SECOND TRIMESTER MULTI-DAY
FACTS ABOUT 2ND TRIMESTER D&E ABORTION
A D&E (dilation and evacuation) procedure is performed to end pregnancy between the 14th and 24th weeks from the first day of the last menstrual period (LMP). The procedure is usually a 2-3 day procedure, depending on gestation and medical history. First, ultrasound will be done. This is done by passing a microphone-like instrument over your abdomen which measures the size of your uterus. The final decision as to whether the D&E may be performed in the clinic will depend on your medical history, physical exam, laboratory tests, and the physician’s evaluation.
The first day of the procedure you will have laminaria (seaweed sticks about the size of your pinky finger) inserted into your cervix that absorb bodily fluid to cause dilation. The second day, the procedure will be performed. You are required to have someone drive you to the clinic and someone to stay with you overnight.
Some procedures are 3-4 days depending on medical history. The first 2-3 days are used for dilation; the procedure will be performed on the last day
HOW A SECOND TRIMESTER ABORTION IS DONE
Insertion of cervical dilators (laminaria): The cervix (the opening in the uterus) can be stretched open over a period of several hours using an osmotic cervical dilator that swells by soaking up fluid from the cervix. The vagina is first cleansed. Then the cervix is numbed with local anesthetic. Laminaria are inserted into the cervix where they will stay overnight, kept in place by a tampon, soaked in betadine, inserted into the vagina. You will be sent home with medications to take around the clock. You will also be given written instructions for your care while the dilators are in place. Depending on your gestation this may be repeated the second day.
DILATION & EVACUATION:
Before the procedure is started, an IV will be inserted into your arm and connected to a bag of fluid. Once this is in place, we will give all your medications through the IV. A local anesthetic is injected into or around the cervix. The tampons and laminaria which were inserted the previous day will be removed. The cervix may need to be stretched more using a series of rods (dilators). Each is a little wider than the one before.
A blunt tipped tube (cannula) is inserted into the uterus. This tube is attached to a suction machine which is then turned on. The contents of the uterus are removed by suction and instrument. This lasts between 10 to 30 minutes. After the uterus has been emptied, a spoon shaped instrument (curette) may be used to determine that the uterus is completely empty.
After this, you will spend as much time as need in the observation room with a patient care technician. When your condition is stable and you are ready to leave, you will receive the necessary prescriptions and follow-up instructions, including what you should do in the event of a complication.
IMPORTANT: If you receive IV sedation you will not be able to drive. You must have someone with you to drive home.
When the procedure is complete, you will be shown how to do uterine massage. You will need to do this for one (1) minute every one half (½) hour for the next eight (8) hours. You will be given an appointment for a check-up, usually about six (6) weeks after the abortion; this appointment usually takes about ten (10) minutes.
Pregnancy tests can read positive for up to six (6) weeks post abortions.
Birth control: You can become pregnant again right after your pregnancy ends. To avoid any unwanted or unplanned pregnancy start using birth control immediately.