Dilation and Evacuation (D & E) Abortion

Dilation & Evacuation has become the preferred method for second-trimester abortions. Medical staff in NZ and elsewhere are reluctant to participate.
  • Because the muscle tissue has toughened, the doctor has to physically dismember the foetus.
  • Nursing staff find the crunching sounds distressing.
  • Care is needed so that the sharp bones do not perforate or become embedded in the lining of the uterus.
  • A nurse then checks that all the body parts have been removed by re-assembling the foetus.
  • It is argued that the foetus should be anaesthetized before being dismembered.
The Dilation and Evacuation (D & E ) technique has become the preferred method for second-trimester abortions. Because the muscle tissue has toughened, the doctor has to physically dismember the foetus.

Heavy sharp-toothed forceps are used because the foetus’s bones and bones have calcified (hardened). The surgeon inserts the forceps up into the uterus, seizes a leg or other parts of the body, and, with a twisting motion, tears it away. This continues until the dismembering is complete and the body parts are placed in a metal dish. The spine must be snapped, and the skull crushed to facilitate removal.

Particular care has to be taken to ensure that the sharp bones of the skull do not perforate, or become embedded in the lining of the uterus.

The sensitive issue of pain allegedly experienced by the foetus is controversial. It is argued by some that the foetus should be anaesthetised before being dismembered. Abortion advocates see problems in acknowledging any 'right,' to the foetus, as it may then be used as a precedent in establishing that a foetus may have other rights, including the 'right to live.' Read more on the issue of Foetal Pain

The task of an assisting nurse is to check that all the body parts have been removed by re-assembling the foetus. Any missing remains are then collected by using the curette.

Because of the nature and crunching sounds of the procedure, nursing staff can be distressed. In New Zealand, both the Canterbury and Auckland District Health Boards have recorded reluctance among medical staff to participate. Christchurch lost “experienced and competent senior nurses” and eventually had to recruit overseas doctors and nurses.

In America, Dr Warren Hern, a Colorado abortionist who has performed a number of D&E abortions, says they can be particularly troubling to clinic staff. They can be traumatic for doctors too: “There is no possibility of denial of an act of destruction by the operator. It is before one’s eyes. The sensation of dismemberment flows through the forceps like an electric current.”

Complications
In addition to the complications common with D&C abortions, this method is especially prone to infections:
  • pelvic
  • renal
  • cervical
  • peritonital
D & E abortions are also associated with:
  • clinically low-birth-weight babies
  • stillbirths
  • ectopic pregnancies
  • neonatal deaths, and
  • congenital abnormalities in future pregnancies

To see aborted foetal images click here.