TYPES OF ABORTIONS: PROCEDURES, TIMING, RISKS, AND MORE  

If you’ve just discovered you’re pregnant, and it’s not what you expected, you may be researching your options, including abortion.

Before developing your plan, it’s important to know the types of abortion procedures, at what stage of gestation each procedure can be performed, and the risks and side effects they may have. 

Little Way is here to provide this knowledge, which will equip you to make a well-informed decision about your next steps. If at any point you have questions or want to make an appointment, know that we are here for you.

Keep reading to learn more about first-trimester abortions, second-trimester abortions, and what to expect.  

FIRST-TRIMESTER ABORTION PROCEDURES 

The first trimester spans from conception to the end of week 12. During this period, abortion providers typically offer medical abortions or surgical abortion procedures.

What Is a Medical Abortion – AKA The Pill?  

A medical abortion, commonly known as the abortion pill, uses two medications: mifepristone and misoprostol. It is FDA-approved for use up to 10 weeks of pregnancy.[1]  The FDA requires the abortion medication to be prescribed and dispensed under the supervision of a qualified physician for your safety.

The first medication, mifepristone, interferes with progesterone receptors and prevents the pregnancy from developing. The second medication, misoprostol, causes the uterus to cramp, bleed, and expel the pregnancy.[1]

Mifepristone, the first medication, is typically taken in an abortion clinic. Misoprostol is taken 24 to 48 hours later at home.[1] The bleeding and cramping will begin between 2 to 24 hours after taking misoprostol.[2] Most women expel the pregnancy within that same timeframe.[3]

You will likely experience severe abdominal cramping, nausea, and heavy bleeding. Follow-up care may be needed if bleeding persists. Approximately 11% of women experience a serious adverse or life-threatening event—including sepsis, infection, hemorrhaging, and hospitalization.[4]

What Is Surgical Abortion – AKA Dilation and Curettage (D&C)?  

A dilation and curettage (D&C), also called vacuum aspiration abortion, is a surgical abortion which can be performed up to 14 weeks of pregnancy.[5]

Hours before or the day before the procedure, small instruments or a medication are used to open (dilate) the cervix. Misoprostol may be given to soften the cervix.[6]

During the procedure, the abortion provider will use a spoon-shaped device called a curette to scrape and remove tissue from the uterus. They will likely follow with a suction device to remove any remaining tissue that was missed. [6] 

SECOND-TRIMESTER ABORTION PROCEDURES  

The second trimester runs from week 13 to week 27. During this stage, dilation and evacuation (D&E) becomes the standard procedure due to the pregnancy’s advanced development.  

What Is Dilation and Evacuation (D&E)?  

A dilation and evacuation (D&E) is a surgical abortion most often performed in the second trimester.[7] It’s more complex than a D&C due to the fetus’ size and requires skilled providers.  

Here’s how a dilation and evacuation is performed:

  • Cervix Dilation: The day before, sponge-like sticks (laminaria) are inserted into the cervix, absorbing moisture to expand and gradually open the cervix. Medication may also be used overnight to soften the cervix.[7]  
  • Procedure: A cannula suctions out uterine contents, and forceps remove the remaining fetal parts.[7]  

D&E procedures are done under anesthesia. You may experience cramping and bleeding for up to two weeks. You will need a follow-up visit to ensure the abortion is complete. 

RISKS AND SIDE EFFECTS OF ABORTION 

Every abortion type—both medical and surgical—carries risks and side effects. Understanding these can help you weigh your options.  

Medical Abortion (The Pill) Side Effects and Risks  

After a medical abortion, expect vaginal bleeding and spotting for 9-16 days, though it can last 30 days or longer in some cases.[2] 

Other common side effects include[2]:

  • Abdominal cramping (from misoprostol)  
  • Headaches  
  • Nausea and vomiting  
  • Diarrhea and digestive discomfort  
  • Chills or mild fever  

Severe risks to watch for:  

  • Hemorrhaging: Bleeding that soaks two full-size pads per hour for 2+ hours requires immediate attention.[8]  
  • Incomplete Abortion: If tissue remains, emergency surgery may be needed to prevent infection.[9]  
  • Infection: Persistent fever, nausea, or vomiting beyond 24 hours post-misoprostol could indicate an infection, potentially requiring antibiotics or surgery.[2]  

A study by the Ethics and Public Policy Center found that 1 in 10 women experience a serious adverse or life-threatening event up to 45 days after a medical abortion—including sepsis, infection, hemorrhaging, and hospitalization.[4] 

Surgical Abortion Side Effects and Risks  

D&C and D&E procedures carry risks such as:  

  • Uterine Perforation: An instrument may accidentally puncture the uterus, possibly needing surgical repair.[10]
  • Asherman Syndrome: Scar tissue inside the uterus from repeated procedures can impact future fertility.[11]  
  • Pelvic Inflammatory Disease (PID): Bacteria introduced during surgery may cause infection in the reproductive tract.[12]  
  • Intense Pain: Studies show second-trimester abortions like D&E can be more painful than expected.[13]  

Mental Health/Emotional Side Effects and Risks

Following an abortion, the initial sense of relief can be followed by regret, anger, grief, and depression. Due to the number of women who have shared their struggles with us, Little Way now offers a post-abortive healing program.

OBTAINING AN ULTRASOUND BEFORE AN ABORTION 

It is extremely important to get an ultrasound prior to an abortion. Determining how far along you are will help you know which abortion options are available. An ultrasound can also determine pregnancy viability. If the pregnancy is likely to end in natural miscarriage, an abortion is not needed. At Little Way, an ultrasound is available at no cost to you and can provide a wealth of information about your pregnancy.

QUESTIONS ABOUT ABORTION IN LOUISVILLE, KY? GET ANSWERS AT LITTLE WAY. 

If you’re exploring abortion, you don’t have to navigate it alone. Little Way’s caring team provides free, confidential medical services, education, and support to help you make the best choice for your health and future.  

Call us at (502) 583-2151 or request an appointment today.   

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Little Way does not offer ongoing prenatal care, perform or refer for abortions, nor place for adoptions. We are a great first step.

Sources

  1. FDA. (2025, February 11). Questions and Answers on Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation?sm_guid=NTU1NzgyfDYzMDE1OTM2fC0xfGppbUBha2ZhbWlseS5vcmd8NTY4OTI4MXx8MHwwfDE5OTYwMDk4OHwxMDg2fDB8MHx8NTQ3NzI2fDA1
  2. U.S. National Library of Medicine. (2024, November 15). Mifepristone (Mifeprex). MedlinePlus. https://medlineplus.gov/druginfo/meds/a600042.html 
  3. Mifepristone (oral route). Mayo Clinic. (2025, February 1). https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123 
  4. Ethics & Public Policy Center. (2025, April 28). Insurance Data Reveals One in Ten Patients Experiences a Serious Adverse Event. https://eppc.org/publication/insurance-data-reveals-one-in-ten-patients-experiences-a-serious-adverse-event/
  5. Cleveland Clinic. (2024, February 9). Dilation and Curettage (D & C). https://my.clevelandclinic.org/health/procedures/dilation-and-curettage 
  6. Mayo Clinic. (2023, November 7). Dilation and curettage (D&C). https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910
  7. Cooper, D. B., & Menefee, G. W. (2023, May 7). Dilation and Curettage. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK568791/ 
  8. Danco Laboratories, LLC & FDA. (2016, March). Mifeprex Label. FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf
  9. Mayo Clinic. (2024, June 28). Medical Abortion. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687
  10. U.S. National Library of Medicine. (2024, April 5). Abortion – Surgical. MedlinePlus. https://medlineplus.gov/ency/article/002912.htm
  11. Mayo Clinic. (2024, July 6). Elective Abortion: Does it Affect Subsequent Pregnancies? https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/expert-answers/abortion/faq-20058551
  12. Mayo Clinic. (2022, April 30). Pelvic Inflammatory Disease (PID). https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
  13. Dzuba, I. G., Chandrasekaran, S., Fix, L., Blanchard, K., & King, E. (2022, May 12). Pain, Side Effects, and Abortion Experience Among People Seeking Abortion Care in the Second Trimester. Women’s Health Reports (New Rochelle, N.Y.). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9148646/

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