[Note: Some of this information was taken from Abortion Facts]
Dilation and Curettage ("D&C"); intrauterine injection of hypertonic saline solution ("salting out"); hysterotomy; and prostaglandin infusion. None of these techniques is without risk to the mother.
Dilation and curettage is the technique most commonly used in first trimester abortions. The cervical muscle ring is first paralyzed and then stretched open. A curette, a loop-shaped steel knife, is then inserted into the uterus. The surgeon then scrapes the uterine wall, dismembering the developing child and scraping the placenta from its attachment on the wall of the uterus. Bleeding is usually profuse. A common first-trimester alternative is a vacuum aspiration or suction abortion. The principle is the same as the D & C. After the cervix has been stretched, a powerful suction tube is inserted into the uterus. The body of the developing child and the placenta are sucked into a jar, where smaller parts of the child's body are often still recognizable.
Even these early, first trimester abortions are not without significant hazards to the woman's health. In a study of 1182 legal abortions at an English teaching hospital, nearly 17 percent of the patients lost more than 500 milliliters of blood and 9.5 percent required transfusions. There were also cases of cervical laceration and perforated uteruses. Another study concluded that perforation of the uterus is an almost inevitable complication of induced abortion by vacuum aspiration or during any other form of dilation and curettage. Even so-called "menstrual extractions" or "lunch hour" abortions performed by vacuum aspiration within one to three weeks after failure to menstruate have been attended with complications: the woman's not being pregnant, the implanted ovum's being missed by the suction curette, and uterine perforation.
Second trimester abortions are often by salt poisoning. A long needle is inserted through the abdomen and a solution of concentrated salt is injected directly into the amniotic sac. The child breathes in the salt solution and is poisoned by it. The concentrated saline solution burns off the outer layer of the baby's skin and brain hemorrhages are frequent. It takes about one hour for the child to slowly die by this method. Approximately one day later the woman goes into labor and delivers a dead baby.
The salt poisoning technique is common in the United States in spite of its well-documented hazards. It was used by the Japanese after World War II but later abandoned because of maternal morbidity and mortality. Maternal deaths have been reported from accidental injection of the saline solution into the circulatory system, from acute kidney failure, from seepage through uterine puncture wounds into the abdominal cavity, and from infections. Other documented complications of saline abortions include fevers, cervical lacerations, serious disruptions of the blood coagulation mechanism, and hemorrhages.
1) Much of the information in this section is drawn from David N. Danforth, ed., Textbook of Obstetrics and Gynecology (New York: Harper and Rowe, 1971); Jack Pritchard and Paul McDonald, Williams' Obstetricks (New York: Appleton Century Crofts, 1976); C. Everett Koop, The Right to Live: The Right to Die (Wheaton, Ill.:Tyndale House, 1976); J.C. Willke, Handbook on Abortion (Cincinnati: Hayes, 1975)
2) J.A. Stallworthy et al., "Legal Abortion: A Critical Assessment of Its Risks," Lancet, December 4, 1976, p. 1245.
3) Peter J. Moberg, "Uterine Perforation in Connection with Vacuum Aspiration for Legal Abortion," International Journal of Gynaecology and Obstetrics 14 (1976):77.
4) Pritchard and McDonald, Williams' Obstetrics, p. 500.
5) Ibid., p. 504.
6) Danforth, Obstetrics and Gynecology, p. 354.
7) Pritchard and McDonald, Williams' Obstetrics, p. 505.
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