Second-Trimester Surgical Abortion – What To Expect?

Second-trimester surgical abortion is conducted for voluntary abortion, for management of a miscarriage and in terminating pregnancy because of fetal abnormalities and existent health conditions of the mother.

During the course of the second trimester (i.e., 15-23 weeks) subsequent to the last menstrual cycle occurred, abortions are usually conducted over a span of two days and do not need all-night hospital stay. This form of procedure is called as dilation and evacuation (D&E).

During the foremost day, one would be required to visit a health educator and doctor for helping in preparation of the procedure. This appointment would take between 2-3 hours.

The following day, one would be required to visit the doctor at the hospital that would take between 4-5 hours. In certain situations, the procedure would be conducted in a single day in case of those pregnancies that are eighteen weeks or lesser, depending on the situation.

The softening and dilatation of the cervix is conducted using medication and the employment of small-sized dilating sticks, known as laminaria or Dilapan that might be inserted into the cervix, depending on what term the pregnancy is and the patient’s medical past. Laminaria are fine sticks that are derived from a particular seaweed substance having a tendency to swell up once they soak in moisture from the body. Dilapan are synthetic sticks that function in analogous manner. The laminaria is intended to be placed in the cervix for the entire night for prepping the body for the subsequent day’s operative procedure.

Pre-Surgical Visit

In a private examination area, the patient would be informed about the procedure, would be examined in detail and undergo an ultrasound scan. The patient would be given oral medicines inclusive of a painkiller and anti anxiety medicines for relaxing and laminaria would be inserted if necessary for all-night dilation. In case, one is administered medications, then it is crucial to abide by the instructions that are advised by the doctor.

One would be in total consciousness during the laminaria insertion. In case the patient is accompanied by someone, he/she could stay in the examination room during this time, in case the patient wishes to. The doctor would carry out the following:

• A speculum would be placed inside the vagina for viewing its interiors.
• The cervix would be cleaned with the help of a soap-soaked gauze piece.
• A de-sensitising medication or local anesthesia would be applied to the cervix.
• The laminaria or Dilapan would be introduced into the cervix – the uterus opening. The insertion of the laminaria would need 5-10 minutes.

The patient would need to rest for some minutes following the procedure. Some degree of cramps and spotting might be experienced subsequently. When one feels alright, one could change into one’s own clothes. The patient would be offered in-depth instructions about the best way of self-caring during the night and the way to ready oneself for the subsequent day’s procedure.

One would need to be driven home in case one has taken anti-anxiety medicines. It is important to rest at home till the effect of the medicines clears out. One is advised not to consume food or drinks subsequent to midnight.

Operative Visit

The subsequent day, one would need to check-in at the hospital welcome-area, after which one would visit the doctor in the pre-operative area.

An intravenous administration of medication in the arm is done for infusing anesthesia or for becoming unconscious. Majority of the women go off to sleep and could hardly recollect any part of the procedure. When one is relaxed, the doctor would take out the laminaria and employ suction procedure and gynaecological apparatus for emptying the uterus employing ultrasound assistance. This procedure conduced in the operating room would take nearly an hour, though the procedure would require merely 15-45 minutes.

Recovery Phase

In the recuperative room, the patient would be monitored for nearly 2 hours. One might sense some cramps and spotting. Prior to returning home, one would be given antibiotics for averting infection and would be given instructions on post-operative care.

The operative procedure and the recovery time in the hospital would take nearly 5 hours.

Due to the medications given during the procedure, one is advised not to drive till the time the effect of the medicines subsides. In case one does not have anybody to escort on the way home, then one of the women’s health rights organizations could be contacted who might have a pro-choice helper driver to assist in safely reaching home.

One could return back to routine activities like going to work or school the following day.

Follow-up Appointments

One would need to visit the primary care doctor for follow-up evaluations in case one in having some kind of complications, or having apprehensions.

Safety quotient and Effectuality

Second trimester surgical abortion is deemed one of the safest medical procedures. Though atypical, probable complications comprise of a blood clot appearing in the uterus that could lead to pain, discomfort and need a repeat session of aspiration; occurrence of an infection – that is usually easily detected and cured; cervical tear that could easily be sutured; perforated uterus; remnant pregnancy tissue that might need repetitive aspiration; and uninhibited blood loss that would require blood transfusion.

Complications arising due to a surgical abortion are significantly less recurrent and less grave as compared to those related to child birth.

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