If earlier than 15.6 weeks go to Early Abortion to 15.6 weeks | If you are further along, keep reading…
Why Choose Us
If you are over 15.6 weeks or later into your pregnancy, we can still HELP you, regardless of your medical history or background. We do not require any particular “reason” for you to be seen here – if you would like to terminate your pregnancy, we will support you in that decision.
How We Can Help
You must schedule an appointment and come in for an evaluation and speak with one of our compassionate counselors.
- We will do all of the necessary lab work and ultrasound that you will need to get an abortion.
- We will discuss your situation according to the gestation age of your pregnancy
- We will help you schedule an appointment
- We will secure funding for your travel and abortion care
Call Us Now – (954) 720-7777
Second Trimester Abortion D&E
Abortions performed in the middle months of pregnancy is a significantly different procedure from the first trimester. Although there are similarities, as pregnancy progresses through the second trimester, the surgical abortion procedure used requires greater time, skill and entails somewhat greater risk, though still significantly lower than carrying a pregnancy to term.
The essential difference is that the cervix must be dilated to increasing diameters with increasing stage of pregnancy.
- The extent to which the cervix can be safely dilated with dilators varies, generally being easier in women who have delivered children previously.
- Most experienced physicians will avoid the use of mechanical dilators beyond the 14th week of pregnancy. Some will avoid them after the 10th week.
- As a general rule, the method of choice for dilating the cervix beyond the 12th week is osmotic dilators.
How It Works
Dilators are basically stalks of material that absorb water and expand once placed inside the cervix. Once they have been inserted they are left in place anywhere from six hours to overnight. The result is that the cervix is both dilated and softened with little risk of the damage that might occur if wide dilation were to be attempted with mechanical dilators.
In more advanced stages of pregnancy, varying from 20-23 weeks and beyond, dilatation is generally accomplished in a serial fashion. This involves the insertion of a number of osmotic dilators for 6 or more hours to Dilate (“D”) the cervix adequately to insert 10 to 20 or more osmotic dilators, followed with the Evacuation (“E”) of the uterus the next day, known as D&E.
This stage of surgery, similar to the first trimester procedure, is usually performed under sedation combined with local anesthesia. The fetus and placenta are generally removed with forceps and followed with suction curettage to remove debris. Sharp curettage may or may not be performed as a final step.
Alternative to Surgical Abortion
In the second trimester and beyond is induction of labor. There are a variety of procedures available to accomplish this end, but in general, they all involve stimulating the uterus to contract much the same way as it does in a spontaneous term labor. This approach would seem at first to be ideal since it may involve no instrumentation and is totally natural.
In reality, however, the uterus is frequently very much disinclined to labor at these early stages, and even when it does, the cervix may be very disinclined to dilate. There are a variety of options for “induction”.
The technique currently most commonly used involves a group of drugs called Prostaglandins. These are administered either in the cavity of the uterus by injection or in the vagina as a gel or suppository. These may be used in conjunction with osmotic dilators as well.
There is some controversy as to which of these techniques is the safest. Most available data suggest that prior to 20 weeks gestation, D&E offers greater safety and efficacy. Beyond that stage, there is probably inadequate data to prove either is superior.
We believe that experience is the primary determinant of safety in this stage. In experienced hands, we believe that D&E is preferable. It is more predictable and entails less serious risk. The final alternative is “hysterectomy” which is basically an early cesarean section.
This procedure is best reserved for situations where emptying the uterus by the vaginal route is not possible. It has the disadvantages of greater risk, greater pain, greater recuperation, higher cost, and perhaps of greatest significance, it precludes future vaginal birth.
We’re a member of National Abortion Federation (NAF).