The choice of abortion method depends upon the age of the foetus and the physical condition of the mother.Although all pregnancies up till about 22 weeks can be terminated by aspiration (sucking out) or D&E (dilation and evacuation), alternative methods may be considered for the very young pregnancy if the equipment for aspiration is not available.
- The most common abortion performed in NZ is suction aspiration in the first trimester.
- The cervix is dilated and the contents of the uterus removed.
- Second trimester abortions are dilation & extraction (D&E) and prostaglandin.
- In the third trimester, hysterotomy abortions are performed in New Zealand.
- D&X (partial-birth) abortions are not performed in New Zealand.
First Trimester Abortion
Before the operation the patient will probably be given a tranquillising injection to help her to relax. This may make her feel a little light headed. She will be on the operating table with her feet in stirrups, or her legs supported by knee pads. During the operation she must lie with her legs apart.
The operating doctor first does a bimanual (internal) examination to check how far advanced the pregnancy is, and the position of the uterus. The woman will probably already have had a bimanual examination done by her doctor.
The doctor then washes the vaginal area with antiseptic liquid. Next he/she places into the vagina a speculum, which is an instrument which holds the vagina walls open so that the doctor can see the cervix.
The cervix is numbed with a local anaesthetic. As there are few nerve endings in the cervix it is quite likely the patient will barely feel this, although occasionally some women will feel a sharp pinch.
Next, the doctor takes hold of the cervix with an instrument which holds the cervix still during the operation. The patient will probably not feel this because of the local anaesthetic.
The cervical canal (the passage through the cervix into the interior of the uterus) is then slowly stretched open with dilators. These are curved smooth instruments with no sharp edges which vary in size from ones as thick as a match stick to those as big as a piece of chalk.
By inserting a small dilator first and then taking it out, then a larger one and taking it out, the cervical canal is opened wide enough to allow a plastic catheter to be passed through it into the interior of the uterus. There is no cutting or stitching involved.
Once the dilation is completed the doctor inserts a plastic catheter through the cervix. This catheter is like a plastic straw attached by a long plastic tube to the vacuum aspiration machine. It makes a sound because of the air in the tube.
The foetus is removed by moving the catheter around inside the uterus and is drawn through the plastic tube and into a container. As the uterus is emptied, it contracts and the woman will feel this like menstrual cramps. This part of the operation takes two to five minutes.
Finally the doctor will check the inside of the uterus with a curette (a long thin instrument with a curved round end) to make certain it is completely empty.
The amount of discomfort women feel during the abortion varies from woman to woman. Some women feel virtually nothing, others feel discomfort from mild cramps, to more severe ones.
The most common abortion performed in NZ is suction aspiration.
A Frontline documentary shows the abortion procedure being performed.
The Dilation and Evacuation (D&E) technique has become the preferred method for second-trimester surgical abortions. Because the muscle tissue has toughened, the doctor has to physically dismember the foetus before removing from the uterus.
Third Trimester Abortion
A Hysterotomy is basically an abortive Caesarean section (C-section). The abortionist makes in an incision in the mother's abdomen and removes the foetus.
As with prostaglandin abortions, the foetus is given a lethal injection before the surgery.
Dilation & Extraction (D&X) abortions, also known as partial-birth abortions, are not presently performed in New Zealand.
At seven or eight months gestation the foetus's muscles and cartilage have toughened to the point where it is virtually impossible to dismember it without harming the mother.
The abortionist turns the foetus to facilitate a breech birth, partially delivers the child, then inserts scissors through the base of the skull and suctions out the brains.