Abortions performed during the second trimester of pregnancy are called dilation and evacuation, also referred to as a D&E.

Before the Procedure

Due to the bigger size of the baby at this stage of pregnancy, more preparation of the cervix is required. Laminaria sticks may be inserted into the opening of the cervix and left in overnight. Women may also be given misoprostol, either by mouth or through the vagina, to soften the cervix and uterus. A pelvic exam and ultrasound are performed prior to the D&E.

The Procedure

The procedure for a D&E begins like a suction abortion: the cervix is numbed and metal rods are used for further dilation. Some abortionist may then administer a shot into the woman’s abdomen, depending on how far along the pregnancy is, that will stop the baby’s heart before it is removed from the uterus. Next, forceps are used to dismember the baby so it can be removed from the uterus. Finally, a curette is used to scrape the sides of the uterus to ensure all the baby’s body parts have been removed. Abortionists may not use an ultrasound to guide them through a D&E. The baby’s tissue will be examined to ensure all body parts have been removed from the uterus.

A D&E is typically completed in 10-30 minutes.

After the Procedure

After a D&E is completed, the woman will be observed in a recovery room for about 30-60 minutes and will be given antibiotics. Women will experience bleeding and cramping after a D&E and should plan to rest for the following few days. Bleeding can last up to two weeks after the abortion. A follow up visit is typically scheduled 2 weeks after an abortion.

Risks

All surgical procedures come with possible risks and complications. Some potential complications include pelvic infection, excessive bleeding, cervical injury, incomplete abortion, perforation of the uterus, complications due to the anesthetic and ongoing pregnancy.

Contact your doctor immediately if you have any of the following symptoms:

• Soak through 2 maxi pads per hour for 2 hours
• Worsening abdominal pain
• Fever lasting more than one day

https://www.webmd.com/women/abortion-procedures#2-4

https://www.plannedparenthood.org/learn/abortion/in-clinic-abortion-procedures/what-happens-during-an-in-clinic-abortion

http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf