Abortion by Medical (Non-Surgical) Induction Abortion

This method is generally used after 16 weeks from the last menstrual period and before the viability of the unborn child, unless such abortion is necessary to prevent the death of the pregnant woman or to prevent impairment to her health.  In a medically induced abortion, medicines will be used to start labor.  Labor induction may require a hospital stay.  For this procedure, the physician will:

• Perform laboratory tests to confirm the pregnancy, test for Rh status, and test for anemia and red blood cell count.
• Take a medical and obstetrical history, including a history of allergies and all current medications.
• Examine the uterus and perform an ultrasound to confirm how far along the pregnancy is.
• Educate the patient about the abortion process, side effects, and clear instructions for assessing emergency services. 
• Insert a speculum into the vagina, to hold it open.  The physician cleans the vagina and cervix with an antiseptic solution.  At this time, a numbing agent (local anesthetic) may be injected in the cervix. 
• Insert osmotic dilators (small tubes that absorb moisture from the tissues surrounding the cervix and swell) approximately 2 or more days before the surgical procedure to open the cervix, allowing access to the uterus. 
• Medicines to start early labor can be inserted into the vagina, or a vein (IV), or swallowed to start uterine contractions and soften the cervix, this can take 12 – 48 hours.
• Inject medicine through the abdomen or vagina into the amniotic fluid, or the heart or umbilical cord of the fetus.  This causes the death of the fetus.
• Monitor the contractions and delivery of the fetus.
• Monitor the expulsion of the placenta.  May scrape the uterus with a curette to ensure there is no retained placenta.

Common side effects include:

• Nausea, fever, vomiting, and diarrhea from the medicine
• Pain from labor and delivery
• Bleeding and cramps after delivery of fetus and placenta

Less frequent complications can include:

• Excessive bleeding
• Damage to the cervix or uterine lining
• Dilators dislodging from cervix
• Prolonged induction time
• Infection due to remaining tissue or infection caused by an STD or bacteria being introduced to the uterus can cause fever, pain, abdominal tenderness and possibly scar tissue
• Incomplete abortion requiring surgical intervention

Rare complications can include:

• Excessive uterine contractions and pain
• Uterine rupture if a uterine scar is present from a previous surgery
• Allergic reaction
• Perforation of the uterus
• Infertility due to the consequences of infection or damage to cervix
• Pulmonary Embolism
• Amniotic Fluid Embolism
• Death