Surgical Abortion – Second Trimester 12 to 21.6 Weeks
Our Process to Prepare You
When you arrive at Philadelphia Women’s Center, you will be treated with compassion and respect while receiving the highest quality, individualized medical care. Your service will include a series of pre-operative assessments with medical and counseling staff.
You will receive the following care as we prepare you for your procedure:
- Ultrasound – The ultrasound exam is used to measure the size of your pregnancy and determine how far along in the pregnancy you are.
- Lab testing and vital signs – Blood work is completed in order to determine your Rh factor (the positive or negative of your blood type) and your hemoglobin level (the level of iron in your blood). Your blood pressure will also be measured.
- History and Physical – Your medical history and current physical state will be reviewed, and birth control options will be discussed.
- Counseling – You have an opportunity to meet in private with a counselor or health advocate to address your questions, concerns and feelings about pregnancy and the procedure.
After your pre-operative assessment has been completed, you will be prepared for your surgery and escorted to the operating room.
At Philadelphia Women’s Center, a second trimester abortion in our Pennsylvania clinic takes place from about 12 weeks from the first day of the last menstrual period (LMP) through 21 weeks and 6 days LMP. During a second trimester abortion your cervix (the opening to your uterus) must be dilated (opened) further than for a first trimester abortion. Depending on where you are in the pregnancy and your medical history, this dilation may take anywhere from an hour up to overnight before your surgical procedure. A second visit to the clinic may be required to complete your procedure. In general, earlier second trimester abortions require a one day procedure and later second trimester abortions will require a two day procedure. Whether you require a one day or two day procedure will be determined by your medical team.
A second trimester abortion begins by dilating (opening) your cervix. This is accomplished through the administration of medication called misoprostol (Cytotec), or by using special dilators, called osmotic dilators, such as laminaria or Dilapan. Your physican may also choose to administer a combination of these treatments.
Misoprostal (Cytotec) is given to relax your cervix so that the physician can dilate it easily and without damaging the muscle. It may be delivered to you one of three ways: orally by swallowing pills; buccally, by placing the pills between your cheek and gums, or vaginally.
Laminaria or Dilapan may be necessary to complete the dilation. Both laminaria and Dilapan are thin rods that are inserted into your cervix by the physician and, over the course of several hours or overnight they slowly absorb the moisture in your body and slowly expand, which opens up the cervix. Laminaria are made of sterilized seaweed and Dilapan are made of a synthetic (man-made) material.
When the dilation of your cervix is complete you will be taken to the operating room, and a Certified Registered Nurse Anesthetist (CRNA) will administer IV sedation. The surgery will begin when the physician inserts a speculum into your vagina in order to view your cervix. If necessary, the physician will then dilate (open) your cervix more by inserting thin, metal rods, one by one, into the opening of the cervix. These rods, also called dilators, gradually increase in width. The physician will then use surgical instruments and vacuum aspiration (suction) to remove your pregnancy. The surgery usually takes approximately 10 to 20 minutes. After your surgery, you will be monitored in our recovery room until you are medically cleared to go home, usually about 45 minutes.
Because some 2nd trimester abortions procedures require IV sedation, you must make arrangements for someone to drive you to and from Philadelphia Women’s Center.
Click here for a copy of our 1 day procedure instructions [PWC 1st Trimester Surgical Forms] and 1-day discharge instructions [Post-Op Pamphlet]. Click the following two links for a copy of our 2 day procedure instructions [PWC 2nd Trimester Surgical Forms] and [2day Discharge Instructions – day 1].