Abortion Procedures in the First, Second, and Third Trimester

Many women with difficult circumstances see abortion as their only option when it comes to an unexpected pregnancy. However, before you move forward with this choice, you should educate yourself about the different types of abortion and how each of them is performed. Not all abortion options are the same.

Learn more about your choices and options below, then give Hope Family Care Center a call to schedule a free and confidential consultation. We’re here to process through all of your questions and concerns with you.

541-386-1050 - Hood River, OR

541-296-0650 - The Dalles, OR


Are You Really Pregnant?

The first thing you need to know when thinking about your pregnancy options is if you’re really pregnant at all. You also need to know how far along your pregnancy is in weeks. The age of your pregnancy determines what options are available to you and how you can proceed.

At Hope Family Care Center, we can help you answer both questions. We provide free and confidential pregnancy testing and referals to local physicians for free verification ultrasounds to tell you with certainty whether you’re pregnant and how far along you are. This is the only way to be sure and to make a fully informed decision about your pregnancy.


Abortion Procedures in

the First Trimester

If you do decide on abortion early on, there are several abortion methods available in the first trimester:

RU486, Mifepristone: (Abortion Pill)


RU486, commonly known as mifepristone or the “Abortion Pill,” is a common abortion procedure. RU486 is only approved for use in women up to 70 days after the first day of their last period.

This abortion method usually takes three office visits. On the first visit, you will be given pills to terminate your pregnancy. On the second visit, you will be given another drug named misoprostol, which causes cramping and uterine contractions that expel the embryo from your body. Finally, you will need to get an ultrasound at a third appointment to verify that the procedure was successful.

Manual Vacuum Aspiration

Unlike RU486, Manual Vacuum Aspiration is a surgical abortion method that is immediately effective but also much more invasive. MVA can only be performed early in your pregnancy - typically within the first 12 weeks of your pregnancy.

In this procedure, a long, thin tube is inserted into your uterus. The doctor attaches a syringe to the end of the tube and suctions the embryo out. MVA can cause discomfort, cramping and bleeding. You may also need a second appointment for ultrasound verification that your pregnancy was terminated. Most Manual Vacuum Aspiration procedures only take 10 to 15 minutes, but appointments can last up to two hours to allow for monitoring and recovery.

Abortion Procedures in the Second and Third Trimesters

These abortion methods are generally reserved for when your pregnancy is further along and more advanced. They require significantly more preparation and are more invasive and expensive.

Suction and Curettage

Suction and Curettage is the most common surgical abortion procedure. It can be performed later into your pregnancy than MVA or RU486.

First, the doctor will manually open your cervix using a device called a tenaculum and several absorbent rods. This must be done in order to allow the parts of the developing fetus to pass through. Opening the cervix can be painful, so most doctors will use local or general anesthetics to prevent extreme discomfort. After the doctor opens your cervix, he or she will insert a hard plastic tube into your uterus, and then connect this tube to a suction machine. The suction pulls the fetus’ body apart and out of your uterus. The doctor may also use a curette - a thin, loop-shaped knife - to scrape the fetus and fetal parts out of the uterus.

The procedure may take as little as 15 minutes, but you may need to spend several hours at the clinic for observation and recovery. You may also need to take antibiotics after the procedure to prevent infection. Suction and Curettage also commonly causes cramps, bleeding, and abdominal tenderness for several days after the procedure.


Dilation and Evacuation

Dilation and Evacuation is one of the most involved and invasive surgical abortion procedures. Because this procedure is only used later in your pregnancy, it can have several extreme side effects. It also takes up to three days to complete and may require several follow-up visits to make sure you are healthy afterward.

Dilation and Evacuation (or D&E) can be performed up to 24 weeks, or approximately six months, after your last period. At this point in pregnancy, your fetus will be too large for a suction machine to function properly. As a result, your doctor will need to first dilate your cervix extensively. One method for doing this is using thin, absorbent rods that expand over time. These rods are inserted into your cervix one or two days before your abortion procedure, where they are allowed to swell and dilate your cervix.

On the day of your procedure, your doctor will first give you a local or general anesthetic to prevent discomfort. Then he or she will use a tenaculum and cone-shaped rods to further dilate your cervix. Once your cervix is stretched open, the doctor will use a suction tube, a curette, and sometimes forceps to remove the fetus from your uterus.

In more advanced pregnancies, your doctor may use forceps or a suction device to evacuate the cranium of your fetus and implode its skull, easing removal. D&E procedures can take 15 to 30 minutes to complete, and require several hours of recovery afterward. They also commonly result in nausea, bleeding, and cramping for days or weeks after the procedure. In some cases D&E can result in damage to your uterine lining or cervix, which may make it harder for you to become pregnant in the future.

Make Sure You’re Informed


Abortion isn’t a simple, risk-free procedure. All abortion methods take time and may have serious side effects. If you want to learn more about these procedures and your other pregnancy options, call Hope Family Care Center today or stop by one of our clinics any time.

541-386-1050 - Hood River, OR

541-296-0650 - The Dalles, OR

Additional Resources:

Surgical Abortion Information: https://medlineplus.gov/ency/article/002912.htm

Medical Abortion Information: https://medlineplus.gov/ency/article/007382.htm

Elizabeth Hartley