Second Trimester Labor Induction Abortion

This procedure, also called a medical induction abortion, is mostly used after 16 weeks of pregnancy. It involves using one or more medications to start labor and delivery of the fetus. This process usually requires a hospital stay of two to three days, but the length of stay can vary.  This type of abortion is most often used in pregnancies with birth defects or pregnancy complications.

Sometimes the process begins with an injection to stop the fetal heartbeat.  The skin on your abdomen is numbed with a pain-killer, and then a needle is used to inject a medication (digoxin or potassium chloride) through your abdomen into the fluid around the fetus or the fetus to stop the heartbeat.  You should discuss the risks and benefits of this step with your doctor.

You will then be given medication to start contractions and to cause your cervix (the opening to your uterus) to dilate (open). One medication (Misoprostol) can be taken by mouth or put in the vagina. This type of abortion usually requires several doses of this medication over several hours.  Side effects of this medication can include abdominal pain, nausea, vomiting, diarrhea, fever, and chills.  Another medication (Pitocin) may be used to cause contractions and opening of your cervix.  This medication is given in a vein (IV), usually over a period of several hours.  Some women receive both medications at some stages during the induction abortion. 

Labor pains usually start within a few hours of receiving medication.  Your doctor should tell you about ways to manage pain during an induction abortion.  These can include relaxation techniques, oral medications or medications injected into a large muscle or a vein. Some doctors may offer you an epidural. You should discuss the types of pain management and their risks with your doctor before you make your choice.

Delivery of the fetus and placenta usually occurs within 24 hours but can be longer.  The length of time you stay in the hospital after the induction is complete will depend on your health and other factors.  Some women stay for a few hours and other women stay for 1-2 days.  You can discuss your likely length of stay with your doctor. 

Risks and Complications

Below are possible risks of this type of abortion.  Not all risks may apply to you. Talk with your doctor about what risks apply to you. 

Risks may include:  infection, heavy bleeding, a hole or tear in the wall of the uterus, injury to the cervix, or a failed induction.  If the induction is not successful, you may need to have a surgical procedure to complete the pregnancy termination.  Serious complications may require an additional surgery or being in the hospital. i

Having more than one abortion could increase the possibility of early delivery in a future pregnancy, having a low birth weight baby, or a condition in which the cervix opens up too early, increasing the risk of a miscarriage in a future pregnancy.

It is rare, but some women may have feelings of sadness, guilt, anger, trouble sleeping or doing daily activities after their abortion. These symptoms can also occur after the birth of a baby or after a miscarriage. Call your doctor or local community mental health, health department, or human services office for help if you have any of these symptoms that are strong or lasting. 

As with any medical procedure, death is a risk.  However death related to abortion occurs in less than one of every 100,000 abortions. ii

Risks and Complications associated with Pregnancy and Delivery

Most pregnancies are normal. Most women who have good care during pregnancy and delivery will give birth to a baby without problems. However, some women may have health conditions or pregnancy problems that may require special care or hospitalization during pregnancy. Just as there are risks with abortion, there are risks with continuing a pregnancy to full term.

Some of the pregnancy problems that may lead to hospitalization include a pregnancy growing outside the uterus (tubal pregnancy), miscarriage, excessive vomiting during pregnancy, urinary tract infection, heavy bleeding or infection, diabetes, preeclampsia and eclampsia (causing swelling, high blood pressure and possible seizures), blood clots, premature labor, death of the fetus, newborn or maternal death.

Maternal death occurs approximately 17 times out of every 100,000 live births in the U.S. iii

Available Services

Many services may be available to you should you choose to continue your pregnancy. You can contact your local health department, the Michigan Department of Health and Human Services, or your local county Department of Human Services office to learn about help in your community. 

If you would like information about adoption, contact your county Department of Human Services or a private adoption agency. 

i M. Paul, E.S. Lichtenberg, L. Borgatta, D.A. Grimes, P.G. Stubblefield, M.D.Creinin; Management of unintended and abnormal pregnancy: comprehensive Abortion Care. Wiley‐Blackwell, 2009, p 136.

ii M. Paul, E.S. Lichtenberg, L. Borgatta, D.A. Grimes, P.G. Stubblefield, M.D. Creinin; Management of Unintended  and Abnormal Pregnancy: Comprehensive Abortion Care. Wiley‐Blackwell, 2009, p. 225.

iii CDC Pregnancy Mortality Surveillance System, December 2016 https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html