FACTS & FIGURES
What types of abortions are there?
There are two categories of abortions performed in New Zealand today: medical abortions (using just drugs) and surgical abortions (using drugs and surgery).
Medical abortions
There are two types of medical abortions: those done early in a pregnancy (up to 9 weeks) and those done during the second trimester (after 12 weeks).
Early medical abortion
An early medical abortion involves the taking of two drugs – Mifegyne and Cytotec – that together end the life of the growing embryo and expel it from the womb.
The woman first takes one Mifegyne tablet. This drug blocks the effects of the hormone progesterone, which is a hormone that is necessary for the embryo to survive. The woman may begin bleeding 12 hours after taking Mifegyne.
Any time from immediately to 48 hours after taking Mifegyne, the woman will either ingest or have inserted into her vagina four tablets of Cytotec. This drug introduces the hormone prostaglandin into the woman’s system, which forces out her embryo a few hours after ingestion or insertion. The woman can clearly see the sac and placenta surrounding her expelled embryo, but the embryo itself is often too small to be seen.
An early medical abortion is similar in sensation to an early miscarriage. The woman will experience intense stomach pain and cramping and will bleed, sometimes quite heavily. In most cases, the embryo will be expelled from the womb in six hours after Cytotec has been inserted into the woman’s vagina. In less than 5% of cases, the medical treatment will fail, and the woman will have to have a surgical abortion.
There are two types of medical abortions: those done early in a pregnancy (up to 9 weeks) and those done during the second trimester (after 12 weeks).
Early medical abortion
An early medical abortion involves the taking of two drugs – Mifegyne and Cytotec – that together end the life of the growing embryo and expel it from the womb.
The woman first takes one Mifegyne tablet. This drug blocks the effects of the hormone progesterone, which is a hormone that is necessary for the embryo to survive. The woman may begin bleeding 12 hours after taking Mifegyne.
Any time from immediately to 48 hours after taking Mifegyne, the woman will either ingest or have inserted into her vagina four tablets of Cytotec. This drug introduces the hormone prostaglandin into the woman’s system, which forces out her embryo a few hours after ingestion or insertion. The woman can clearly see the sac and placenta surrounding her expelled embryo, but the embryo itself is often too small to be seen.
An early medical abortion is similar in sensation to an early miscarriage. The woman will experience intense stomach pain and cramping and will bleed, sometimes quite heavily. In most cases, the embryo will be expelled from the womb in six hours after Cytotec has been inserted into the woman’s vagina. In less than 5% of cases, the medical treatment will fail, and the woman will have to have a surgical abortion.
Second trimester medical abortion
Once the woman’s pregnancy has entered the second trimester, a medical abortion again involves the two drugs Mifegyne and Cytotec, but this time will induce labour, will take longer and will be more painful.
The woman first takes one to three tablets of Mifegyne. Twenty-four to 48 hours later, she returns to the abortion clinic to be given a dose of Cytotec either orally or inserted into her vagina. This dose of Cytotec will be repeated every few hours until the woman delivers her premature baby. Labour and delivery usually occur about 8 hours after starting the doses of Cytotec, but some women may require two to three days of dosage.
The experience of a second trimester medical abortion is similar to labour with the cramping and pain associated with giving birth to a live baby.
Once the woman’s pregnancy has entered the second trimester, a medical abortion again involves the two drugs Mifegyne and Cytotec, but this time will induce labour, will take longer and will be more painful.
The woman first takes one to three tablets of Mifegyne. Twenty-four to 48 hours later, she returns to the abortion clinic to be given a dose of Cytotec either orally or inserted into her vagina. This dose of Cytotec will be repeated every few hours until the woman delivers her premature baby. Labour and delivery usually occur about 8 hours after starting the doses of Cytotec, but some women may require two to three days of dosage.
The experience of a second trimester medical abortion is similar to labour with the cramping and pain associated with giving birth to a live baby.
Surgical abortions
There are two types of surgical abortions: vacuum aspiration, which can be performed between about 5 to 11 weeks into a pregnancy, and dilatation and evacuation, which is often used for pregnancies over 14 weeks.
Vacuum aspiration
Before beginning the surgery for a vacuum aspiration – also known as suction curettage or dilatation and curettage – the woman will take Cytotec to soften her cervix, making it easier for the abortionist to open it.
The abortionist begins by numbing the woman’s cervix and stretching it open. He or she then inserts a small plastic tube called a cannula through the cervix into the uterus. The cannula is attached (outside the woman) to a mild suction pump or a syringe. This is used to suck out the fetus, its placenta, and the lining of the woman’s uterus. In a later-stage pregnancy, forceps may also be used to pull out the fetus.
A woman experiences cramping pain similar to menstruation, though some women feel more intense pain. It is possible to see and take home the deceased baby and its placenta for burial, if that is the woman’s wish.
There are two types of surgical abortions: vacuum aspiration, which can be performed between about 5 to 11 weeks into a pregnancy, and dilatation and evacuation, which is often used for pregnancies over 14 weeks.
Vacuum aspiration
Before beginning the surgery for a vacuum aspiration – also known as suction curettage or dilatation and curettage – the woman will take Cytotec to soften her cervix, making it easier for the abortionist to open it.
The abortionist begins by numbing the woman’s cervix and stretching it open. He or she then inserts a small plastic tube called a cannula through the cervix into the uterus. The cannula is attached (outside the woman) to a mild suction pump or a syringe. This is used to suck out the fetus, its placenta, and the lining of the woman’s uterus. In a later-stage pregnancy, forceps may also be used to pull out the fetus.
A woman experiences cramping pain similar to menstruation, though some women feel more intense pain. It is possible to see and take home the deceased baby and its placenta for burial, if that is the woman’s wish.
Dilatation and Evacuation
Dilatation and evacuation is similar to vacuum aspiration, in that the woman’s cervix will be opened and her fetus, its placenta and the lining of her uterus will be removed, except that the fetus has developed too much to be able to be removed with a vacuum and must instead be removed using forceps.
Again the abortion begins by the woman taking Cytotec prior to surgery to soften her cervix. Several hours after taking the Cytotec, the abortionist opens the woman’s cervix. Using a large suction catheter, the abortionist empties the woman’s uterus of amniotic fluid. Then using forceps, the abortionist removes the fetus, either as one whole or in pieces. If the fetus comes out in pieces, nurses must put the pieces back together to ensure that the entire fetus has been removed from the uterus. Once the fetus has been removed, the abortionist uses a curette to scrape the uterus, removing the uterine lining and the placenta.
The woman may experience some intense cramping pain, but many times she is put under local or general anaesthetic.
Dilatation and evacuation is similar to vacuum aspiration, in that the woman’s cervix will be opened and her fetus, its placenta and the lining of her uterus will be removed, except that the fetus has developed too much to be able to be removed with a vacuum and must instead be removed using forceps.
Again the abortion begins by the woman taking Cytotec prior to surgery to soften her cervix. Several hours after taking the Cytotec, the abortionist opens the woman’s cervix. Using a large suction catheter, the abortionist empties the woman’s uterus of amniotic fluid. Then using forceps, the abortionist removes the fetus, either as one whole or in pieces. If the fetus comes out in pieces, nurses must put the pieces back together to ensure that the entire fetus has been removed from the uterus. Once the fetus has been removed, the abortionist uses a curette to scrape the uterus, removing the uterine lining and the placenta.
The woman may experience some intense cramping pain, but many times she is put under local or general anaesthetic.
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