Second Trimester Abortion
Second trimester termination of pregnancy, also called dilatation and evacuation (D&E) is performed for pregnancies that are between 13-24 weeks. When you call for an appointment a staff member will ask you for the first day of your last normal menstrual period. We can use this date to estimate the stage of your pregnancy. When you arrive at the facility a sonogram will be performed to get an exact measurement of the pregnancy.
After a certain point in the pregnancy, a second trimester abortion must take place in two consecutive days. On the first day, cervical dilators will be inserted into the cervix to gently and comfortably dilate the cervix through the night. You may also receive an injection into the uterus that will achieve pre-operative fetal demise and make the pregnancy easier and safer to remove the following day. On the first day, after receiving confirmation of a positive pregnancy test by submitting samples of blood and urine, you will receive an ultrasound to determine how long you have been pregnant.
After the length of your pregnancy has been determined, you will complete the first day procedure. In the operating room, you will be attended to by a team of warm, friendly healthcare professionals in the operating room. Throughout your procedure our anesthesia staff will monitor your vital signs to ensure maximum safety. Our anesthesia staff will insert an intravenous catheter into a vein in your arm or hand and an anesthetic will be administered. You will be asleep for approximately 3-7 minutes during the procedure. Once asleep, the surgeon may give you an injection through the abdomen and into the uterus, depending on the length of your pregnancy. The surgeon will then insert a speculum into the vagina so that the cervix can be seen. The surgeon will insert laminaria, which are thin dilators, to dilate the cervix gently and comfortably overnight.
You will return in the morning to have the pregnancy removed. Upon arrival, you will return to the operating room, where the anesthesia staff will monitor your vital signs and provide you with anesthesia. For the second day procedure, you will be asleep for approximately 5-15 minutes. Once asleep, the pregnancy tissue will be removed. The surgeon will insert a speculum in the vagina to improve access to the cervix. The cervical dilators will be removed and the pregnancy tissue will be removed from the uterus via the dilated cervix. The surgeon will apply gentle suction to the lining of the uterus to ensure that all pregnancy tissue was removed.
All second trimester abortion patients receive prescriptions of medications to be taken postoperatively. An antibiotic is prescribed to prevent an infection. You will also be given a prescription for a medication to help the uterus to return to its pre-pregnant size. The cervix will be dilated using a series of thin, metal so that a plastic vacurette can be inserted. The vacurette is connected to a suction catheter so that light suction can be used to remove the pregnancy tissue. Following this, a spoon-like instrument may be used to lightly swab the inside of the uterus to ensure that all pregnancy tissue has been removed. Following this, a spoon-like instrument is used to lightly swab the inside of the uterus. Finally, the surgeon will perform uterine massage, which helps control bleeding and begins the process of the uterus contracting back to pre-pregnant size.
You must stay within the 5 boroughs of New York City (Manhattan, Queens, Brooklyn, the Bronx and Staten Island) after the laminaria have been inserted. You will be asked to return to the facility the next morning at 7:30am. Please remember that you must have an escort accompany you home on both days. You may return to the office for your free postoperative appointment within 2-3 weeks. A healthcare provider will discuss birth control with you at that time.