Understanding Abortion: Facts, Procedures, and Options

An abortion is a medical procedure that ends a pregnancy. Merriam-Webster's dictionary defines an abortion as “the termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus.  It is a complex and often deeply personal decision influenced by various medical, ethical, and personal considerations. It is important to fully understand the options, procedures, and potential risks that can help individuals make informed choices.

Types of Abortion Procedures

There are two primary types of abortion procedures done here in the state of North Carolina: medication abortion and surgical abortion. The choice of procedure depends on factors such as the gestational age of the baby, medical history, and personal preference.

1. Medication Abortion (Medical Abortion)- Abortion Pill 

Medication abortion involves taking prescribed drugs to end a pregnancy. In North Carolina, medication abortion is legal for up to 10 weeks. 

• Process:
  
  • Day 1: Take the pill, mifepristone. This begins the process that causes the baby's death. 
  • Day 2 or 3: Take misoprostol, cramping begins and the baby is expelled. 
  • Day 7 to 14: Follow up with your provider to check to see if the abortion is complete.
• When: Up to 10 weeks from the last missed period. 
• Side Effects: 
  
  • Abdominal pain
  • Severe cramping
  • Nausea
  • Vomiting
  • Diarrhea
  • Headaches
  • Dizziness
  • Fever and Chills
• Risks:
  
  • Seeing parts of the baby expelled 
  • Some pregnancies fail to fully abort the baby
  • In pregnancies that continue, misoprostol may cause birth defects
  • 1% of women need a D&C to stop hemorrhaging
  • Undiagnosed ectopic pregnancy 
  • Possible life-threatening infection

How does it work? 

When you take the abortion pill it blocks the effect of the hormone progesterone, which is needed for the continuation of the pregnancy. When progesterone is blocked the baby is unable to keep the connection with the uterus, causing death over the course of days.  

If you have taken the abortion pill and want to reverse the effects please contact us immediately by texting “Abortion Pill Reversal” to ‪(919) 351-9423 or contact the Abortion Pill Reversal hotline at 1-877-558-0333.

2. Aspiration (Suction) Surgical Abortion-

An Aspiration (suction) surgical abortion is performed in the first trimester of pregnancy, and performed in a surgical setting.  This can be done up to 14-16 weeks, this procedure involves using suction to remove the baby from the uterus. In North Carolina this is only legal for up to 12 weeks. 

• Process: 
  
  • Cervix is sometimes softened using laminaria (seaweed sticks that swell to expand the cervix) and or vaginal medication the night before
  • Local anesthetic injected into the cervix
  • Cervix is stretched open using metal dilating rods
  • A plastic tube is inserted in the uterus and connected to an electric or manual vacuum device that pulls the baby’s body apart and sucks the baby out. 
  • A curette (a small, scoop-shaped surgical instrument used to scrape or remove tissue or debris from various body parts) may be used to remove any remaining parts of the baby that were not initially removed. 
  • The removed baby will be examined to ensure all parts were removed. 
• When:  Up to 14 weeks, but only up to 12 weeks in the state of North Carolina 
• Risks:
  
  • Excessive bleeding 
  • Infection
  • Incomplete abortion
  • Allergic reaction to the medicine
  • Organ damage (ex: torn uterus or cervix and/or punctured bladder or bowel)
  • Death (complications can lead to the death of the mother)

3. Dilation and Evacuation (D&E) Surgical Abortion-

Used for pregnancies beyond 14 weeks, D&E involves dilating the cervix and using medical instruments and suction to remove the baby.  This is the most common method of abortion for pregnancies after 13 weeks.  This is not legal in North Carolina past 12 weeks. 

• Process: 
  
  • Cervix is softened using laminaria (seaweed sticks that swell to expand the cervix) and or vaginal medication for 2 days prior to procedure.
  • Local anesthetic and sedation given, or general anesthesia, if available 
  • Cervix further stretched open with metal dilating rods
  • Forceps used to pull the baby apart and out of the cervix
  • Accounting for all parts of the baby: spine, skull, ribcage, four limbs
  • A curette (small scraping tool) is used to remove any remaining tissue or blood clots
• When:  Up to 12 weeks in North Carolina
• Risks:
  
  • Incomplete abortion with remaining parts of baby
  • Heavy bleeding
  • Reactions to anesthesia
  • Infection
  • Organ damage (ex: torn uterus or cervix and/or punctured bladder or bowel)
  • Risk of complication and death increase with duration of pregnancy
  • Breast health (no protection from breast cancer by terminating pregnancy)

4. Partial Birth/Late Term Abortion: 

A late-term abortion (Intact D&E) is used to describe a procedure that occurs at 23 weeks or later in the pregnancy. The goal of this procedure is to remove the fetus in one piece. This procedure is not legal in the state of North Carolina but is available in other states. 

• Process: 
  
  • Takes 2-3 days
  • Lethal Injections may be given to stop the baby’s heartbeat
  • Cervix softened and dilated for 3 days prior using laminaria (seaweed sticks that swell to expand the cervix) and vaginal medication. 
  • General anesthesia may be used, if available, or IV sedation & local anesthetic
  • Surgical instruments are used to grasp and pull the baby out through the opened cervix.
  • An alternative procedure, “Intact D&E”, attempts to remove the baby in one piece, reducing the risk to the mother
  • The baby’s skull is crushed before or during the removal process
• When:  Illegal in North Carolina 
• Risks:
  
  • Increased risk to the life and health of the mother
  • Highest risks of death with this procedure
  • Anesthesia complications
  • Heavy bleeding
  • Embolism 
  • Infection
  • Organ damage (to the reproductive system and organs in the abdomen) 

Considerations and Alternatives

Before deciding on an abortion, you will want to explore all available options, including:

• Continuing the Pregnancy: Some individuals choose to carry their pregnancy to term and consider parenting or adoption. Support resources, such as prenatal care and counseling services, are available.
• Counseling and Support: Many organizations provide unbiased counseling to help individuals navigate their options and feelings surrounding the decision.
• Legal and Medical Considerations: Abortion laws vary by location, and access may depend on state or country regulations. Consulting a healthcare provider or legal expert can clarify available options.

After an abortion, individuals are advised to rest, monitor for any unusual symptoms, and follow up with a healthcare provider if needed. Emotional support, whether through friends, family, or professional counseling, can be beneficial.

Above is information for the forms of abortion that are available in the state of North Carolina.  This is a very personal decision that involves medical, emotional, and ethical considerations. We at Choices Pregnancy Center want you to fully understand the different types of procedures, potential risks to help you make the best informed choice. Regardless of the decision, seeking medical guidance and emotional support is essential to ensure safety and well-being. 

We are here to help you discuss the choices you have and help you with the support you need.  If you want more information on these procedures or you are in need of support post-abortion please contact us at choicespc.nc@gmail.com or give us a call at 919-989-9897.

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Resources: 

Care Net. "Before You Decide." Care Net Magazine, 2020, 3.1.

Care Net. Compassion, Hope & Help. Course Manual.

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