Surgical Abortion – Second Trimester Abortion
Our Process to Prepare You
When you arrive at Hartford GYN Center, you will be treated with compassion and respect while receiving the highest quality, individualized medical care. Our services include a series of pre-operative assessments with medical and counseling staff.
You will receive the following care as we prepare you for your procedure:
- Ultrasound – to determine the gestational age of the pregnancy
- Lab testing – to determine Rh blood type and hemoglobin level and blood pressure
- History and Physical – to review your medical history, current physical state and birth control options
- Counseling – to address your questions, concerns and feelings about the pregnancy and the procedure
After your pre-operative assessment has been completed, you will be prepared for your surgery and escorted to the procedure room.
At Hartford GYN Center, a second trimester abortion takes place from about 12 weeks from the first day of the last menstrual period (LMP) through 21 weeks and 6 days (LMP). During a second trimester abortion your cervix must be dilated (opened) more than for a first trimester abortion. Depending on where you are in the pregnancy and your medical history, this dilation may take anywhere from an hour up to overnight before your surgical procedure. A second visit to the clinic may be required to complete your procedure. In general, pregnancies between 12 weeks LMP and 16 weeks LMP will require a one day procedure and pregnancies greater than 16 weeks will require a two day procedure. Whether you require a one day or two day procedure will be determined by your medical team.
A second trimester abortion begins by dilating (opening) your cervix. This is accomplished through the administration of misoprostol (Cytotec). Misoprostol (Cytotec) may be delivered in one of three ways:
Misoprostal (Cytotec) may be given to relax your cervix so that the physician can dilate it easily and without damaging the muscle.
Laminaria or Dilapan may be necessary to complete the dilation. Both laminaria and Dilapan are thin rods that are inserted into your cervix by the physician and, over the course of several hours or overnight they slowly absorb the moisture in your body and expand, dilating your cervix. Laminaria are made of sterilized seaweed and Dilapan are made of synthetic material. It is up to the medical team to determine the form of dilation that is best for you.
When the dilation of your cervix is complete you will be taken to the operating room, and a Certified Registered Nurse Anesthetist (CRNA) will administer IV sedation. The surgery will begin when the physician inserts a speculum into your vagina in order to view your cervix. If necessary, the physician will then dilate (open) your cervix more by inserting thin, metal rods, one by one, into the opening of the cervix. These rods, also called dilators, gradually increase in width. The physician will then use surgical instruments and vacuum aspiration (suction) to remove your pregnancy. The surgery usually takes approximately 10 to 20 minutes. After your surgery, you will be monitored in our recovery room until you are medically cleared to go home, usually 30-45 minutes.
Because some 2nd trimester abortions procedures require IV sedation, you must make arrangements for someone to drive you to and from Hartford GYN Center.
Click here for a copy of our Pre-Operative Instructions in English or Spanish and click here for a copy of our Hartford Aftercare instructions in English or Spanish (these will also be provided to you on the day of your procedure).