Before seriously considering abortion, you should first realize that you may not need an abortion because around 25% of pregnancies end naturally in a miscarriage. If this happens, you can avoid the pain, cost and risks of having a surgical abortion. A good way to determine if there's a likelihood of your pregnancy ending naturally is by having an ultrasound exam. Robbinsdale Women's Center provides this service free of charge.

Robbinsdale Women's Center is not here to sell you a surgical abortion or any other service. We are here to help you make an informed decision about your pregnancy. So call or come in today for free confidential services.

Pain: Despite the use of local anesthesia, a full 97% of women having abortions reported experiencing pain during the procedure, which more than a third described as intense, severe or very severe. Compared to other pains, researchers have rated the pain from abortion as more painful than a bone fracture, about the same as cancer pain, though not as painful as an amputation. [1-4]

Studies also reveal that younger women tend to find abortion more painful than do older adults, and that patients typically found abortion more painful than their doctors or counselors expected. The use of more powerful general anesthetics can reduce the pain, but significantly increases the risk of cervical injury or uterine perforation. [5-7]

Common Complications: bleeding, hemorrhage, laceration of the cervix, menstrual disturbance, inflammation of the reproductive organs, bladder or bowel perforation and serious infection. [8-13]

Long Term Physical Complications: from abortion may surface later. For example, overzealous currettage can damage the lining of the uterus and lead to permanent infertility. Overall, women who have abortions face an increased risk of ectopic (tubal) pregnancy and a more than doubled risk of future sterility. Perhaps most important of all, the risk of these sorts of complications, along with risks of future miscarriage, increase with each subsequent abortion. [14-16]

Medical experts are still researching and debating the linkage between abortion and breast cancer. Here are some important facts:

• Carrying your first pregnancy to full term gives protection against breast cancer. Choosing abortion causes loss of that protection.
• A number of reliable studies have concluded that there may be a link between abortion and the later development of breast cancer. [17-18]

Death: Of course, death of the mother is the most serious of all complications. The risk of death increases according to the duration of pregnancy and the complexity of the abortion technique employed. [19-20]

1. Phillip G. Stubblefield, M.D., et al, "Pain of first-trimester abortion: Its quantification and relations with other variables," American Journal of Obstetrics and Gynecology, Vol. 133, No. 5 (March 1, 1979), p. 489.

2. Nancy Wells, D.N.Sc., R.N., "Pain and Distress During Abortion," Health Care for Women International, Vol 12 (1991), pp. 296-297. Actually, all 35 women participating in Wells’ study (100%) reported some degree of pain during the abortion, which 34.4% described as "intense."

3. Stubblefield, et al, cited in note 80, p. 493.

4. Eliane Bélanger, Ronald Melzak, and Pierre Lauzon, "Pain of first-trimester abortion: a study of psychosocial and medical predictors," Pain, Vol. 36 (1989), pp. 343, 345.

5 . Belanger, et al, cited above, p. 345, and Stubblefield, et al, cited in note 80, p. 495.

6 . See Tables VII, VIII, IX, X, and XIII, in Stubblefield, et al, cited in note 80, pp. 493-496.

7 . Kenneth F. Schulz, David A. Grimes, Willard Cates, Jr., "Measures to Prevent Cervical Injury During Suction Curettage Abortion," The Lancet, May 28,1983, p. 1184. See also Steven G. Kaali, M.D., et al, "The frequency and management of uterine perforations duing first-trimester abortions," American Journal of Obstetrics and Gynecology, August 1989, p. 408.

8 . Schulz, et al, cited in note 87, p. 1182.

9.  Stubblefield, cited in note 9, pp. 1023-1024, and S. Kaali, cited in note 87 pp. 406-408.

10.  Stubblefied, cited in note 9, p. 1023

11.  L.H. Roht, et al, "Increased Reporting of Menstrual Symptoms Among Women Who Used Induced Abortion," American Journal of Obstetrics and Gynecology, Vol. 127 (1977), p. 356.

12. Ibid.

13 . David N. Danforth, Ph.D., M.D., ed., et al, Obstetrics and Gynecology, 5th ed. (Philadelphia: J.B. Lipincott, 1986), pp. 217, 257, 382-383. See also Jack Pritchard, et al, Williams Obstetrics, 17th ed. (Norwalk, CT: Appleton-Century-Crofts, 1985), p. 484.

14. Danforth, cited above, p. 887, and David H. Nichols, M.D., Gynecologic and Obstetric Surgery (St. Louis: Mosby-Year Book Inc., 1993), p. 260, and Leon Speroff, Robert H. Glass, Nathan G. Kase, Clinical Gynecological Endochrinology & Infertility (Baltimore: Williams & Wilkins, 1983), pp. 156-157.

15. A. Levin, et al, "Ectopic Pregnancy and Prior Induced Abortion," American Journal of Public Health, Vol. 72, No. 3 (March 1982), pp. 253-256.

16. Anastasia Tzonou, et al, "Induced abortions, miscarriages, and tobacco smoking as risk factors for secondary infertility," Journal of Epidemiology and Community Health, Vol. 47 (1993), p. 36.

17. Daling, J. et al, "Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion," Journal of the National Cancer Institute, Volume 86, #21, 1994

18. Howe, et al, Induced abortion and breast cancer; Int J Epidemiol 18:300-4; 1989.

19. Pritchard, cited in note 92, p. 483.

20. Hern, Abortion Practice, cited note 50, pp. 26-35. See also Centers for Disease Control, Abortion Surveillance, 1978, (November 1980) and Christopher Tieze, et al, "Maternal mortality associated with legal abortion in New York State: July 1, 1970-June 30, 1972," Obstet Gynecol, Vol. 43 (1974), p. 315.

Most common first trimester abortion procedures are:

Suction aspiration: or "vacuum curettage," is the abortion technique used in most first trimester abortions. A powerful suction tube with a sharp cutting edge is inserted into the womb through the dilated cervix. The suction dismembers the body of the developing baby and tears the placenta from the wall of the uterus, sucking blood, amniotic fluid, placental tissue, and fetal parts into a collection bottle.

Great care must be taken to prevent the uterus from being punctured during this procedure, which may cause hemorrhage and necessitate further surgery. Also, infection can easily develop if any fetal or placental tissue is left behind in the uterus. This is the most frequent post-abortion complication. [9-13]

Dilatation (Dilation) and Curettage (D&C): In this technique, the cervix is dilated or stretched to permit the insertion of a loop shaped steel knife. The body of the baby is cut into pieces and removed and the placenta is scraped off the uterine wall. Blood loss from D & C, or "mechanical" curettage is greater than for suction aspiration, as is the likelihood of uterine perforation and infection.

This method should not be confused with routine D&C’s done for reasons other than undesired pregnancy (to treat abnormal uterine bleeding, dysmenorrhea, etc.). [14-16]

RU 486: While many people focus solely on RU 486, the so-called " French abortion pill," the RU 486 technique actually uses two powerful synthetic hormones with the generic names of mifepristone and misoprostol to chemically induce abortions in women five-to-nine weeks pregnant.

The RU 486 procedure requires at least three trips to the abortion facility. In the first visit, the woman is given a physical exam, and if she has no obvious contra-indications ("red flags" such as smoking, asthma, high blood pressure, obesity, etc., that could make the drug deadly to her), she swallows the RU 486 pills. RU 486 blocks the action of progesterone, the natural hormone vital to maintaining the rich nutrient lining of the uterus. The developing baby starves as the nutrient lining disintegrates.

At a second visit 36 to 48 hours later, the woman is given a dose of artificial prostaglandins, usually misoprostol, which initiates uterine contractions and usually causes the embryonic baby to be expelled from the uterus. Most women abort during the 4-hour waiting period at the clinic, but about 30% abort later at home, work, etc., as many as 5 days later. A third visit about 2 weeks later determines whether the abortion has occurred or a surgical abortion is necessary to complete the procedure (5 to 10% of all cases).

There are several serious well documented side effects associated with RU 486/prostaglandin abortions, including prolonged (up to 44 days) and severe bleeding, nausea, vomiting, pain and even death. FDA reported in March of 2006 that it had 2 additional documented deaths in the United States in addition to the 4 deaths reported from September, 2003 to June, 2005.

Long term effects of the drug have not yet been sufficiently studied, but there are reasons to believe that RU 486 could affect not only a woman’s current pregnancy, but her future pregnancies as well, potentially inducing miscarriages or causing severe malformations in later children. [17-33]

References:

9. Phillip G. Stubblefield, "First and Second Trimester Abortion," in Gynecologic and Obstetric Surgery, ed. David H. Nichols (Baltimore: Mosby, 1993) p. 1016. Also, the U.S. Centers for Disease Control (CDC), "Abortion Surveillance: Preliminary Data -- United States, 1991, " Morbidity and Mortality Weekly Report, Vol. 43, No. 3, 1994, p. 43, puts the percentage of suction curettage abortions relative to other techniques at 98%, though the CDC admits that their numbers include a number of D & E abortions which should be classified otherwise (personal communication with Lisa Koonin,Division of Reproductive Health, CDC, March 6, 1996).

10. U.S. Senate Report of the Committee on the Judiciary, Human Life Federalism Amendment, Senate Joint Resolution 3, 98th Congress, 1st Session, legislative day June 6, 1983, p. 36. (Hereafter referred to as Human Life Federalism Amendment).

11. A. Jefferson Penfield, M.D., Gynecologic Surgery Under Local Anesthesia, (Baltimore: Urban & Schwarzenburg, 1986), p. 79.

12. Jane E. Hodgson, M.D.,"Abortion by vacuum aspiration," Abortion and Sterilization: Medical and social aspects, Jane E. Hodgson, ed. (New York: Academic Press, Grune and Strathon, 1981), pp. 256-258.

13. Ibid, pp. 256, 260-261.

14. Human Life Federalism Amendment, cited in note 10, p. 36.

15. F. Gary Cunningham, M.D., et al, Williams Obstetrics, 19th ed. (Norwalk, CT: Appleton & Lang, 1993), p.683.

16. Penfield,cited in note 11, pp. 50-51.

17. According to Andrea Sachs, because of these generic names, the RU 486 technique is sometimes referred to as the "M & M " method. "Abortion Pills on Trial," TIME, December 5, 1994, p. 45.

18. Étienne-Émile Baulieu, M.D., Ph. D., "1993: RU 486 -- A Decade on Today and Tomorrow," in Clinical Applications of Mifepristone (RU 486) and Other Antiprogestins, Institute of Medicine, eds. Molla .S. Donaldson et al (Washington, D.C.: National Academy Press, 1993), p. 92-96. Though Baulieu, creator of the abortion pill, recommends its use up to nine weeks, American trials have found the method considerably less effective after the seventh week, according to Carol Jouzaiis, "Abortion Pill Clinic Tests Drawing to a Close in U.S.," Chicago Tribune, Wednesday, August 30, 1995, p. 1.

19. The Population Council of New York, Release, October 27, 1994, p. 3. The Population Council is the entity conducting tests on RU 486 in the United States. The regimen in France, where the drug was first developed and approved, involves a total of four visits, adding an additional week for reflection prior to the ingestion of the pills (Diane Gianelli, "RU 486 effective, not problem-free," American Medical News, April 12, 1993, p. 25.

20. See Janice G. Raymond, Renate Klein, Lynette J. Dumble, RU 486: Misconceptions, Myths, and Morals (Cambridge, MA: Institute on Women and Technology, 1991), pp. 17, 34, 35; and Beatrice Couzinet, M.D., et al, "Termination of Early Pregnancy by the Progesterone Antagonist RU 486 (Mifepristone)," New England Journal of Medicine Vol. 315 (December 18, 1986), p. 1565; Louise Silvestre, M.D., et al, "Voluntary Interruption of Pregnancy with Mifepristone (RU 486) and a Prostaglandin Analogue," New England Journal of Medicine, Vol. 322 (March 8, 1990), p. 645.

21. Raymond, Klein, and Dumble, Misconceptions, cited in note 20, pp. 57-62.

22. André Ulmann, et al, "Medical Termination of Early Pregnancy With Mifepristone (RU 486) Followed By A Prostaglandin Analogue," Acta Obst. Gyn. Scand., Vol. 71 (1992), pp. 280-281.

23. Population Council, Release, cited in note 19, p. 3

24. Gianelli, "RU 486 effective..." cited in note 19, p. 25.

25. Élisabeth Aubeny and É.É.Baulieu, "Contragestion with Ru 486 and an orally active prostaglandin," C.R. Acad. Sci. Paris (III), Vol. 312 (1991), pp. 539-545, obtained a 95% completion rate with women 49 days amenorrhea or less. Carolyn McKinley, et al, "The effect of dose of mifepristone and gestation on the efficacy of medical abortion with mifepristone and misoprostol," Hum. Reproduc., Vol. 8 (1993), pp. 1502-1503, obtained a completion rate of 89.1% for women 50-63 days amenorrhea.

26. Mary W. Rodger and David T. Baird, "Blood loss following a prostaglandin analogue (Gemeprost)" Contraception, Vol. 40 (1989), pp. 439-447.

27. UK Multicentre Trial, "The efficacy and tolerance of mifepristone and prostaglandin in first trimester termination of pregnancy, B.J. Obst. & Gyn., Vol. 97 (1990), pp. 480-486.

28. Population Council, Release, cited in note 19, p. 3.

29. McKinley, et al, "The effect of dose of mifepristone...," cited in note 25, p. 1504.

30. Alan Riding, "Frenchwoman’s Death is Linked To Abortion Pill and a Hormone," New York Times, April 10, 1991, p. A-10

31. Mark Louviere, M.D., "Group lied when it said ‘abortion pill’ test resulted in no complications,’ Waterloo Courier, September 24, 1995, p. F3. See alsoTom Carney, "‘Abortion pill’ test goes awry for one patient," Des Moines Register, September 21, 1995, pp. 1M, 5M.

32. Raymond, Klein, and Dumble, Misconceptions, cited in note 20 , pp. 71-79.

33. FDA Public Health Advisory "Sepsis and Medical Abortion Update"; March 17, 2006. www.fda.gov/cder/drug/advisory/mifeprex200603.htm

Most common second and third trimester abortions are:

Dilatation (Dilation) and Evacuation (D&E): Used to abort unborn children as old as 24 weeks, this method is similar to the D&C. The difference is that forceps with sharp metal jaws are used to grasp parts of the developing baby, which are then twisted and torn away. This continues until the child’s entire body is removed from the womb. Because the baby’s skull has often hardened to bone by this time, the skull must sometimes be compressed or crushed to facilitate removal. If not carefully removed, sharp edges of the bones may cause cervical laceration. Bleeding from the procedure may be profuse.

Dr. Warren Hern, a Boulder, Colorado abortionist who has performed a number of D&E abortions, says they can be particularly troubling to a clinic staff and worries that this may have an effect on the quality of care a woman receives.  Hern also finds them traumatic for doctors too, saying "there is no possibility of denial of an act of destruction by the operator.  It is before one's eyes.  The sensation of dismemberment flow through the forceps like an electric current." [1-2]

Prostaglandins: are naturally produced chemical compounds which normally assist in the birthing process. The injection of concentrations of artificial prostaglandins prematurely into the amniotic sac induces violent labor and the birth of a child usually too young to survive. Often salt or another toxin is first injected to ensure that the baby will be delivered dead, since some babies have survived the trauma of a prostaglandin birth and been born alive. This method is used during the second trimester.

In addition to risks of retained placenta, cervical trauma, infection, hemorrhage, hyperthermia, bronchoconstriction, tachycardia, more serious side effects and complications from the use of artificial prostaglandins, including cardiac arrest and rupture of the uterus, can be unpredictable and very severe. Death is not unheard of. [3-8]

1. Warren M. Hern, M.D., Abortion Practice (Philadelphia: J.B. Lipincott Company, 1984), pp. 153-154. See also Human Life Federalism Amendment, cited in note 10, p. 36.

2. Warren M. Hern, M.D., and Billie Corrigan, R.N., "What About Us? Staff Reactions to the D & E Procedure," paper presented at the Annual Meeting of the Association of Planned Parenthood Physicians, San Diego, California, October 26, 1978.

3 . Nancy K. Rhoden, "The New Neonatal Dilemma: Live Births from Late Abortions," The Georgetown Law Journal, Vol. 72 (1984), p. 1458.

4. Liz Jeffries and Rick Edmonds, "Abortion, The Dreaded Complication," The Philadelphia Inquirer, August 2, 1981, 4 page insert.

5. Warren M. Hern, M.D., Abortion Practice, cited in note 50, pp. 123, 125. 66. Ibid., p. 125.

6.  Ibid., p. 125.

7. James R. Scott, Danforth’s Obstetrics and Gynecology, cited in note 58, p. 726.

8. Willard Cates, M.D. and H.V.F. Jordaan, "Sudden Collapse and Death of Women Obtaining Abortion Induced by Prostaglandin F2 Alpha," American Journal of Obstetrics and Gynecology, Vol. 133 (February 15, 1979), pp. 398-400. See also David Grimes, M.D., et al, "Midtrimester abortion by intra-amniotic prostaglandin F2a: Safer than saline?" Obstet Gynecol, Vol. 49 (1977), p. 612 and A.C. Wentz, et al, "Posterior cervical rupture following prostaglandin-induced midtrimester abortion," American Journal of Obstetrics and Gynecology, Vol. 115 (1973), p. 1107.