Third Trimester - 25 Weeks and Above

Induction Abortion

Performed in the 2nd and 3rd Trimesters
A surgical procedure (rarely performed) in which salt water, urea or potassium chloride is injected into the amniotic sac.  Laminaria is sometimes inserted to assist with dilation. Prostaglandin's are inserted into the vagina and pitocin is injected intravenously. Uterine contractions begin after which the fetus is expelled. This procedure is normally only performed when a medical problem problem or illness is present.
Side effects include nausea, bleeding, cramping (up to 2 weeks after the procedure). More severe side effects include damage to the uterine lining or cervix, perforation of the uterus, infection and blood clots.

Intercardiac Injection

Performed at 16 weeks and above
Ultrasound is used to pinpoint the location of the fetal heart. Fluid from a needle is injected into the heart, causing immediate cardiac arrest which terminates the pregnancy. Used commonly in 'pregnancy reduction' abortions when multiple fetuses are present and some are aborted to give others a better chance of survival, or they are taken because of defects or gender.

Prostaglandin's

Used after 3-4 months of gestation
Prostaglandin is a synthetic, hormonal drug which is injected into the amniotic sac, causing uterine contractions resulting in expulsion of the fetus. Often salt or another toxin is first injected to ensure that the fetus will be aborted, since some have survived this procedure. In addition to risks of retained placenta, cervical trauma, infection, hemorrhage, hypothermia, bronchoconstriction, tachycardia, more serious side effects and complications from the use of artificial prostaglandin's, including cardiac arrest and rupture of the uterus and rarely, death.
For these reasons, this method is falling out of favor and being replaced by other methods.

Dilation and Extraction (D&X); Partial Birth Abortion

Procedure used for late-term abortions (20 weeks to full-term pregnancies).
This technique does not dismember the fetus; rather, the fetus is delivered intact, without infusions, hence the term 'partial birth abortion'.

As described and performed by abortion physician Martin Haskell, D&X abortions take three days to complete. In the first two days, the woman's cervix is dilated with laminaria in two or more sessions, with medication given for cramping. On the day of the procedure, the laminaria are removed, and the patient is injected with Pitocin to induce contractions.

The abortion provider next determines the fetus orientation in the uterus through ultrasound. The fetus is rotated and forceps are used to pull the legs, shoulders and arms through the birth canal. An incision is made at the base of the skull to allow a suction catheter inside. The catheter is used to remove the cerebral matter until the skull collapses, then the fetus is completely removed. The physician removes the placenta with forceps and scrapes the uterine walls with a suction curette.
Source: Martin Haskell, M.D., “ Second Trimester Abortion: From Every Angle,” paper presented at the Fall Risk Management Seminar at the National Abortion Federation, September 13-14, Dallas, Texas.
Note: This technique is no longer performed in some States, therefore Digoxin is injected into the fetal heart. This is an unlabeled use of Digoxin.
Side effects include nausea, bleeding, cramping (up to 2 weeks after the procedure). More severe side effects include damage to the uterine lining or cervix, perforation of the uterus, infection and blood clots.


Hysterotomy

Performed at 20 weeks and above
This method is generally used if chemical methods such as saline abortion or prostaglandin's fail. As in a Cesarean section, the abdomen and the womb are opened surgically; the baby, placenta and amniotic sac is lifted out and the cord clamped. The fetus is sometimes born alive during this procedure and usually too young to survive without immediate medical treatment and put aside to die. This method offers the highest risk to the health of the mother, because the potential for rupture during subsequent pregnancies is appreciable. This method has been replaced with Partial Birth or Cardiac Injection.