Second Trimester Surgical Abortion

A patient who is 12 to 17.5 weeks gestation as determined by ultrasound is considered to be in the second trimester. The abortion procedure for a second trimester abortion is done in two steps and in two separate days. This is necessary to allow the body time to prepare for the second trimester procedure.

What Happens on the first day of the Second Trimester Surgical Abortion?

When you arrive at the center you will be asked to fill out some paperwork. You will next be called in for ultrasound to determine your pregnancy gestation and to ensure you are between 12-17.5 weeks. Once this is complete you will be asked to give us a urine sample. Next our laboratory staff will call you into our lab to take your vital signs, obtain a small blood sample, and analyze your urine sample. At this time we will determine if your blood type is RH-negative, patients who have a negative blood type need to pay an additional fee for a Rhogam shot. Next the patient will be sent to payment. Payment is expected in full prior to the procedure. One payment has been made the patient will meet with a counselor to discuss their paperwork, medical history, and to explain the procedure. We would be happy to answer any questions that you have during the counseling session. We will then get you prepared for the procedure.

What happens during the first part of the Second Trimester Surgical Abortion?

Each patient will be led to a private surgical suite. At this time the patient will meet all the staff needed to assist in the procedure. The medical assistants will assist the patient onto the operating room table. Once the patient is comfortable the Surgeon will ask questions in regards to the patients medical history and allergies the patient may have. The Surgeon will then do a pelvic examination, similar to your annual gynecological exam. The Surgeon will then insert a speculum into the vaginal area, and clean the cervix with an antiseptic solution. The surgeon will give the patient a local injection to numb the cervical area. This allows the surgeon to easily insert the Laminaria (dried pieces of seaweed sticks that once they are inserted into the cervix will expand overtime) and allow the body to naturally expand the cervix for the next phase of the procedure. The Surgeon will insert anywhere from 3-6 Laminaria. There may be some minimal cramping at this time. Once the procedure is complete staff will bring them into the recovery room for observation till they are ready to go home.

What happens after the first part of the Second Trimester Surgical Abortion?

Once the patient is in the recovery room they will be allowed to rest for a few minutes. Some people experience cramping, nausea, headaches, or dizziness. These are symptoms of the procedure and will go away quickly. If the patient is having any cramping the Nurse may administer some medication. The patient will be allowed to go home after about 15 minutes of observation. The patient will be given home care instructions and will be reminded of next day appointment. The patient will need to go home once they are discharged to relax in bed.

What happens on the second day of the Second Trimester Surgical Abortion?

When you return to the center on the second day of the procedure you will be brought into the laboratory for a recheck of your vital signs, and a quick blood test. You will then meet with the counselor to prepare you for the final step of the procedure. If you have any further questions at this time we would be happy to answer them. Once you are done in counseling we will prepare you for the procedure.

What happens during the second part of the Second Trimester Surgical Abortion?

Each patient will be led to a private surgical suite. At this time the patient will meet with all the staff needed to assist in the procedure. The medical assistants will assist the patient onto the operating room table. Once the patient is comfortable the Anesthesiologist will ask questions in regards to the patients medical history and allergies the patient may have. The Anesthesiologist will then prepare the patient for an IV to receive the medication for a Twilight procedure. Just prior to being given the last medication, the Surgeon will do a pelvic examination, similar to your annual gynecological exam. Once the patient is asleep the Surgeon will then insert a speculum into the vaginal area, remove any Laminaria still in the cervix, and clean the area with an antiseptic solution. Next the Surgeon will insert an instrument called a curettage and perform the procedure with suction. The Surgeon will check the uterine walls to make sure the pregnancy was successfully evacuated. Once the procedure is complete staff will bring them into the recovery room for observation till they are ready to go home.

What happens after the second part of the Second Trimester Surgical Abortion?

Once the patient is in the recovery room they will slowly wake up from the effects of the anesthesia medication. On average a patient is in the recovery room for about a half an hour. While you are resting the staff will be taking your vital signs and monitoring you. Some people feel cramping, nausea, have a headache, and may feel dizzy. These are usually symptoms of the procedure and should go away quickly. Some people may also have emotional feelings at this time, this is also normal and we are able to offer you referrals for counseling. Then the patient will be given something small to eat and drink. If the patient is having any cramping the Nurse may administer some medication. Once the patient is ready to leave we will ask some questions related to any current bleeding or cramping, and give the patient discharge instructions. The patient will need to go home once they are discharged to relax in bed for the day.

To ensure that you have a healthy recovery make sure to:

• Drink plenty of fluids and avoid alcohol while taking medications
• Avoid any strenuous activities or heavy lifting (over 15 pounds).
• DO NOT drive for 24 hours after surgery.
• Monitor your temperature.
• DO NOT immerse yourself in water until after your follow-up exam.
• DO NOT use any type of a douching product
• DO NOT use tampons, only maxi pads.
• DO NOT engage in sexual activity.
• If you have heavy bleeding (saturating 2-3 pads in an hour) or any large blood clots please call the center right away.
• You can take any non-aspirin products for cramping.
• Your menstrual period will usually return in 4-8 weeks.
• You will need to make a follow-up exam in two weeks.
• Please call our office at any time if you have any questions.