Surgical Second Trimester Abortion – Up to 23.6 weeks
Our Process to Prepare You
When you arrive at Atlanta Women’s Center (also known as Atlanta Women’s Medical Center) for your abortion, you will be treated with compassion and respect while receiving the highest quality, individualized medical care. Our services include a series of pre-operative assessments with medical and counseling staff.
You will receive the following care as we prepare you for your abortion procedure at Atlanta Women’s Center:
- Ultrasound – The ultrasound exam is used to measure the size of your pregnancy and determine where you are in your pregnancy.
- Lab testing – Blood work is completed in order to determine your Rh factor (the positive or negative of your blood type) and your hemoglobin level (the level of iron in your blood). Your blood pressure, weight and temperature will also be measured.
- History and Physical – Your medical history and current physical state will be reviewed, and birth control options will be discussed.
- Counseling – You have an opportunity to meet in private with a counselor or health advocate to address your questions, concerns and feelings about pregnancy and the procedure.
After your pre-operative assessment has been completed, you will be prepared for your surgery and escorted to the operating room. During the surgery there will be approximately 3-5 medical staff in the operating room with you (depending on your individual needs).
At Atlanta Women’s Center, a second trimester abortion takes place from about 12 weeks from the first day of the last menstrual period (LMP) through 23.6 weeks (LMP). During a second trimester abortion your cervix must be dilated (opened) more than for a first trimester abortion. Depending on where you are in the pregnancy and your medical history, this dilation may take anywhere from an hour up to overnight before your surgical procedure. A second visit to the clinic may be required to complete your procedure. In general, pregnancies between 12 weeks LMP and 17 weeks LMP will require a one day procedure and pregnancies greater than 17 weeks will require a two day procedure. Whether you require a one day or two day procedure will be determined by your medical team.
A second trimester abortion begins by dilating (opening) your cervix. This is accomplished through the administration of misoprostol (Cytotec). Misoprostol (Cytotec) may be delivered in one of three ways:
- By mouth
Misoprostal (Cytotec) is given to relax your cervix so that the physician can dilate it easily and without damaging the muscle.
Laminaria may be necessary to complete the dilation. Laminaria are thin rods that are inserted into your cervix by the physician and, over the course of several hours or overnight they slowly absorb the moisture in your body and expand, dilating your cervix. Laminaria are made of sterilized seaweed.
When the dilation of your cervix is complete you will be taken to the operating room, and a Certified Registered Nurse Anesthetist (CRNA) will administer IV sedation. The surgery will begin when the physician inserts a speculum into your vagina in order to view your cervix. If necessary, the physician will then dilate (open) your cervix more by inserting thin, metal rods, one by one, into the opening of the cervix. These rods, also called dilators, gradually increase in width. The physician will then use surgical instruments and vacuum aspiration (suction) to remove your pregnancy. The surgery usually takes approximately 10 to 20 minutes. After your surgery, you will be monitored in our recovery room until you are medically cleared to go home, usually 30-45 minutes.
Because 2nd trimester abortions procedures require IV sedation, you must make arrangements for someone to drive you to and from Atlanta Women’s Center.
Click here for a copy of our pre-appointment reminders click here (AWC – Appointment Confirmation and Reminders for Patients) and click here (AWC Post Op Instructions) for a copy of our discharge instructions (these will also be provided to you on the day of your procedure).
If you are having a two day procedure (17 – 23.6 weeks), click here (AWC DandE info) for information about the D & E procedure; and click here (AWC Overnight Laminaria instructions) for overnight laminaria instructions.