An abortion or abortion is the premature termination of pregnancy before the 20th week of pregnancy (SSW), after which one speaks of a premature birth.
An abortion can be divided into spontaneous abortion (miscarriage) and induced abortion (i.e. the deliberate premature termination of an unwanted pregnancy or pregnancy that endangers the health of the woman).
There are two methods of abortion: medical and surgical abortion.
An abortion with medical indication is performed so as not to endanger the health of the mother or to avoid giving birth to a child with serious illnesses or disabilities.
Medical abortion up to the 3rd month
Abortion with MTX
Abortion takes place up to the 7th week of pregnancy, using two chemical products. The first is called methotrexate, or MTX, an anticancer drug that attacks, destroys and inhibits the growth of diseased cells.
It also has the same effect on the fetus in the womb.
Methotrexate attacks the rapidly growing child’s cells and the tissue formed during pregnancy that forms the child’s vital system.
Without vital support, the child dies.
Misoprostol is the second drug to be used at home 4-7 days later. The agent is inserted into the vagina like a suppository and leads to a contraction of the uterus, as a result of which the dead child is expelled from the womb.
In the abortion clinic, a further examination is carried out to ensure that the abortion is complete.
If the abortion is not successful, surgery must be performed.
In the case of abortions caused by MTX, the following side effects are possible: the agent is potentially toxic, it can cause damage to the liver, kidneys and heart muscle, lung failure, gastrointestinal problems, stroke and convulsions.
Possible side effects of using the misoprostol suppository are: kidney problems, infertility, cramps, bleeding.
RU-486, the so-called abortion pill, is used in the first 7 to 9 weeks of pregnancy.
The patient first swallows a steroidal drug (mifepristone), which consists of three pills.
This medicine blocks the action of progesterone, the corpus luteum hormone that causes the development of the lining of the uterus during pregnancy; the lining of the uterus allows the feeding of the fetus.
Then a second drug is administered: prostaglandin.
This causes the uterus to contract and expell the embryo.
Alternatively, 4 compresses of misoprostol can be inserted into the vagina, causing contractions of the uterus, with cramping and bleeding.
This procedure requires 2-3 visits to the doctor.
At the third visit, which usually takes place about two weeks after the first, the follow-up is carried out to determine whether the abortion was successful.
The percentage of treatment with unsuccessful abortion is 10-20%.
Suction method (aspiration)
Suction is a surgical abortion method in which the fetus is removed by a delicate aspiration.
First, the cervix is dilated by the use of dilators, then the fetus and placenta are suctioned.
After the procedure, tissue remnants are removed by means of scraping (curettage).
Cramping and bleeding last for about four hours, but can also last for a long time.
Medical abortions after 3 months
Induced labor by saline injection into the amniotic fluid (from 4th to 9th month) In this method of termination,
the doctor uses a saline solution.
The doctor pierces the amniotic sac with a long needle through the abdomen.
Part of the amniotic fluid is removed and then the saline solution is injected.
The child ingests the poisonous saline solution, which he slowly kills by destroying the organs and corrosing the child’s skin.
A few hours later, the child is dead.
The induced birth is difficult to bear and the child is born, usually the next day, dead.
Injecting the saline solution can lead to liquefaction of the blood, which makes blood clotting difficult.
As a result, heavy internal bleeding is possible, which can lead to death.
This method is banned in Japan and other countries due to the potential harm to the mother’s health.
Prostaglandin hormone method
Prostaglandins are chemically produced hormones that are used to induce labor.
These hormones are injected into the amniotic sac.
The doctor allows these painful contractions to continue until the child is forced to leave the uterus. Then the expulsion phase begins and the child is delivered. In most cases, it is a stillbirth, but there are also children who
he have survived this procedure.
Following birth, a scraping may be performed to remove the placenta.
The injection of prostaglandin and abortion with saline solution are no longer carried out because many children were born alive.
Suction curettage or scraping with dilatation (up to the 15th week of pregnancy)
The suction method uses a sharp-square, hollow tube connected to a suction pump.
The suction power of this device is about 30 times as strong as a vacuum cleaner.
Since the cervix is hermetically sealed to hold the child, the doctor usually injects a local anesthetic there.
At birth, the body releases hormones so that the cervix opens naturally, in a
Abortion, it must be opened gradually in another way.
The cervix is stretched with fine metal pins (dilators). Even though local anesthesia renders the cervix numb, the insertion of the dilators can cause cramps.
The dilators are inserted successively in different thicknesses to allow gradual widening of the cervix.
Sometimes the cervix is injured.
When the cervix is sufficiently open, the doctor inserts a suction tube into the uterus.
The suction pump is switched on and the amniotic sac is sucked out together with the fetus. With a curette (thin, ring-shaped instrument) the walls of the uterus can be scraped off.
Dilation and clearance (up to the 20th week of pregnancy)
This method is carried out in two steps.
The cervix must be further stretched in the event of an abortion after the first trimester of pregnancy, because the child is larger and more developed.
This can take several hours or even the whole night.
Intravenous medications can relieve pain and prevent infection.
A local anesthetic is injected into or near the cervix and the dilators are removed.
The doctor combines forceps, suction and scraping to separate the child’s arms and legs. The abortor then punctures the softest point of the head, sucks off the brain and crushes the skull.
Then the remains are removed with forceps and put back together outside the body to ensure that no remnants remain in the uterus. Since the incision is made along the inside of the uterus, heavy bleeding usually occurs and the uterus can be damaged.
Abortion by “caesarean section” (hysterotomy)
In the last trimester of pregnancy, the doctor may perform a hysterotomy, a type of small cesarean section.
The doctor cuts the abdomen is inserted, clamps the umbilical cord, waits about 5 minutes, and then lifts the dead child out of the uterine cavity.
Some children have survived this procedure.
Approximately at the 16th week, an ultrasound scan is performed to determine the position of the child’s heart. The lethal fluid injected into the heart causes immediate heart failure and the child dies. Then the birth of the dead child can be initiated.
Risks and complications of abortion
In the case of induced abortion, undesirable side effects can occur with both surgical and drug methods.
An abortion can also bring serious complications, such as bleeding, infection, and organ damage.
Severe complications occur in less than 1% of cases with a first abortion and in 2% of cases with further abortions.
Serious complications include:
Heavy bleeding – minor bleeding after an abortion is quite normal.
However, if the cervix is damaged or the uterus is punctured, severe blood loss is possible.
In this case, a blood transfusion may be necessary.
Also with the abortion pill RU-486 there is a risk of heavy bleeding.
One in 100 women treated with RU-486 will need to undergo surgery to stop the bleeding.
Infection can develop due to the insertion of the medical instruments into the uterus or by fetal particles that have accidentally been left behind (incomplete abortion).
The infection of the pelvic organs may cause a persistent fever that can last for many days and prolong the hospital stay.
In addition, scars may appear in the organs of the pelvis.
Some patients have died of blood poisoning (sepsis) after taking RU-486 (mifepristone).
Anesthesia There are complications of general anesthesia
, which is administered to perform the procedure.
Abortion can cause convulsions, heart attacks and, in extreme cases, death.
Damage to the cervix
The cervix can be incised, torn or damaged by the instruments used in abortion.
This can cause bleeding that needs to be treated surgically.
Scars on the uterine lining Suction tube, curette and other instruments for abortion can leave permanent scars on the uterine lining.
The uterus can be pierced or torn by the abortion instruments.
The danger increases as pregnancy progresses. In this case, complex operations may be necessary, including removal of the uterus (hysterectomy).
Damage to internal organs
If the uterus is pierced or torn, there is a risk that the nearby organs, such as the intestine and bladder, will suffer damage.
In extreme cases, abortion can cause further physical complications, such as high blood loss, infections, damage to internal organs due to uterine perforation, and counter-reactions to anesthesia, which can lead to death.
This consequence is rare, but possible.
Other risks of abortion should be considered.
Abortion and premature birth:
Women who have already had one or more abortions are significantly more at risk of suffering premature birth in the future. Premature birth can be associated with an increased number of cerebral palsy, as well as with other complications of a birth that takes place before the due date (disorders of the brain, respiratory system, intestines and eyes).
Abortion and breast cancer:
The experts are still researching a connection between abortion and breast cancer.
Here are important facts:
In the case of a first pregnancy carried to the end, protection against breast cancer arises. In the case of an abortion, this protection is lost.
A certain number of reliable studies conclude that there may be a link between abortion and later onset of breast cancer.
A 1994 study by the Journal of National Cancer Institute showed that: “the risk of breast cancer was 50% greater in the women who had an abortion than in the other women who had been pregnant at least once.”