Late-Term Abortion in Wanted Pregnancies

I went in to the Center (that specializes in late-term abortions) on a Monday to have 5 laminaria sticks (a cervical dilator) inserted into the cervix to help slowly open it.  I was under “light” general anesthesia (for 10 minutes) for this insertion process and I was grateful for that option after reading stories of women who felt a lot of pain during this part of the procedure with topical anesthetic to the cervix.  The baby was also euthanized by a shot of digoxin on this day.  Although it was a relatively pain-free process for me, the feeling of ending the life that had grown inside me for 5 months, was emotionally horrible and took a big toll on me for months after the procedure.  I had some brief moments of nausea after the laminaria insertion but felt very little discomfort or cramping  that Monday.  The doctors gave me Anaprox, Vicodin and some sleeping pills and told me to use them only if I needed them. I took two of the Anaprox, more out of anxiety for possible pain than for any actual discomfort  I experienced, which was very mild, like common menstrual cramps. Thankfully, I dilated quickly enough to have the procedure done the following day (for others, I had heard it could take up to 4 days). I think I also started taking antibiotics in case of infection on this day as well.

(Halcion, .25MG. tablets.  4 prescribed to me as a sleep aid after the abortion.  If I had taken one maybe I wouldn’t have had the bad case of phantom kicking that night.  )

On Tuesday, I went into the Center many hours earlier than my appointment to get ready for the D&E procedure. I was put under “light” general anesthesia again (this time for 20 minutes) and the doctor performed the D&E without complications.  I felt lucky to have had the option to “go under” during both procedures.  I found out later that it is rare to have a full-time anesthesiologist working alongside the OBGYN performing later abortions.  After the procedure, I had some very light bleeding and a little cramping for about a week, but nothing physically difficult.  From Monday night I had some phantom kicking, followed by a couple of phantom crying episodes, and then my milk came in.  Having to deal with breast milk without a baby there to nurse was quite a sad and nightmarish experience.

Above: Here are the instructions I was given after the termination procedure.  The instructions say to monitor the amount of bleeding, pain, cramping and fever I  experience after the procedure.  For me, I was lucky to have had only mild bleeding and cramping for a week after the procedure. You can click the image to read the instructions.

Here is an overview of the D&E procedure from everydayhealth.com that is very similar to the explanation my doctor gave us when we asked for details–

D&E usually takes 30 minutes. It is usually done in a hospital but does not require an overnight stay. It can also be done at a clinic where doctors are specially trained to perform abortion. During a D&E procedure, your doctor will:

• Give you a first dose of antibiotic to prevent infection.

• Position you on the exam table in the same position used for a pelvic exam, with your feet on stirrups while lying on your back.

• Insert a speculum into the vagina.

• Clean the vagina and cervix with an antiseptic solution.

• Give you a pain medicine injection in the cervical area (paracervical block) along with a sedative. If the procedure is done in an operating room, you could receive a spinal anesthesia injection into the fluid around the spinal cord, which numbs the area between your legs, or general anesthesia, which makes you unconscious.

• Grasp the cervix with an instrument to hold the uterus in place.

• Dilate the cervical canal with probes of increasing size. An abortion in the second 12 weeks will need the cervix to be dilated more than required for a vacuum aspiration.

• Pass a hollow tube (cannula) into the uterus. The cannula is attached by tubing to a bottle and a pump that provides a gentle vacuum to remove tissue in the uterus. Some cramping is felt during the rest of the procedure.

• Pass a grasping instrument (forceps) into the uterus to grasp larger pieces of tissue. This is more likely in pregnancies of 16 weeks or more and is done before the uterine lining is scraped with a curette.

• Use a curved instrument (curette) to gently scrape the lining of the uterus and remove tissue in the uterus.

• Use suction, which may be done as a final step to make sure the uterine contents are completely removed.

• Give you a medicine to reduce the amount of bleeding with the procedure.

• The uterine tissue removed during the D&E is examined to make sure that all of the tissue was removed and the abortion is complete.

• Doctors may use ultrasound during the D&E procedure to confirm that all of the tissue has been removed and the pregnancy has ended.

Dilation and evacuation (D&E) is a surgical procedure. A normal recovery includes:

• Irregular bleeding or spotting for the first 2 weeks. During the first week, avoid tampons and use only pads.

• Cramps similar to menstrual cramps, which may last from several hours to a few days, as the uterus shrinks back to its nonpregnant size.