 Suction Curettage--This
is the most common method for first trimester abortions. In a suction abortion,
the abortionist dilates the cervix with mechanical dilators or laminaria, a
porous substance that is inserted hours or a day before the abortion and that
gradually dilates the cervix by soaking up fluid. Next, the abortionist
attaches a cannula to a vacuum source, and inserts the cannula into the uterus.
(The cannula is necessarily wider in diameter, because of the larger body parts,
than the straw like cannula used in very early abortions.) The suction created
by the vacuum tears the fetus' (unborn baby's) body apart and detaches the
placenta from the wall of the uterus, sucking the fetal parts and placenta into
a collecting bottle. If the fetus' body parts are too large and stop up the
suction tubing, the abortionist must remove the remaining parts with instruments.
The
abortionist dilates (opens) the cervix with mechanical dilators or laminaria (a
porous substance that is typically inserted a day before the abortion).
Overnight the laminaria gradually dilates the cervix by soaking up fluid. The
day of the abortion the abortionist attaches tubing to a suction machine, and
inserts the tubing into the uterus, The suction created by the vacuum pulls the
unborn baby’s body apart and detaches the placenta from the wall of the uterus,
sucking the fetal parts and placenta into a collection bottle. (1)
Great care must be taken to prevent the uterus from being punctured during
this procedure, which may cause hemorrhage and necessitate further surgery. Also, infection can easily develop if any fetal or
placental tissue is left behind in the uterus. This is the most frequent
post-abortion complication.
Complications
-
Perforation of the uterus by instruments; serous bowel damage can occur if suction is
applied after perforation and the intestines are sucked through the
perforation.
-
Hemorrhage and shock,
especially if the
uterine artery is lacerated. If the abortionist doesn’t realize quickly
enough that the artery is cut, death can soon follow.
-
Cervical tearing and laceration
from
instruments used to dilate the cervix and enter the uterus. The risk of
cervical damage is heightened when the abortionist has failed to dilate the
cervix properly, which could be caused by unwillingness to use laminaria (a
much slower process tat takes hours or a day to dilate the cervix) instead of
mechanical dilators, a misjudgment of the length of gestation, or hasty and
careless procedure. Most first-trimester abortions are performed in
freestanding clinics in one visit, not two visits as would be required when
the cervix is dilated overnight with laminaria.
-
Failure to
recognize an ectopic pregnancy.
This could lead to the disastrous
complications of hemorrhage and resulting
infertility
or death, if treatment is not provided in time.}
-
Post-abortal
syndrome,
also known as uterine atony, referring to an enlarged, tender,
and boggy uterus retaining blood clots. This condition manifests itself
within several hours after an abortion, and if not treated promptly with
reaspiration (resuctioning) and medication, can lead to more serious
complications, such as sepsis, excessive blood loss, and the need for major
surgery, including possible hysterectomy. Many abortionist do not keep a
first-trimester abortion patient in the recovery room long enough to observe,
diagnose, and treat this condition before she leaves.
-
Infection,
local and systemic (sepsis)
1.
Warren Hern, Abortion Practices (Philadelphia: J.B. Lippincott Company, 1990, pp.
108-117.
|
