CHILDREN BY CHOICE ASSOCIATION INCORPORATED

Second Trimester Abortion

For terminations later on in a pregnancy, different procedures may be used compared to a first trimester abortion. 

Some pregnancies up to 17 weeks may still have a one-day procedure depending on the individual woman and the clinic she goes to.  A medication called Misoprostol is given to the woman before she proceeds to theatre. This drug allows the cervix to soften and is therefore helping to protect the cervix during the manual dilatation.

Serial Dilation and Vacuum Evacuation/Extraction

The Serial Dilation and Evacuation/Extraction procedure involves the gradual opening of the cervix over two or three days. It is the gradual nature of the procedure that makes this operation very safe.  

Each morning in theatre after the woman is heavily sedated the cervix will be manually dilated by using special rods (varying in size), after which a number of “passive dilators” are inserted into the cervix. These dilators absorb fluid from the cervical cells. Insertion of the passive dilators takes approximately 10 minutes. Once the passive dilators have been inserted into the cervix, they gradually begin to swell. They swell by drawing moisture from the cells in the cervix. As a result the cervical tissue is softened, the cervical cells begin to flatten and the cervical canal starts to dilate. After the insertion the vagina is packed with antiseptic soaked gauze.  The woman may also be given some  medication (by mouth) to assist with the softening and flattening of the cervix.

Dilation of the cervix will continue until the cervix has opened wide enough to allow for the removal of the pregnancy. The doctor will measure this opening during the procedures. Toward the end of the procedure and before proceeding to theatre, the doctor may administer Misoprostol, which is medication that softens the cervix and allows for greater flexibility, thus helping to protect the cervix from any trauma which might otherwise be caused during manual dilation.

Once the pregnancy has been removed using forceps the doctor will perform a suction curettage which empties the uterus completely. This procedure takes 5 minutes. Following the procedure the woman will spend time in recovery and will be given post-operative instructions prior to leaving the clinic.

Differences between a 1st and 2nd trimester abortion

Some differences between a 1st and 2nd trimester procedure involve the procedure technique, the time spent at the clinic and cost of the procedure. The procedure technique with an abortion later on in the pregnancy is often taken over more than one day, whereas a first trimester procedure will be completed within a one-day time frame and requires the woman to spend about 4 to 5 hours at the clinic.

The cost of an abortion increases gradually after 12 weeks with a steeper rise in cost after 14 weeks’ gestation when the procedure is no longer attracting a Medicare rebate.

A termination at 16 weeks’ gestation may cost as much as $1100.  At 19 weeks the cost can range from $1100 to $3000.

Other issues to be aware of with a termination later on in the pregnancy include the necessity to stay fairly close to the clinic.  It is also very important to be very sure of your decision before the doctor starts the dilation procedure.  Changing your mind after the doctor has started this procedure has serious implications for the pregnancy and may also jeopardise your health.