Dilation and Evacuation (D&E)
This is a procedure generally used after 12 weeks of pregnancy. The procedure will generally be done on an outpatient basis but may sometimes require hospitalization. The physician will often use ultrasound to determine how far along you are in your pregnancy.
To prepare for the procedure, the physician will enlarge (dilate) the cervix (the opening to the uterus). This may be done over a period of several hours by inserting a small rod or sponge into the cervix which swells as the sponge absorbs moisture. The doctor may choose to enlarge the cervix right before the abortion by inserting and withdrawing larger and larger smooth metal rods until the cervix has been opened to the necessary size.
Most women experience some pain, so the physician will give you a pain-killer, either locally by shots in the area of the cervix or by a general anesthetic.
The uterus may be scraped with a curette (a sharp, spoon-like instrument). The fetus and placenta are extracted, using forceps or other instruments. This procedure will take approximately 30 minutes.
You will remain for one to several hours for observation. If you are not experiencing heavy bleeding or other complications you will be allowed to leave.
Risks and Complications
Following is a list of some of the risks which in the past have been associated with this type of abortion procedure. Not all of these risks may pertain to any one patient. This procedure should be discussed with your physician for information regarding risks which may apply to you.
Complications may include infection, heavy bleeding, and perforation of the uterus (a hole or tear in the wall of the womb). The risks of uterine perforation and laceration are slightly greater at this stage of pregnancy than they are in an abortion done earlier due to the larger fetus and thinner uterine walls.
Other complications could include cervical incompetence (a condition in which the cervix opens up too early, increasing the risk of a miscarriage in future pregnancies) and injury to the cervix.
Repeated abortions could increase the possibility of premature delivery or a low birth weight infant in future pregnancies.
While rare, some women may experience depression, feelings of guilt, anger, sleep disturbance, or loss of interest in work or sex, as a result of an abortion. If these symptoms occur and are intense or persistent, professional help is recommended.
Maternal death occurs in less than one of every 100,000 abortions.
Risks and Complications associated with Pregnancy and Delivery
For every 100 hospitalizations for delivery there are approximately 22 hospitalizations for pregnancy complications. Some of the complications of pregnancy which may result in death or hospitalization include heavy bleeding or infection, preeclampsia and eclampsia (characterized by seizures, swelling and high blood pressure), blood clots, ectopic pregnancies (fertilized eggs growing outside the womb), miscarriage, death of the fetus or newborn, premature labor, urinary tract infection, excessive vomiting during pregnancy, and diabetes.
Maternal death occurs approximately eight times out of every 100,000 pregnancies.
Many services may be available to you should you choose to continue your pregnancy. You should contact your local health department, the Michigan Department of Community Health, or your county Family Independence Agency office if you would like to know about services available in your area.
If you would like information about services available through public agencies to assist you in placing your child in an adoptive or foster home, you should contact your county Family Independence Agency office. Or, contact a local private adoption agency. Check the yellow pages of your local phone book under the listings for adoption or pregnancy services.
If you experience subsequent adverse psychological effects from your abortion, you may contact your community mental health office, your local public health office or your county Family Independence Agency office for assistance in obtaining counseling.
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