This is the most common method of abortion during the first 12 weeks of pregnancy. General or local anaesthesia is given to the mother and her cervix is dilated. A suction curette (a hollow tube with a knife-edged tip) is inserted into the womb. This instrument is then connected to a vacuum machine by a transparent tube. The vacuum suction, 29 times more powerful than a household vacuum cleaner, tears the unborn child into pieces which are sucked through the tube into a bottle and discarded.
At a very early stage in the pregnancy, suction abortions are performed using a smaller tube, and the cervix does not have to be dilated so greatly. This is called a "menstrual extraction." If all the pieces of the child are not removed, however, infection results, requiring full dialation of the cervix and scraping out of the womb.
Dilation and Curettage (D&C)
This method is similar to the suction method with the added insertion of a loop-shaped knife (curette) which cuts the baby into pieces. The pieces are scraped out through the cervix and discarded. [Note: This abortion method should not be confused with a therapeutic D&C done for reasons other than pregnancy.]
Dilatation and Evacuation (D&E)
This method is used up to 18 weeks gestation. Instead of the loop-shaped knife used in D&C abortions, a pair of forceps is inserted into the womb to grasp part of the fetus. The teeth of the forceps twist and tear the calcified bones of the unborn child. This process is repeated until the baby is totally dismembered and removed. Sometimes the head of the child is too large and it must be crushed in order to remove it.
"Salt poisoning," or the saline method, is used after the sixteenth week of pregnancy. A needle is inserted through the abdominal wall, through the uterine wall and into the amniotic sac. Some of the amniotic fluid is removed and replaced with a concentrated salt solution. The unborn child breathes in and swallows the salt and is poisoned by it. The outer layer of the child's skin is usually burned off by the corrosive effect of the salt. The mother goes into labour and a dead or dying baby is delivered 24 to 48 hours later. This method of abortion is so dangerous to the mother that its use is banned in Sweden and Japan.
Prostaglandins are hormones needed for birth. Injecting them into the amniotic sac induces intense labour and the premature birth of a child usually too young to survive. This method is generally used for abortions done during the second half of pregnancy. Saline or urea are sometimes injected first to kill the baby before delivery and make the procedure less distressful for the mother and the abortion staff.
Hysterotomy abortion is similar to a Ceasarian Section delivery, except that its purpose is to kill rather than save the child. This method is sometimes used when a tubal ligation is performed at the same time. Almost all hysterotomy abortion babies are born alive. The abdomen and womb are opened surgically; the baby is lifted out and the umbilical cord is clamped. The child often struggles before dying. Some babies have survived this procedure and are subsequently accepted by their natural mothers or adopted.
Other reported methods
In addition to the methods listed above, there are other methods of abortion used less frequently in Canada. One is the use of urea, injected into the uterus in the same manner as saline. Another category of abortion is listed as hysterectomy: removal of the unborn child at the same time as the removal of the uterus.
Abortion may also be performed by a combination of methods--in such cases the procedure is usually designated simply as "other".
The best known abortion pill is RU 486, also knows as mifepristone. It is only one of a family of chemical abortifacients which kill the developing human being after fertilization. These pills are sometimes referred to as "contragestives", "menses regulators' or "post-coital contraceptives."
Chemical abortifacients are extremely potent drugs. RU 486 is a synthetic steroid that blocks the action of the hormone progesterone, which is essential to maintaining pregnancy. Deprived of progesterone, the lining of the uterus sloughs off, killing the developing child. In most cases the mother's body responds by releasing prostaglandins to cause a miscarriage. The "success" rate of the pill is improved by administering artificial prostaglandins several days after RU 486 is used. RU 486 facilitates self-administered abortion, easily obtained in the earliest days of pregnancy. Although promoted as a safe alternative to surgery, the drug has been linked to the deaths of six women in the U.S., along with multiple cases of severe life-threatening side effects, including haemorrage and septic infection. The drug is not available in Canada, in part due to the death of a Canadian woman during early trials of the drug. The long-term effects of this drug and others like it are as yet unknown.
"(A) physician performing a D & E must deal with the second- trimester fetus in an intimate, physical way. Ossified parts such as the skull, must often be crushed. The bone fragments must be extracted carefully to avoid tearing of the cervix. Reconstruction of the fetal sections after removal from the uterus is necessary to ensure completeness of the abortion procedure."
"Emotional Impact of D & E vs. Instillation," Family Planning Perspectives, Nov. Dec. 1977
"You are doing a destructive process," said Dr. William Benbow Thompson of the University of California at Irvine. "Arms, legs, chests, come out in the forceps. It's not a sight for everybody."
"The Dreaded Complication" by Liz Jeffries and Rick Edmonds, The Philadelphia Inquirer, Aug 2, 1981
"Although technically the result of legal abortion, each fetus expelled alive because of prostaglandin lives for several hours. One series of 607 second trimester abortions from the Mt. Sinai Hospital in Hartford, Connecticut, resulted in 45 live births including one set of twins. None of the babies survived more than 13 hours." C. Everett Koop, M.D,, Sc.D., former U.S. Surgeon General, The right to Live, the Right to Die, page 24, Life cycle Books, Toronto
"Hysterotomy is an operation like a Caesarian section in which the infant is surgically removed from the mother's abdomen and uterus. With the hysterotomy type of abortion there is no chemical that is inducing fetal death. When the surgeon [cuts open] the uterus the baby is still alive."
Thomas W. Hilgers, M.D., Associate Professor of Obstetrics and Gynecology before the U.S. Senate Constitution Subcommittee, October 14, 1981