There are a variety of different abortion procedures depending on what is available to the woman seeking an abortion, how far a particular pregnancy has progressed, and any pre-existing conditions or health concerns. A medical abortion is pill regimen that can be taken at home in the early stages of pregnancy. Other than medical abortions, first trimester abortions are typically vacuum aspirations, and second trimester abortions can either be dilation and evacuation (D&E) or dilation and extraction (D&X), also called partial-birth abortion.
Vacuum aspirations take place in the first 14 weeks of pregnancy. The simple procedure begins by opening the cervix, if necessary, and application of local anesthesia to the cervix. The vagina is held open with a device called a speculum. A small and powerful suction device called a cannula is then inserted into the uterus to remove the fetus and placenta.
After 14 weeks of pregnancy, dilation and evacuation procedures are much more common. The preparation for the procedure begins by dilating the cervix and softening the uterus. Like the vacuum aspiration procedure, local anesthesia is applied to the cervix. In addition to using the cannula for suction, forceps and a scraping tool called a curette will be used to remove the fetus and placenta. Sometimes, an injection is provided that stops the fetal heartbeat before the procedure begins.
For late-term pregnancies, most states have restrictions on abortions except in the case of a threat to the life of the mother or complications with fetal development. This procedure is called dilation and extraction. The procedure is similar to D&E, however, there are some differences due to the size of the fetus at this stage of development. Every part of the fetus is removed from the uterus using forceps, and the fetal skull is punctured and collapsed with the use of a suction catheter before being removed completely from the uterus.