At the Akron Women’s Medical Group, second trimester surgical abortions are provided for women who are between 13 weeks and 19 weeks pregnant. There are several steps that you will take to ensure your safety and well-being.
Ohio law requires a woman to meet privately with the physician at least 24 hours before an abortion procedure. So on day one, the pregnancy verification, pre-operative evaluation and counseling are performed and you speak with the physician. The abortion procedure can be scheduled the next day or as soon after as possible.
Every patient will have an ultrasound. This advanced diagnostic technique is used 3 weeks or more after the last menstrual period to determine the correct length of the pregnancy. It is an important procedure that improves the accuracy of the physician's preoperative diagnosis and further assures the safety of the patient and the procedure.
Further laboratory work is completed to screen all potential patients. Routine laboratory analysis includes hematocrit testing, urinalysis, Rh typing and tissue pathology. Patients with Rh-negative blood type will receive an injection of Rhogam which is administered for an additional charge.
With the completion of the laboratory testing, the medical staff will evaluate your health. This includes a review of your medical history, a physical exam and a pre-screening for anesthesia risks. Our facility is concerned with the success of your termination and we want to make sure that your current health and size of your pregnancy will allow the safest of procedures.
Individual counseling supplies important information and support for patients scheduled for a pregnancy termination. Each woman receives personal confidential attention and care throughout her visit. All counseling is private and confidential. Detailed information is provided about the abortion and birth control. Patient educators are there to help with feelings and concerns related to the termination and each patient is treated with warmth, understanding, and sensitivity.
DILATION AND EXTRACTION PROCEDURE
The Akron Women’s Medical Group performs abortions up to 21 weeks of pregnancy by the dilation and extraction method, the most common method of abortion available today. The procedure involves the gradual widening of the cervix followed by the removal of the uterine contents with forceps and suction.
On day one you will receive pre-op testing, counseling, and your ultrasound. You then return 24 hours or more later for your first day of your procedure.
The first day of your two day procedure you will have laminaria inserted into your cervix to help soften and dilate your cervix. This will help ensure that the procedure will go safely and easily for you and the physician. You will be given a local anesthetic to numb your cervix and then laminaria will be inserted. If you are between 20-21 weeks pregnant you will receive an injection of Digoxin through your abdomen to the fetus to stop the heart beat. You will go home or to your hotel with pain pills and our 24 hour number for you to call if you have any questions or concerns. You will also be given an antibiotic to take with your last meal of the day. This is to insure that you do not get a infection. After midnight we do not want you to eat, drink, smoke or chew anything except for the pain pills if you need them. You will be told what time to return to the clinic to finish your procedure.
A patient who chooses to have sedation anesthesia will also have medications given through an IV. Sedation anesthesia is conscious (“awake”) sedation. Patients are relatively pain-free and tranquil and yet still aware of their surroundings. Most of the time, a patient doesn’t remember what happened during the abortion procedure.
A patient choosing a local anesthetic is given an injection, which numbs the cervix. A Medical Assistant is present during the procedure and the doctor will be explaining what he/she is doing so that there are "no surprises".
Patients with Rh-negative blood type will receive an injection of Rhogam which is administered for an additional charge. (See Fee Schedule)
WHAT TO EXPECT AFTERWARDS
Your aftercare in the three weeks following an abortion is very important. Please carefully read the information below; it will help to insure an easy and worry-free recovery. You will receive additional information at the time of your visit.
It is perfectly normal to experience some bleeding after a pregnancy termination. Some women have bleeding similar to a normal period and others bleed very little or not at all. After your procedure, you will be taking a medication called methergine/ergonovine or Cytotec for a few days. This medication helps to control bleeding and contract the uterus. Your first normal period following the abortion should come in four to six weeks.
We ask that you monitor your bleeding for three days after your abortion. If your bleeding becomes excessive and you begin to saturate a full size pad within one hour or if you are passing clots of blood larger than the size of a quarter, you should contact us by calling our emergency telephone number. This number will be given to you during your visit and provides twenty-four hour emergency access.
It is not unusual to experience cramping after your procedure. You may take any non-aspirin pain reliever or a pain reliever that is prescribed by us to relieve your discomfort. Avoid aspirin as it may thin the blood and cause heavier bleeding.
Breast Soreness and Mood Changes
As your hormones shift to the non-pregnant state, you may feel a slight "down" or "blue" period. These feelings should subside in a few days. A small percentage of women experience some increased breast tenderness for a few days after the procedure and some women produce milk. This is best remedied by wearing a tight-fitting bra for 24-48 hours, applying ice to the breasts, refrain from touching the breasts and taking hot showers. Milk production should diminish in a few days.
In order to avoid infection and to ensure a healthy recovery, it is most important that you completely take your antibiotic prescription.
Also, there are some restrictions that you must stick to for three weeks after your abortion and until you have received a follow-up exam:
1. Abstain from sexual intercourse
2. Do not use tampons
3. No douching, tub baths or swimming
4. Avoid strenuous activities such as heavy lifting (lifting anything over fifteen pounds) and all exercise.