Second Trimester Surgical Abortion - Women's Care Center

Second Trimester Surgical Abortion

Abortion costs and procedures vary greatly depending on how far along you are in your pregnancy. The second trimester of pregnancy is defined as weeks 12 through 26 and is calculated from the first day of your last menstrual period (LMP).  In the second trimester only a surgical abortion is available but may be limited based on state laws and limitations. Below is information about a Second Trimester Surgical Abortion.

As you are learning more about abortion, consider the following questions to ensure you are prepared for whatever decision you make.

What is a Dilation & Evacuation Abortion (D&E)?

The abortion method used in the second trimester differs from the first trimester because the fetus is larger and will need to be removed in an evacuation process rather than suction method.

When can a Dilation & Evacuation (D&E) be preformed?

A dilation and evacuation abortion can be performed at 15 weeks LMP and up. 

How is a D&E performed?

A dilation and evacuation abortion involves removing the pregnancy from inside the uterus with various instruments through the cervix.

The typical steps are as follows:

• The cervix is dilated and softened using laminaria and/or vaginal medication. Laminaria is a seaweed material made into thin sticks that widen as they absorb moisture in the body. This is usually done two days before the abortion procedure. A two-visit process for pregnancies generally over 18 weeks will be required.
• Local anesthetic, sedation, or general anesthesia may be offered or administered. Cost can vary based on what is used.
• The cervix will need to be stretched to allow medical instruments to be inserted and the uterine contents to be removed. Metal dilating rods may be used for additional stretching.
• A cannula (a long tube), a curette (a surgical instrument like a scoop), and forceps may all be used to complete the abortion procedure. The last step is a final suctioning to remove any remaining tissue or blood clots.
• Removed parts of the fetus will be reassembled and examined to verify the procedure was complete.

Additional Information about costs and risks:

Costs:

The cost of a surgical abortion varies greatly from state to state and is based on weeks of pregnancy along with medications received. The average cost of a 2nd trimester abortion is $1,500-$2,000.

Risks:

Although immediate serious complications are rare, you should review the list of possible immediate and longer-term symptoms and complications before considering a medical abortion.

Immediate Risks:
  • Incomplete procedure with tissue remaining in the uterus
  • Heavy Bleeding
  • Reaction to anesthesia
  • Infection
  • Organ damage

Note: risk of complications increase with duration of pregnancy.

Longer Term Risks:

Emotional –Abortion as a pregnancy outcome can be difficult with varying emotional responses. Some women immediately feel the impact of their decision while others report the effects of their decision five to eight years after the abortion experience. Some of the emotional factors experienced by women choosing abortion include:

  • Elevated rates of depression compared to women without a history of abortion. The instance of depression is higher in women who have abortions in their 2nd and 3rd trimester.
  • Increased substance abuse.
  • Anxiety, anger, guilt, shame, and feeling “numb” are some of the descriptions used in Post Abortion Syndrome. Post Abortion Syndrome (PAS) has been included as a subset of Post-traumatic stress syndrome (PTSD) in recent years.

Relational – An abortion decision will impact relationships in your life whether you have shared this information with people around you or not. If those in your life are aware of your decision, this can affect your relationship with them. Maybe you did what they wanted or maybe you did not. If they are unaware of your decision, your perception of what they would think may affect your relationship. Relationships which are likely to be affected include:

    • your partner
    • your parents
    • your current children
    • your future children

Spiritual – Would you consider yourself to be spiritual? What was your opinion about abortion before you found yourself in this place? What are your beliefs about God? Because we are made of mind, body, and soul, exploring the effects abortion has on your spiritual future is important.

Fetal Development

14-16 Weeks

The baby is approximately 5 inches long. Movement of the baby may be felt. Intricate details such as nails, lashes, fingerprints, and eyelashes are well developed. The baby can make different facial expressions.

17-19 Weeks

At 18 weeks the skin is covered with vernix—a greasy material that protects the skin. Respiratory movements occur, but the lungs are not fully developed.  The brain is rapidly growing. Fetal heartbeat can be heard with a stethoscope. The kidneys are starting to work. Baby may suck thumb and is more active.

20-26 Weeks

By week 20, the baby measures 10 inches and weighs about 9 oz. The larynx or voice box begins moving in a way similar to the movement seen during crying after birth. By the end of the 2nd trimester the sense of smell is functioning, and eyes produce tears. About 23 weeks is considered the age of viability because survival becomes possible.

Sources for this page:

Coleman P., Coyle C., Rue V. (2010, August 1). Late-Term Elective Abortion and Susceptibility to Posttraumatic Stress Symptoms. Retrieved from: https://www.hindawi.com/journals/jp/2010/130519/

Cougle J., Reardon D., Coleman P., (2003, April 9). Depression Associated With Abortion and Childbirth: A Long-Term Analysis of the NLSY Cohort. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/12709667/

Reardon D., Coleman P., Cougle J., (2004, May25) Substance Use Associated with Unintended Pregnancy Outcomes in the National Longitudinal Survey of Youth. Retrieved from: https://www.tandfonline.com/doi/abs/10.1081/ADA-120037383

Speckhard A., Rue V. (1992 Fall) Postabortion Syndrome: An Emerging Public Health Concern. Retrieved from: https://spssi.onlinelibrary.wiley.com/doi/abs/10.1111/j.1540-4560.1992.tb00899.x

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