Second Trimester Procedural Abortion
Second trimester abortions require an extra day to accomplish the cervical dilation & evacuation (D&E) that is required.
If you’re considering a second trimester abortion, there are a few things you should know. The second trimester of pregnancy technically starts after the 13th week. The time between 12 to 15 weeks is a grey area. Depending on various factors, you will need a two day procedure as early as the 12th week, or you will not need a two day procedure until week 15. Dr. Seletz will review your medical history and share her thoughts during the consultation.
Your partner or a guest will have the ability to be with you during the consultation but if you’d prefer to be alone, that’s totally fine.
The second trimester abortion starts the same as the first trimester abortion. You’ll have a consultation with Dr. Seletz, give consent, and then receive an ultrasound and lab work. An IV will be put in where you’ll receive antibiotics, sedation, and local anesthesia on both days.
On the first day, the cervix is dilated and laminaria are inserted into the cervix. Laminaria are naturally occurring sticks of seaweed which have been sterilized. They absorb moisture from the body and gradually expand overnight to passively dilate and soften the cervix. If the pregnancy is greater than 18 weeks, our medical team will administer an injection into the fetus to cause the heart to stop. On the second day, the laminaria are removed and forceps as well as suction are used to remove the fetus and placenta. Dr. Seletz performs the removal under ultrasound guidance which greatly decreases any risk of a complication. Late second trimester surgical abortions, between 18-24 weeks of gestation, may require an additional day of cervical dilation.
On both days you will rest in a private recovery room with your guest. We will give you medications to take home. Dr. Seletz will personally check on you before you leave and will be available by phone afterwards. You need a driver to take you home on both days. Plan to be in the facility about 2 hours the first day and 3 hours the final day.
Complications The risks of an abortion in the second trimester are inherently greater than those of the first trimester. Dr Seletz has more than 25 years of experience performing abortions in the second and even in the third trimester. Our rates of short term complications such as infection, bleeding, retained tissue, and injury are very low. In addition, our rates of long term complications such as scar tissue in the uterus are also very low. We do not employ part-time physicians nor do we have any students participating in your care. We will send you a text message to come back in 6 weeks for an ultrasound of the uterus to make sure there is no scar tissue.
Fetal abnormality Dr Seletz is a specialist in late abortions for fetal abnormalities, genetic disorders, and for fetal death. She will coordinate your care with your OB and arrange genetic testing if necessary. She can arrange special disposition of the fetus such as cremation or burial if desired. If the fetus has died she will discuss any other available test to try to figure out the reason. You may want to schedule the consultation a day or two before starting the procedure if you need time to adjust to the loss of a wanted pregnancy.
How To Prepare
Eat a light meal about 2 hours before each appointment. You may continue to drink clear fluids until you arrive. Wear comfortable loose clothing and underwear that can hold a maxi pad. Have some ibuprofen and some maxi pads at home.
