During the second trimester of
pregnancy (14-22 weeks since your last menstrual period), abortions are
performed as two- or three-day outpatient procedures, known as
"D&E" (dilation and evacuation). On the first day (or two)
you will meet with a health educator and a doctor in our office. On the
final day, you will meet the doctor in the hospital operating room.
It is natural to wonder, "What will happen during
my visit?" We hope the following will prepare you for what to expect.
Your first visit(s) will take 1½ to 2 hours. Your final visit will take
4-5 hours.
DAY 1: Your Pre-Operative Appointment
Reception Area
When you check in for your appointment, the receptionist
will notify us that you have arrived. The Comprehensive Women's Health
Center is integrated into the general clinic practice; women are not
identified in the reception area as desiring pregnancy termination and
there are no signs advertising our clinic. This ensures the privacy and
safety of our patients and staff.
5 minutes
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Health Education
Shortly after you arrive, one of our female health
educators will bring you to a private room. At this time, we will
collect payment and give you some paperwork to complete, including a
medical history form. You will discuss and learn about pregnancy
options, the abortion procedure, and various birth control methods. You
may remain fully dressed for this part of your appointment. The health
educator will take your blood pressure, pulse, and weight. If you brought
a support person with you, s/he may accompany you during the health
education.
15 to 20 minutes
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Meeting with the Doctor
After your conversation with the health educator, you
will meet the doctor. Our physicians are obstetrician-gynecologists with
specialized training and interest in abortion provision and family
planning. The doctor will review your medical history, perform an
ultrasound exam to determine your pregnancy's gestation, and address any
questions or concerns you may have.
20 minutes
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Preparing Your Cervix
After you have consented to the procedure, the doctor
will begin the abortion process by (1) inserting a speculum to view inside
your vagina; (2) cleaning your vagina and cervix (the tight opening to
your uterus) with gauze soaked in soap; (3) apply numbing medication to
your cervix; and (4) inserting dilating (widening) laminaria into your
cervix. Laminaria are thin sticks made from a special seaweed material
that widen as they absorb moisture from your body. The laminaria will stay
in your cervix overnight and will prepare your body for the surgical
procedure the next day. You may feel some cramping while the laminaria are
in your cervix.
20 minutes
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Going Home
You will be given detailed instructions on how to take
care of your body overnight and how to prepare for tomorrow's procedure.
15 minutes
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DAY 2 (Friday): Your Surgical Appointment
You will register at the hospital reception area. You
will then meet the doctor at the hospital operating room. You will receive
anesthesia medicine through an IV in your arm. The anesthesia will make
you very relaxed and sleepy. When you are well relaxed, the doctor will
remove the laminaria and will use suction and instruments to empty your
uterus. When you wake up, you won't remember the procedure.
After the procedure, nurses will monitor you for two
hours as you wake up. You will probably have some cramping and spotting;
we will provide you with a heat pack and a maxi-pad for your recovery and
ride home. You will be given instructions on how to take care of your body
after your abortion, antibiotics to prevent infection, and a prescription
for birth control if you desire it. If you are terminating due to
fetal anomaly, we can arrange for our perinatal loss nurse specialist to
contact you.
You MUST have a ride home. You may take a taxi home only
if you have someone to accompany you. You should go home, rest, and let
the medications wear off. You should be able to return to normal
activities, such as work and school, the next day.
4-5 hours
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Follow-up Visits
Unless you are experiencing complications related to
your abortion, you do not need to visit our office again. We recommend
that you make an appointment to see your regular physician for an annual
pap smear, physical/gynecologic exam, and birth control refill requests.
Coming soon: "Frequently Asked Questions about
Second-Trimester Surgical Abortion". E-mail us with your questions and
we'll add them to the site!
Comprehensive
Women's Health Center
