Labor induction abortion
No woman wants an abortion as she wants an ice cream cone or a Porsche. She wants an abortion as an animal caught in a trap wants to gnaw off its own leg - Frederica Mathewes-Green
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Medical abortion
Women have attempted to induce abortion throughout history using whatever devices and folk remedies nature and tradition allowed. Plato, Aristotle, Hippocrates, and Soranus all discussed methods of medically inducing abortion.38 Bas-reliefs at the Temples of Angkor Wat illustrate massage-induced abortion, a method still practiced in parts of rural Asia. Even today, an Internet search of “herbal” and “induced abortion” identifies hundreds of sites touting pennyroyal with blue cohosh, mugwort, cotton root bark, and other herbal products either as teas or decoctions to medically evacuate the uterus. Fortunately, a far safer array of second-trimester abortifacients has evolved during the past…
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Induction Abortion
Induction abortion is a second and third-trimester medical abortion method. It involves administering medication vaginally, under the tongue, or as an injection to induce labor and delivery. The procedure is completed in two steps, identical to early medication abortion. The same medication combination is used: Mifegyne® (mifepristone), followed by Cytotec® (misoprostol), but the process is more prolonged and painful. It is possible to use misoprostol only, as practiced in South Africa. In the USA, 2-5% of late-term abortions are induced. Other countries, such as Canada, rarely offer D&E abortions and therefore primarily rely upon the induction method.
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Labor induction abortion in the second trimester
Based on existing evidence, the Society of Family Planning recommends that, when labor induction abortion is performed in the second trimester, combined use of mifepristone and misoprostol is the ideal regimen to effect abortion quickly and completely. The Society of Family Planning further recommends that alternative regimens, primarily misoprostol alone, should only be used when mifepristone is not available.
Labor induction abortion in the second trimester
Labor induction abortion is effective throughout the second trimester. Patterns of use and gestational age limits vary by locality. Earlier gestations (typically 12 to 20 weeks) have shorter abortion times than later gestational ages, but differences in complication rates within the second trimester according to gestational age have not been demonstrated. The combination of mifepristone and misoprostol is the most effective and fastest regimen. Typically, mifepristone 200 mg is followed by use of misoprostol 24–48 h later. Ninety-five percent of abortions are complete within 24 h of misoprostol administration. Compared with misoprostol alone, the combined regimen results in a clinically significant reduction of 40% to 50% in time to abortion and can be used at all gestational ages. However, mifepristone is not widely available.
Labor Induction Termination of Pregnancy
Labor induction abortion is an alternative to surgical abortion in the second trimester, and provides access to abortion services when there are no providers trained in second trimester surgical abortion techniques. Induction of labor is also indicated in some cases of pregnancy termination for fetal abnormalities, such as when an intact fetus is important for diagnosis or for the patient's grieving process. However, an intact fetus is not necessary solely to confirm prenatal diagnosis of a genetic abnormality; accurate chromosomal analysis can be performed in almost every case after a dilation and evacuation (D&E) procedure.
Mid-trimester induced abortion: a review
The combination of mifepristone and misoprostol is now an established and highly effective method for termination of pregnancy (TOP).
Second-trimester pregnancy termination: Induction (medication) termination
Patients may choose medication abortion if they prefer more awareness of the termination process, if they prefer an intact fetus, or if they want to avoid surgery. An intact fetus may be desirable if the patient desires to hold the fetus or, in cases of fetal anomalies, if an intact fetus is beneficial for a morphologic evaluation. In some health care settings, there is more access to second-trimester induction abortion than surgical abortion.
Resources
AbortionProcedures.com
A third trimester induction abortion is performed at 25 weeks LMP (25 weeks since the first day of the woman’s last period) to term. At 25 weeks, a baby is almost fully-developed and is considered viable, meaning he or she could survive outside the womb. For this reason, the abortionist will usually first kill the baby in utero by injecting a substance that causes cardiac arrest, and induces the mother’s labor to deliver her baby stillborn.
