Second trimester surgical abortions are performed for various reasons including elective abortion, miscarriage management and for pregnancy termination due to fetal anomalies and/or maternal health conditions. During the second trimester, 15 to 23 weeks after your last menstrual period, abortions are typically performed over a two-day period but don’t require an overnight stay in the hospital. These procedures are known as dilation and evacuation.
Professional Brooklyn Gynecological Services specializes in second trimester termination of pregnancy. In general, this procedure requires a two-day visit to our office. A second trimester surgical abortion is performed in a similar manner as a first trimester abortion. The patient’s cervix must be dilated, or opened, several hours or days prior to surgery. Since the dilation process is different for every woman, a second trimester abortion surgery may be performed on the same day as the dilation or up to one or two days after depending on your dilation progress. If our doctors determine that the 2-day abortion procedure is best for you, it will be imperative that you are able to stay in the area and commit to returning the next day. The first day, we take your medical history, discuss your procedure and after-care, and begin the preparation for the overnight dilation of your cervix. When you return the next day, your abortion procedure will be completed.
What to expect during your visit (Pre-Operative Assessment):
In a private exam room, you will learn more about your procedure, undergo an exam and an ultrasound, and receive oral medications that may include a pain reliever. Laminaria is required for overnight dilation. If you’re given medications, it’s important that you follow the instructions provided by your doctor. Cervical softening and dilation is performed with medication and small dilating sticks, called Laminaria or Dilapan, that may be placed in the cervix, depending on the term of the pregnancy and your medical history. Laminaria are thin sticks made from a special seaweed material that widen as they absorb moisture from your body. Dilapan are synthetic sticks that work in the same way. The Laminaria will stay in your cervix overnight and prepare your body for the next day’s surgical procedure. During the insertion the cervix is numbed with a local anesthetic and the procedure typically takes about 5-10 minutes. After the procedure, you will rest for a few minutes. You may get dressed when you feel able. We will give you detailed instructions on how to take care of your body overnight and how to prepare for the next day’s procedure.
What happens next?
Depending on how long it takes for the dilation process to complete, if necessary the next day you will return to our office for the completion of the procedure. Medication will be administered intravenously (IV) in your arm to induce anesthesia or loss of consciousness. Most women fall asleep and don’t remember the procedure. After you’re well relaxed, the doctor will remove the Laminaria and use suction and gynecological instruments to empty your uterus, with ultrasound guidance. You’ll be in the operating room for about an hour but the procedure may take from 15 to 45 minutes. All surgical abortion procedures are performed in our clean, private surgical rooms and each patient is attended to by our caring health professionals.
What to expect after the procedure:
In the recovery room our nurses will monitor you for about 2 hours. You may experience mild to moderate cramping and bleeding. Before you return home you will receive antibiotics to prevent infection and instructions for post-surgery care. The procedure and recovery period typically takes about 5 hours. Please make arrangements for someone to take you home. Most women can resume normal activities within a few days. You may experience bleeding & cramping for up to 2 weeks following the procedure. Blood-tinged discharge is common as bleeding slows and discharge may appear as yellow or brown and may have a sour odor. Take Ibuprofen or Tylenol for cramps and use sanitary pads only for bleeding, no tampons. Do not douche or engage in vaginal intercourse for at least 2 weeks after. We encourage our patients to return for a follow-up visit 2 weeks following the procedure.
Safety & Effectiveness:
Second trimester surgical abortions are one of the safest medical procedures. Although rare, possible complications include a blood clot in the uterus that can cause pain or require a repeat aspiration, an infection, which is generally easily identified and treated, a tear in the cervix that can be easily repaired with suture, or retained pregnancy tissue requiring repeat aspiration.
Professional Brooklyn Gynecological Services promises you will be treated with the dignity & respect you deserve in a caring, clean and comfortable environment.