The majority of abortion clinics in the US are highly efficient in performing first trimester abortion procedures. It is approximately 10 times safer than carrying a pregnancy to full term for the mother. With proper anesthetics and analgesics, there is minimal to no discomfort when the surgical procedure is performed on patients from 3 to 14 weeks gestation. In addition; most patients do not remember the procedure after they receive sedation.
Abortion facilities generally go over the different options for abortions, risks and benefits, what to expect while at the office facility, and the costs of the abortion procedures on the initial phone call. If a patient is between the gestational ages of 3 to 12 weeks, the medical or surgical abortion procedure can be done. One of the surgical options that can be performed in the office is the dilation and curettage (D & C).
The Dilation and Curettage is used between 3 and 14 weeks gestation. After undergoing lab work, sonogram and counseling where the risks and benefits of the procedure are discussed, the patients will sign the appropriate consent forms after discussion with the Physician.
An exam is performed on the GYN table where the patient is placed in the same position as under a Pap smear. A gynecological speculum is placed into the vagina for adequate visualization and cervical dilators are used to open the cervix until adequate dilation is obtained. This is followed by inserting a sterile plastic cannula (a tube) through the cervical opening and suctioning (removing) the contents of the uterus.
The process generally takes 3 to 4 minutes and the patient is awakened and walks to the recovery room. Patients remain in the recovery room from 20 to 45 minutes and are discharged home with an instruction sheet that includes a 24 hour emergency number for any questions. Antibiotics are given to help prevent infection and pain medications are given for possible discomfort. Reasons for patients to call the emergency number include vaginal bleeding that is more than 2 pads per hour, an elevated temperature of 100.4, or severe abdominal discomfort. Patients will be asked to come into the office immediately or the following day to evaluate the patient.
All patients are given an appointment to return to the facility two to 3 weeks after the surgical abortion procedure is performed to insure that there are no complications and to follow-up on birth control.
It is rare for the abortion pill procedure to be ineffective, but a few complications are heavy vaginal bleeding, retained products of conception or pelvic infection which may require an emergency dilation and curettage. Once the procedure is done, most patients feel better immediately and are discharged without further incident.
In summary; the Suction Dilation and Curettage (D & C) surgical procedure was introduced in the US in the late 50's and early 60's from Russia. It reduced the maternal morbidity and mortality significantly as compared to the manual curettage procedure that was associated with a high compression rate that included retained products of conception, perforated uteri, and significant pelvic infections. This makes the D & C one of the safest and most common procedure performed in the United States and the World.