Types of Abortions: Procedure, Availability & Recovery

She Might Staff

11/6/2024

If you’re looking to gain a comprehensive overview of abortion, you’re in the right place. In this piece, we’ll explore the types of abortions available in the US, when they’re offered, and what to expect post procedure.

You may also want to read our pregnancy options guide as well. It offers practical strategies to help you translate your research into a clear direction for your life. Thousands of women have experienced unexpected pregnancy and found life beyond this moment, so rest assured you’re in good company.

DIY Abortions: An Unsafe Option

Never try to induce an abortion with unprescribed medication, using substances not intended for abortion, or physically harming yourself.

There are websites on the internet that promote “natural” or “DIY” abortions you can do at home. Unsurprisingly, the websites that share these ideas are run by people who are not medical professionals. Most of the ideas are not only ineffective, but also dangerous to your health.

If you are unsure whether or not an abortion method is safe, check with your doctor.

Types of Abortions

After taking a pregnancy test, your next step is to determine how far along you are in your pregnancy. Your healthcare provider will use the day of your last period and an ultrasound to determine your gestational age and decide which abortion option is available to you.

Medication Abortion (Abortion Pill): Weeks 1-10

Medical abortions are only available during the first ten weeks of pregnancy. 

There are two medications used to end a pregnancy, Mifepristone and Misoprostol. Depending on your state laws, the first medication, mifepristone may be administered at a clinic or it can be self-administered at home. Mifepristone works by blocking your body's production of progesterone, stopping the pregnancy from growing.

The second medication is called Misoprostol, which is taken at home within 48 hours of taking mifepristone and causes the embryo to be expelled. Sometimes, rather than an oral pill, the misoprostol is placed in the vagina or between the teeth and gums. In some cases, vaginal misoprostol is the only medication used early on in the pregnancy, but this method is not as effective as both mifepristone and misoprostol together.

Following the abortion, patients may be given pain medication. Patients experience cramping and bleeding as the embryo exits the body. The amount of time that bleeding continues varies depending on the gestational age of the embryo. If the medical abortion fails and the patient still desires to remove the pregnancy, a surgical abortion is the next option.

Doctors recommend waiting two weeks before having sex after a medical abortion and using birth control immediately following the procedure to prevent another unwanted pregnancy.

Vacuum Aspiration: Weeks 5-12

Vacuum aspiration is an abortion method that can be used prior to 13 weeks gestation. Unlike a medical abortion, it’s considered an invasive procedure and is more costly. Vacuum aspiration uses a tool called a cannula and a syringe to remove the fetus or embryo.

The first step of vacuum aspiration is dilation. Once the patient has received ibuprofen for discomfort, the practitioner uses forceps to slowly dilate the cervix so that the cannula can fit.

Once this is done, the practitioner inserts the cannula and attaches the syringe. The syringe is used to suction the patient’s uterus until it is empty, removing the syringe to dispose of tissue and reinserting as necessary.

Following the procedure, patients experience bleeding for a little over a week as well as moderate pain, which is treated with medicines called ibuprofen or paracetamol. Patients may be kept in the office for a couple of hours in order to be monitored.

Although regular periods don’t usually return for a month or two, fertility returns around the time that bleeding ends, so it’s important to use contraception.

Dilation and Evacuation: Weeks 13-24

Dilation and Evacuation (D&E) is an abortion procedure that is done during the second trimester of pregnancy, which means it can be used after the 13th week of pregnancy up until the 24th week.

The first step in a Dilation and Evacuation is an ultrasound, so the practitioner can ensure that the patient is in the right stage of pregnancy for this procedure. Next, the practitioner will dilate the cervix either with a cervical dilator or the medication misoprostol.

Once the cervix is dilated, the patient lays on the examination table with their feet in stirrups, and the practitioner inserts a tool called a speculum in the vagina. This is the same process that is done during vaginal exams at OBGYN appointments.

Next, the practitioner gives the patient pain medication and a sedative. This could be an injection in the cervical area along with general anesthesia or a spinal injection. Once the patient is numbed, the practitioner can continue to dilate the cervix to accommodate the removal of the fetus.

When the cervix is the proper size, the practitioner uses a cannula to vacuum smaller pieces of the fetus, forceps to pull out larger pieces of tissue, and a scraping tool to clean the edges of the uterus. Finally, the practitioner may suction out any remaining contents of the uterus.

After the procedure, patients experience about two weeks of bleeding and spotting as well as cramps as the uterus shrinks back to pre-pregnancy size. Patients are given antibiotics to prevent infection as well as pain medications such as acetaminophen or ibuprofen.

Patients cannot have sex for one week after abortion, and birth control is recommended to prevent another pregnancy.

Dilation and Extraction (Partial-Birth Abortion): Weeks 18-40

A rare method of abortion known as dilation and extraction (D&X) or, colloquially, as partial-birth abortion, is used only in late second trimester pregnancies, or occasionally, during the third trimester. The entire process can take three or four days and is one of the most painful and expensive abortion methods.

When women choose D&X abortions over D&E abortions, it is often because it allows the fetus to remain intact. This is potentially safer for the patient, as there is no risk of leaving fetal tissue within the uterus. In the case of abortions chosen because of fetal health risks, it also gives the patient the opportunity to have closure as part of the grieving process or to request an autopsy.

Patients will experience the same after-abortion effects as those of a D&E abortion. Many women find it helpful to receive counseling, including grief therapy, following a dilation and extraction abortion.

Induction Abortion: 16+ Weeks

An induction abortion is rarely performed in the United States, always after 16 weeks and usually later. It’s a procedure where labor and birth are induced to remove the fetus from the uterus.

First, the patient’s cervix is dilated. Then, medicines to induce labor and stop the fetus’ heartbeat are administered. These medicines can be injected into the amniotic fluid or directly into the fetus, inserted into the vagina, or given through an IV.

Once labor is induced, the patient experiences contractions and often side effects of the medication, including fever and nausea. Usually, labor lasts less than 24 hours before the pregnancy is ended.

Following an induction abortion, patients stay in the hospital for a few hours or up to two days. Many women choose to receive counseling following an induction abortion.

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