By Jenny Tindall
Abortion means the ending of a pregnancy by the removal or expulsion of an embryo or fetus. Embryos are the early stage of a fertilized egg by sperm after sexual reproduction. A fetus is the growth of the embryo after 11 weeks, and lasting until birth. There are two types of abortions: spontaneous and induced. Spontaneous abortions are miscarriages, the loss of a pregnancy out of our control that may happen for many reasons. Induced abortions are in our control and take two main forms, medical and surgical.
The “abortion pill” is the common term for medical abortions. Most often these occur in two main steps. Firstly, the patient takes a medicine called mifepristone. This stops the hormone that allows the pregnancy to continue. Then, after 24-48 hours, the patient takes the medicine misoprostol in tablet form. This tablet is swallowed, dissolved in the mouth or placed in the vagina. Then, within 4-6 hours, the inner lining of the womb (organ where the fetus grows) breaks down. This causes bleeding and the loss of pregnancy. Medical abortions usually happen before 9 weeks of the pregnancy. When they happen after 9 weeks, more misoprostol may be needed.
After a medical abortion, common short-lived side effects are nausea and diarrhea. Stomach cramps and vaginal bleeding last for 1-2 weeks, and light vaginal bleeding may last up to a month after.
For up to the first 15 weeks of the pregnancy, vacuum/suction abortions are most common. These involve inserting a tube through the cervix into the womb. The cervix, which is the entrance to the womb, must be gently widened (dilated) at first. To do this, the cervix is softened by placing a tablet in the vagina or taking it by mouth. Next, a suction removes the pregnancy. This vacuum aspiration, which is the removal of uterine contents through the cervix, takes 5-10 minutes.
The second main type of surgical abortion is dilation and evacuation (D&E). This usually happens after 15 weeks and up to 24 weeks of the pregnancy. D&Es involve inserting forceps (smooth metal tools that look like large spoons or tongs) to remove the pregnancy. Up to a day before the procedure, the cervix must be gently dilated. Then the D&E itself takes 10-20 minutes.
Common side effects for surgical abortions include 1-2 weeks of cramping and vaginal bleeding.
Risks of abortions
Induced abortions by trained doctors in clean facilities are generally safe, but even so, do have some small risks that a patient must be aware of. Firstly, it is important to consider that abortions are most safe early in pregnancies (during the first trimester). For health reasons, it is rare to induce abortions during the third or end of the second trimester, which would be after 24 weeks. Some risks include infection of the womb, some pregnancy remaining in the womb, excessive bleeding, damage to the cervix and damage to the womb.
Why I chose this topic
I chose to speak about abortions because I believe that the knowledge of how abortions work should be available to us. In my school, there is a class where we create social justice action projects. A group of my friends decided to talk about reproductive rights, but the school told them that they could not mention abortions in their talks. They could not objectively speak about what an abortion was or answer questions about them. Then when talking to the nurse, they found out that she cannot mention them in her sexual health education talks. In a country where abortion is legal, the knowledge of how they work should be available to us in school. I wanted to write this paper to inform people on what safe abortions in clean medical facilities are, and how they work.