Abortion Procedures

Abortion is one of the most common surgical procedures in Canada, with approximately 300 occurring each day.

There are two different kinds of abortion, chemical and surgical.

Surgical abortions are the most common. Manual Vacuum Aspiration occurs in approximately 53,000 reported cases each year in Canada. Dilation and Curettage occur in over 8,000 reported cases (from 14 to 21 weeks gestation). After 24 weeks, drugs such as Prostaglandins are used to expel the baby. Hysterotomy is also used. Several hundred late-term abortions occur each year in Canada.

Chemical Abortion

A chemical abortion uses drugs to empty the contents of the uterus. These abortions can be done only within the initial seven weeks of pregnancy (following last menstrual period). There are two drug combinations used to induce these abortions:

 

• methotrexate and misoprostol
• mifepristone (RU 486) and misoprostol

 

Only the first combination is available in Canada. The second combination of mifepristone (RU 486) and misoprostol is not approved for sale in Canada, due to severe complications including death that resulted from the clinical trials held in Vancouver, BC in 1998.

Methotrexate is a drug used to treat severe cases of psoriasis and cancer. It inhibits the replication of RNA and DNA in the human cell, preventing the baby in utero from continuing its development. Methotrexate is usually given to the mother by injection.

When the baby in utero has died, misoprostol is administered. It is a drug commonly used to treat stomach ulcers; however, in higher doses, it causes the muscles of the uterus to contract, pushing out the contents of the womb.

Tablets of misoprostol are placed in the vagina five to seven days after the methotrexate injection is given. In most cases the uterus will be emptied within 24 hours, but in about 35% of cases, it can take several days or weeks. Pain medication is used to ease the pain of the cramps, which occur when the pregnancy tissue comes out of the uterus.

Effects of Chemical Abortion

The drugs that induce chemical abortions cause birth defects. A woman who takes these drugs must be prepared to have a surgical abortion if the chemical abortion is unsuccessful. A follow-up exam is done one or two weeks after the methotrexate injection to make sure that the abortion has happened.

Although this procedure avoids surgery, is less invasive and can minimize the risk of damage to the uterus with surgical instruments, it takes place over a week or more and involves several visits to the doctor.

There is a ten percent risk that the procedure will be incomplete and a surgical abortion will need to be done.

The procedure often involves heavy bleeding.The drugs may have unpleasant side effects including nausea, diarrhea, abdominal cramping or pain, vomiting, hot flashes.

Surgical Abortion

Manual Vacuum Aspiration (MVA)

Performed during the first trimester in pregnancy, this procedure involves passing a long thin tube through the opening of the cervix. Suction is used to separate the placenta from the uterine wall. Depending on the size of the baby the suction will also separate the appendages from the main body of the fetus, drawing them into a container. This is the most common method of abortion.

Dilation and Curettage (D&C)

This method of extraction involves dilation of the cervix. A curette or looped shaped knife is used to dismember the body of the baby. Pieces are then removed through the cervix by way of a suction tube.

Medically accurate illustration of D&C abortion. Due to the nature of the procedure, image may seem graphic.

Dilation and Evacuation

The cervix is dilated with the use of laminaire insets. Specially designed tools are used to dismember the body of the baby and to crush the baby's skull. No fetal anesthetic is used. All of the dissected and crushed parts are removed using ring forceps. This method is used up to 18 weeks gestation.

Medically accurate illustration of D&E abortion. Due to the nature of the procedure, image may seem graphic.

Saline Injection

Although outlawed in some countries because of its risk to the mother, this procedure has been used in Canada after the forth month of pregnancy. A concentrated salt solution is injected into the amniotic sac surrounding the baby. The baby inhales and swallows the solution, has convulsions, and dies one to two hours later from salt poisoning dehydration and hemorrhage of the internal organs. The mother is induced into labour. A dead or dying baby is delivered within 48 hours.

Prostaglandin Abortion

Prostaglandins are hormones that induce labour. They are injected into the amniotic sac surrounding the baby or given in vaginal suppository form. The mother then goes into labour, giving birth to a child either dead or too young to survive. Sometimes poisonous salts are injected with the prostaglandins into the amniotic sac to kill the baby.

Hysterotomy Abortion

Like a caesarean section, the abdomen and the womb are opened surgically. In the hysterotomy, however, the baby who is lifted out is usually too young to survive without immediate medical treatment. The baby is simply put aside to die.

Partial Birth Abortion

This procedure involves birthing an almost full-term baby feet first, in the breech position. When only the baby's head is left in the birth canal, the body is turned so that the head is face down. Surgical scissors are inserted into the back of the scull, and a suction apparatus is passed through the hole. The baby's brains are suctioned out of its head, collapsing the scull. Then the dead baby is fully removed from its mother’s body.

Effects of Surgical Abortion

Short Term

• Hemorrhage-
  Due to blood loss, the patient may need transfusions.
• Infection-
  Because parts of the baby may be left inside of the uterus or because of the lack of sterile conditions in the operating room, tubule infection with subsequent sterility can occur.
• Damaged Cervix-
  Instruments used to stretch open the cervix during an abortion procedure can damage it. Miscarriage and premature delivery of future pregnancies may result.
• Perforation of the Uterus-
  The curette can puncture the uterus. This causes peritonitis and can necessitate removal of the uterus, making a woman unable to have more children.
• Perforation of the Bowel-
  Punctures in the bowel can result from the use of abortion instruments, requiring a bowel resection.

Long Term

• Stillborn and Handicapped Babies-
  Low birth weight and preterm birth are leading causes of infant mortality and the rates of both have increased steadily since the mid-1980s. Studies link the increase in these complications to abortion. (Infant Mortality Statistics, 2005 Period Linked Birth/Infant Death Data Set," Vol. 57, No. 2, National Vital Statistics Report.)
• Miscarriages-
  Women who have had abortions experience miscarriages at a 35% higher rate than controls.
• Premature Births-
  After multiple abortions, the risk of delivering a premature baby doubles and in some cases even triples.
• Ectopic Pregnancies-
  Scar tissue and damage to the fallopian tubes from previous abortion can increase the risk of ectopic pregnancy. In this pregnancy, the baby develops in the mother’s fallopian tube. It is a condition that significantly increases the risk of death to the mother. Surgery must ensue to remove the growing fetus from the fallopian tube in order to preserve the mother’s life. The baby is usually too young to survive; however, there is never intent to kill, nor is it ever medically necessary to do so in order to preserve the mother’s life. The baby dies of natural causes.
• Breast Cancer-
  For years medical studies and publications have shown that there may be a link between breast cancer and abortion; this is now a proven fact. Research consistently shows that a woman's first full pregnancy causes hormonal changes which permanently alter the structure of the breast. A pregnancy ending in birth greatly reduces the risk of breast cancer. A premature termination of a first pregnancy interrupts this process. The breast cells are left suspended in a transitional state. Cells in this state face an exceptionally high risk of becoming cancerous.

To learn more about abortion and women’s health please go to our "Women’s Health" section of the web-site.

Images of aborted babies

Images of aborted babies are real and disturbing. Signal Hill has chosen to not show these photographic images. Other organizations depict images of aborted babies.

However, in order to remain true to our mission of providing accurate and objective information on abortion, the following links are medically correct illustrations of the two most common surgical abortion procedures performed in Canada. These pictures are developed by medical illustrators at Nucleus Communications Inc. in collaboration with medical doctors. (The images obtained through Nucleus Communications, Inc. may only be reproduced with their permission.)

These images are no longer available.

Suction & Curettage Abortion
* Stats Canada reported over 70,772 of these abortions for 2005.

Dilation & Evacuation Abortion
*Stats Canada reported over 7,067 of these abortions for 2005.

For more information on this subject call 1-877-7SIGNAL.

We invite you to view this youtube video of incredible National Geographic images that use 3D imaging to show babies growing in the womb.