Abortion Facts

In a medication abortion, sometimes called a medical or chemical abortion, a woman is administered an abortion-inducing compound called mifepristone (also called RU-486 or Mifeprex). Mifepristone blocks the action of progesterone, the natural hormone vital to maintaining the lining of the uterus. As the nutrient lining disintegrates, the embryo starves. Subsequently, the woman takes a dose of artificial prostaglandins which initiate uterine contractions and cause the embryo to be expelled from the uterus. Abortions by mifepristone are usually done prior to 49 days after the woman’s last menstrual period, but are sometimes done as late as 70 days.

In a prostaglandin abortion, a dose of prostaglandin hormones is injected into the uterine muscle, which induces violent labor resulting in the death of the fetus. Prostaglandin abortions, typically performed in the second and early third trimester, are rarely used today, due to the relatively high chance that the fetus will survive the abortion and be born alive.

In a saline abortion, amniotic fluid is removed from the uterus and replaced with a saline solution, which the fetus swallows. The fetus is killed by salt poisoning, dehydration, brain hemorrhage and convulsions. Saline abortions, typically performed in the second and early third trimester, are rarely used today, due to the risk of particularly serious health complications to the woman.

A D&X (dilation and extraction) or partial-birth abortion is typically performed in the late second or third trimester. As with a D&E abortion (see above), the cervix must first be dilated, usually with laminaria (dried seaweed sticks). Forceps are then inserted into the uterus to grasp the fetus’s legs. The fetus is delivered breech while the head remains inside the birth canal. Using blunt-tipped surgical scissors, the base of the skull is pierced, and a suction catheter is inserted to extract the contents of the skull. This causes the skull to collapse, and the dead fetus is then fully delivered.

Despite the fact that the United States Supreme Court upheld the federal Partial-Birth Abortion Ban Act in 2007, D&X abortions are still being performed. An abortionist can avoid violating the law by first injecting the fetus with a lethal intracardiac injection to ensure that the fetus will already be dead when it is partially delivered.

• See also How is an intracardiac injection abortion performed?

A D&E (dilation and evacuation) abortion is typically performed in the first half of the second trimester (13-20 weeks), but can be used up to approximately 28 weeks. At this stage of pregnancy, the fetus’s tendons, muscles, and bones are more developed. In a D&E abortion, forceps are inserted into the uterus to forcibly dismember the fetus, and the pieces are removed one by one. Larger fetuses must also have their skulls crushed so the pieces can pass through the cervix.

Typically, the cervix must be dilated for a period of one to three days prior to a D&E abortion. This is most often done by inserting laminaria (dried seaweed sticks) into the cervix. Therefore, a D&E abortion usually requires two visits to the abortion facility.

In an intracardiac abortion, a needle is guided into the fetus’s heart with the aid of ultrasound, and poison (often potassium chloride or digoxin) is injected, causing an immediate heart attack. Intracardiac injection is most commonly used for “pregnancy reduction” abortions following in vitro fertilization (IVF) procedures, if multiple embryos were implanted to increase the likelihood of pregnancy. In these cases, the procedure is typically performed between 10 and 12 weeks gestation.

Intracardiac injection is also used in late term abortions when there is likelihood of delivering a live baby, in order to avoid state laws that would require the baby to be resuscitated and given medical care.

In a D&C (dilation and curettage) abortion, typically performed in the first trimester, a curette (a sharp looped knife) is inserted into the uterus to scrape its walls. The curette is then used to dismember the fetus and placenta.

Suction aspiration, the most common abortion method, is typically performed at 6-12 weeks gestation, but can be used up to 16 weeks. The cervix is dilated, and a hollow plastic tube with a sharp tip is inserted into the cervix and then into the uterus. An aspirator attached to the tube tears the body of the fetus apart and suctions the pieces through the tube.

Eight abortion methods are practiced in the U.S.:

Suction (Vacuum) Aspiration
Dilation and Curettage (D&C)
Intracardiac Injection Abortion
Dilation and Evacuation (D&E)
Dilation and Extraction (D&X or Partial-Birth Abortion)
Instillation (Saline) Abortion
Prostaglandin Abortion
Chemical (Medical) Abortion

Each of these methods is described in detail below.

Women often report that they feel pressured to get an abortion by others in their lives—boyfriends, parents, teachers, friends, employers and others. One survey found that 64% of American women who sought abortions felt coerced into doing so.

In 2012, a panel of physicians meeting in Ireland, a country with one of the world’s lowest rates of maternal mortality, concluded: “We affirm that direct abortion—the purposeful destruction of the unborn child—is not medically necessary to save the life of a woman.” They further stated: “The prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women.”