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They did not realize they were pregnant earlier. (Women may skip their period for many, non-pregnancy-related reasons, including stress.) |
| • | They did not have funds and did not know that New York Medicaid can assist. |
| • | They were too embarrassed or fearful to tell anyone and didn't know where to go for help. |
| • | They were pressured by boyfriends or parents to continue the pregnancy. |
| • | They were uncertain of their own feelings and what to do. |
| • | They live in a state with restrictive laws and very few abortion providers. |
Whatever the reason, CHOICES provides the safest and most appropriate method of abortion for every stage of pregnancy up to 24 weeks.
No matter how far along in pregnancy a woman is, when she comes to CHOICES she spends time with a sympathetic, non-judgmental female counselor trained in reproductive health and women's psychology. The counselor discusses the appropriate abortion procedures and any concerns or questions the woman may have. She will also discuss other options such as adoption. There is no pressure either to have or not to have the abortion.
The Second Trimester Abortion Procedure
Second trimester abortion (13 to 24 weeks) is done at Choices Women's Medical Center by the procedure known as D & E (dilation and evacuation), a very safe surgical procedure. This procedure is done in two stages and will require you to come to Choices for part of two or three days.
Stage One - Dilation of the Cervix
Our professional sonographer will take a sonogram to determine exactly how far along the pregnancy is. Once this has been determined, you will go to the procedure room where you will lie on a table and be positioned as if for a regular GYN examination. The physician will then insert the dilators.
The dilators are little rods about the size of wooden match sticks made either of a dried, compressed, plant substance or a synthetic material. This material has the ability to absorb many times its own volume in moisture from your body. As the dilators gradually absorb this moisture, they also gradually expand. As the dilators expand they very gently stretch the opening of your cervix to provide an outlet big enough to remove the pregnancy.
While it will take only a few minutes to insert the dilators, they must remain in place in your cervix for many hours for enough expansion to take place in the cervical opening. The number of dilators you need inserted will depend on several factors, such as the number of previous vaginal deliveries you have had, the condition of your cervix, as well as the estimated size of the fetus based on the sonogram. The physician will use experience and judgment as well as clinical guidelines to decide how many dilators will work best for you.
You may experience some contractions as short but sharp cramping as the dilators are eased into the cervix, even though they are lubricated and carefully placed. However, the process is brief and the cramping should subside in a short time. Gauze will be placed high up in your vagina after the dilators are in place. When the physician is finished, your legs are lowered, and you will be able to come off the table after a few moments.
After the insertion, you will be instructed on when to return to the clinic (which will usually be the next day), what to expect during the period when the dilators are in place and how to care for and observe yourself to prevent complications and manage any problems.
If your pregnancy is more advanced in the second trimester, you may need to have the dilation done in two stages to open your cervix adequately without causing injury. While it is usually possible to know this in advance to advise you so that you are prepared, it isn't always predictable. If the first set of dilators has not created a wide enough opening, keep in mind that it is in your best interest that a repeat insertion be done so that damage to your cervix, which can affect future childbearing, can be avoided.
Once the dilators are inserted the cervix begins to stretch and the abortion has begun. There is no possibility of changing your mind about having the abortion once dilators are inserted.
Stage Two - Evacuation of the Uterus
Once inside the procedure room you lie on a table and are positioned as if for a regular GYN examination. The total time for the actual procedure at this stage can be as much as a half hour. You will be given general anesthesia and for most of that time you will be asleep.
The physician removes the dilators that have been in place since insertion. After that s/he has access to the inner part of your uterus, and by use of various instruments, the pregnancy is removed. When the physician has finished, your legs are lowered and you remain lying on your back and are wheeled to the recovery room. You may bleed, but most likely the flow will be similar to the flow of a normal period.
Immediately afterward you may experience lightheadedness, dizziness, nausea, cramping or weakness. Your condition will be observed and monitored and after about an hour you will be transferred to a sitting area and then progress to dressing and leaving for home.
You will receive discharge information from your nurse regarding aftercare and a reminder of the date of your follow-up examination. You may expect to have some bleeding and cramping for several days. You will not be able to do any heavy lifting or straining for two weeks and you must abstain from placing anything inside the vagina for two weeks.
Return to Recovery section of "I'm Coming To CHOICES."
| At CHOICES, we emphasize our philosophy of Patient Power, which means being an
informed consumer of medical treatment with the knowledge and information that enables each individual to make appropriate decisions about medical care, whether in the area of general health, surgery or birth control.
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