Treatment Overview

Starting (inducing) labour and delivery in the second or third trimester of a pregnancy is done using medicines. Your doctor may also use a medicine to stop your pregnancy before the induction abortion. This is given by injection into the uterus, either through your belly or vagina.

To prevent complications, the cervix may be slowly opened (dilated) with a device called a cervical (osmotic) dilator before the induction is started. Medicines to start early labour can be:

• Inserted into the vagina to start uterine contractions and soften the cervix. This allows uterine contents to pass through the cervix. Vaginal medicines include prostaglandins, such as misoprostol.
• Taken by mouth to start uterine contractions and soften the cervix. These medicines include misoprostol and mifepristone. Your doctor may have you swallow the medicine or let it dissolve under your tongue or between your cheek and gum.
• Injected into a vein (intravenously, or IV) to start uterine contractions. Oxytocin (Pitocin) is commonly used for this purpose.

The different medicines available for an induction abortion may be combined for effectiveness and to decrease the amount of bleeding.

An induction abortion does cause you to go through the stages of labour and delivery. Pain medicines can be used during the procedure.

What To Expect

As your body returns to its non-pregnant condition, there are some things you can expect during the days and weeks after the procedure.

• You may have irregular bleeding or spotting for the first 2 weeks. Use sanitary pads until you stop bleeding. Using pads makes it easier to monitor your bleeding.
• You may have cramps similar to menstrual cramps. They may last for several hours and maybe for a few days as the uterus shrinks back to its non-pregnant size.

Here are some things to do as you recover:

• Rest quietly for the next several days. You can return to your normal activities based on how you feel.
• Ask your doctor if you can take acetaminophen (such as Tylenol) or ibuprofen (such as Advil). They may help relieve cramping pain. Be safe with medicines. Read and follow all instructions on the label.
• Ask your doctor when it is okay for you to have sex.
• If you don't want to get pregnant, use birth control when you start having sex again.

Why It Is Done

Induction is one option for abortion in the second or third trimester.

• Induction abortion is sometimes offered to women diagnosed in the second or third trimester with a fetus that has severe medical problems or abnormalities.
• A woman may not realize that she is pregnant until later in the pregnancy. When this happens, induction may be necessary for abortion.
• A woman who doesn't have access to an abortion earlier in the pregnancy may need an induction abortion.

How Well It Works

Induction abortion is effective in the second and third trimesters.

Dilation and evacuation (D&E) is more commonly used in second-trimester abortions. It is safer, quicker, and more effective than induction abortion.

Risks

The risk of problems from induction abortion is rare. But some problems may include:

• Failure to end the pregnancy.
• Tissue remaining in the uterus.
• Injury to the cervix.
• Uterine rupture if a uterine scar is present from a previous surgery.
• Heavy vaginal bleeding.
• Infection.