Abortion at the end of the first and beginning of the second trimester

Officially, abortions at the 13th week are no longer performed at the woman’s request; the final deadline is 12 weeks. Further, according to the law, termination of pregnancy without serious grounds is prohibited.

This is due to a number of reasons, divided into two main groups:

1. Impossibility of removing the fetus without serious harm to the body. Pregnancy has already entered a phase after which violent termination can cause serious disruptions in the functioning of the body. This often leads to quite severe consequences, ranging from hormonal imbalance to infertility. The likelihood of complications increases markedly.
2. The moral aspect of the situation. If up to the 12th week inclusive we can talk about a fertilized egg, which in the early stages does not even attach to the uterine mucosa, then at 13 weeks the fetus is much more like a child. It is already easy to determine the gender, you can notice defects in the formation of the jaw, and any other pathologies associated with the development of the skeleton. Among other things, this also means that the child is already quite well formed.

The moral side of the issue is largely an abstract concept. Today, many women consider the most important thing to be in charge of their own health. Others who go to the clinic for an abortion at this stage are depressed. Often they take such a step not out of a desire to get rid of the child, but out of necessity, for personal reasons. These include conception resulting from rape, the child’s father being in prison, and more. This is the topic of many discussions.

In any case, a woman does not have the right to have an abortion at 13 weeks of her own free will. If she does not want a child, then such a patient can carry it to term, give birth and write a refusal. The sooner this happens, the higher the likelihood that the baby’s fate will be arranged, that he will have adoptive parents. However, this is a question of prospects, a distant future for a pregnant woman. In the present, you need to understand the state of your own health.

Late abortion techniques

If a decision is made to terminate a pregnancy at a late stage, specialists determine the method by which the abortion will be performed. Currently, there are three techniques: saline filling, minor caesarean section and artificial birth.

Saline filling is currently recognized as an ineffective method of late-term abortion, because... often leads to the development of undesirable consequences and has a large number of contraindications.

When using this method of late abortion, amniocentesis (puncture of the amniotic sac) is performed under ultrasound guidance and a hypertonic sodium chloride solution is injected into the amniotic fluid. As a result of this procedure, fetal death occurs and a miscarriage occurs within 24 to 48 hours.

Induced childbirth is a late miscarriage caused by the use of medications. With it, everything happens in exactly the same way as with spontaneous childbirth, but only contractions are induced artificially.

The surgical method is a minor caesarean section, performed in the same way as a regular caesarean section, i.e. The fetus is surgically removed from the uterine cavity. Due to the immaturity of the lungs, the baby cannot breathe on his own and dies. This method of terminating a late pregnancy is mainly used when continuing the pregnancy threatens the health and life of the mother.

Late pregnancy termination is recommended at 21-22 weeks, if possible, because It is during this period that complications occur much less frequently.

Until what week of pregnancy can you legally have an abortion?

In order to prevent harm to an already viable fetus and to avoid risks to the health of the mother, time limits are set for abortion. If a woman wants to get rid of pregnancy, it is usually recommended to do this as early as possible. This will be safer for her and the abortion will be easier to perform.

Although abortion is legal under certain conditions in most countries, these conditions vary widely. According to the UN publication World Abortion Policy 2013, induced termination of pregnancy is legal in most countries (97%) to save a woman's life. Other common reasons include maintaining physical (68%) or mental health (65%). In approximately half of the countries, abortion is permitted in cases of rape or incest (51%), if pathologies are detected in the fetus (50%). Abortion for economic or social reasons is performed in 35% of countries. But only at the request of a woman is allowed in only 30% of countries, including Ukraine, Russia, the USA, Canada, most European countries and China, with 42% of the world's population living in such countries.

Most countries in the European Union allow abortion upon request during the first trimester. Later, it is permitted only under certain circumstances, such as risk to the woman's life or health, fetal abnormalities, or other specific situations that may be related to the circumstances of conception or the woman's age. For example, in Austria, second-trimester abortions are only permitted if there is a serious danger to the woman's physical or mental health or life (which cannot be prevented by other means); serious pathologies of the fetus (physical or mental); or if the woman is under 14 years of age. A similar number of reasons are spelled out in Danish legislation. In Finland, technically abortions even up to 12 weeks require permission from two doctors (except in special circumstances), but in practice the permission is only a stamp and is granted if the mother simply does not want to have the child.

In Russia and Ukraine, it is possible to perform a legal artificial termination of pregnancy at the request of a woman up to 12 weeks. Later abortions (12-22 weeks) are allowed only when there are compelling social or medical reasons for this. To what extent these laws are observed by doctors is another matter.

There are individual recommendations for each type of abortion (may vary slightly in different countries):

• Medical abortion (abortion pills). You can use this method up to 9 weeks of pregnancy. The doctor will give the first medicine in the clinic to start the process, and then the second medicine is taken at home or also at the doctor.
• Surgical abortion . It can be done at any time up to 12 weeks. Safer and more preferable today is vacuum aspiration (mini-abortion), but in most clinics this method is applicable only up to 5-7 weeks, although with suitable equipment and experienced specialists it can be used up to 12 weeks. A dilatation and curettage method (curettage) is available after 6 weeks and is usually used in cases where vacuum aspiration can no longer be performed or is not available. In the second trimester, especially after the 14th week, surgical abortion is done with a more complex method called dilation and evacuation, which is a combination of the previous two.
• Induced abortion (induced birth) . This method is used after the 16th week of pregnancy with the consent of the woman, for this she is hospitalized and given drugs that cause premature birth. If necessary, the doctor can combine this procedure with a surgical abortion to ensure that the uterus is completely empty.

Abortion at 13 weeks of pregnancy

At the 13th week of pregnancy, the fetal head makes up one third of the total length of its body. The weight reaches about 20 grams, and the length is about 7–7.5 cm. Cartilaginous formations appear - the rudiments of arms, legs, spine, ribs. The intestine begins to make its first peristaltic waves.

Due to the intensive development of the fetus, abortion at 13 weeks threatens a woman with many complications. This period is the most undesirable for termination of pregnancy. But it is at this time that frozen pregnancies are often detected. To preserve the health and life of a woman in such cases, abortion is inevitable.

Abortion at 13 weeks is usually done instrumentally, i.e. the fetus is scraped out from the body of the uterus, but in case of an infectious or inflammatory process this method is contraindicated. Possible use at 13 weeks and opening of the amniotic sac, followed by hanging a load on the presenting part of the fetus. In this case, 50% of women experience a protracted late abortion, sometimes lasting more than a day and leading to bleeding, cervical rupture, and infection.

Social factors

While the Ministry of Health is moving towards increasing the number of medical indications for abortion, social ones are gradually being reduced. The latest progress in this direction was made in 2012, when any reasons for abortions after 12 weeks were removed, with an exception made only for victims of violence. This practice has caused a wave of criticism; many experts fear an increase in the number of criminal abortions and child abandonment.

Experts note that in the present the total number of social orphans is greater than in wartime, when the loss of parents occurred everywhere. Therefore, such a policy is quite controversial, and it is difficult to unequivocally agree with it.

What are the risks of terminating a pregnancy?

Abortion is an unnatural operation, it goes against nature. The female body is not able to decide on its own whether it needs pregnancy or not. And the body perceives any surgical intervention in the reproduction of offspring differently. The most dangerous termination of pregnancy is abortion during the first pregnancy. If you terminate the first pregnancy, the body may perceive this in a special way, the process of reproduction of its own kind is disrupted, and pregnancy will never occur. When terminating a pregnancy, it is necessary to remember that a woman is encroaching on the most important function in her life - the function of childbearing.

It is because of artificial termination of pregnancy that a large number of women on our planet lost the joy of motherhood; as the years passed, they regretted that they would never be able to hear the most important word in life. This is the word “Mom”, from your desired baby.

Until how many weeks is abortion legal?

After 12 weeks, abortion is performed only for medical reasons. This is due to the fact that late termination of pregnancy is fraught with a large number of health-threatening consequences. Even an abortion at 9 weeks can make a woman infertile or disabled. Therefore, you should be attentive to your body, avoid promiscuous sexual intercourse and always think about protection during sex. In addition, it should be understood that an interrupted pregnancy is a possible subsequent serious treatment for complications.

pregnancy, abortion

What are the risks of abortion?

The risks of complications from abortion increase as the fetus develops. This is one of the reasons that explains why it may be too late to have an abortion. The other is ethical, when the fetus can already survive outside the uterus. The risks of abortion, including late abortion, include:

• Uterine perforation (rupture of the wall) and infections
• Damage to the cervix
• Bleeding
• Complications from anesthesia
• Preservation of uterine contents (second procedure required)
• Traumatic injury to the genital organs
• In rare cases, death

Complication statistics based on gestational age are as follows:

• up to 8 weeks – less than 1%
• 8-12 weeks – 1.5-2%
• 12-13 weeks – 3-6%
• 2nd trimester – up to 50%

According to the US Centers for Disease Control and Prevention (CDC), the average risk of death due to abortion is less than 1 in 100,000 people. This risk increases with each week of pregnancy. For example:

• up to 8 weeks inclusive – 1 death for every 530,000 abortions
• 16-20 weeks – 1 death in 17,000
• After 21 weeks inclusive – 1 death in 6000

By comparison, the risk of dying during childbirth is less than 1 in 10,000.

If a medical abortion (using pills) is chosen to terminate a pregnancy, then in order to avoid risks, the woman must meet certain criteria:

• Have access to transport
• Stay away from emergency services in case of severe bleeding
• Have a phone nearby to call a doctor or ambulance if necessary
• There should be someone nearby to help if needed

Due to the above risks, abortions must be performed very carefully, and the methods used must be selected correctly in accordance with the stage of pregnancy.

Content

1. Termination of pregnancy at 2-7 weeks
2. Medical or vacuum abortion?
3. Surgery at 7-12 weeks
4. Until how many weeks is abortion legal?

According to statistics, 60% of pregnancies in Russia end in abortion.
Our country is one of the leaders in the number of this procedure. The period at which an unwanted pregnancy can be terminated varies from 4 to 28 weeks. Moreover, the sooner a woman decides to have an abortion, the lower the likelihood of complications awaiting her.

Abortion at 12 weeks is the latest date at which a woman can terminate her pregnancy at will. If before this time she has not decided to have a medical or surgical abortion, then just the desire to get rid of the child will not be enough. Abortion at the 13th week in Russia is carried out strictly for social or medical reasons or illegally, which is fraught with physical and psychological complications.

Termination of pregnancy at 2-7 weeks

If a woman is attentive to her health, she will be able to understand about the onset of an unwanted pregnancy as early as 2-4 weeks. Delayed menstruation, nausea, weakness, heightened sense of smell - all this may indicate that she is in an “interesting position.” You can have an abortion at 2 weeks by visiting the hospital and confirming pregnancy with a gynecologist. Before 4 weeks, it is recommended to perform a medical termination of pregnancy.

Before having an abortion at 2-4 weeks, you should undergo the following tests:

• urine test for hCG;
• gynecological smear;
• blood test for hepatitis, HIV and syphilis.

In addition, regardless of the duration of the week, an abortion will not be performed in the clinic without an ultrasound and a full medical examination. Only after an examination by specialists and a gynecologist's conclusion is a woman given permission to terminate her pregnancy. Typically, tests and examinations take 2-3 days, after which a medical abortion is performed. How many weeks a pregnancy lasts can best be determined by an ultrasound. Therefore, it is important to go through it as quickly as possible and determine whether it is too late to carry out a medical abortion or whether it is better to use a vacuum abortion.

Surgery at 7-12 weeks

At 7-12 weeks, abortion is performed surgically. This method of getting rid of the fetus is similar to the vacuum method. The surgical intervention differs in that instead of a syringe, a special instrument is inserted into the uterine cavity. An abortion at 8 weeks is performed under anesthesia after taking medications and using a special cervical dilator.

Abortion at 10 weeks and beyond is particularly difficult. After all, the size of the fetus increases significantly, and it becomes more difficult to remove it from the uterine cavity. This means that curettage should be carried out with greater force, injuring the uterus and its mucous membrane. In addition, to open the cervix, the woman is injected with kelp 1-2 days in advance in order to extract the fetus with forceps after the uterus is fully opened if an abortion is performed at 10 weeks. In this case, a woman’s psychological adaptation after a surgical termination of pregnancy is much more difficult than after other types of permitted abortions.

Medical or vacuum abortion?

At 2 weeks, medical abortion is easier for several reasons. Firstly, the connection between the fertilized egg and the uterine wall is quite weak. There is a high probability that medications will have a more effective effect on the body’s rejection of eggs. The woman will feel only a slight tugging in the lower abdomen, similar to pain during menstruation. Secondly, the psychological aspect is important, which makes medical abortion more “attractive”. 4 weeks is the period during which a woman will not yet feel like a mother and will not get used to the idea that a new life is developing under her heart. Therefore, psychological adaptation after a medical abortion occurs faster.

There is also a negative side to medical abortion. Abortion drugs affect a woman's hormonal levels. As a result, subsequent pregnancies may have complications and end in miscarriage. In addition, a medical abortion at 5 weeks or later may not lead to complete rejection of the fertilized egg. Then the woman will have to undergo surgery.

Medical abortion may be accompanied by heavy bleeding, fever and weakness. Smoking and heart problems are contraindications to this type of abortion.

At 5-7 weeks, abortion can also be performed using vacuum surgery. It is performed under anesthesia. At the clinic, a catheter is inserted into a woman’s arm, and she wakes up not pregnant. Local anesthesia is also used. During an abortion, the woman's uterus is dilated, making the cervix dilate wide. A tube with a syringe is inserted into the uterus. With the help of such an instrument, the fetus is sucked out. If a vacuum abortion is performed at 7 weeks, the baby’s body may not be completely removed, so the doctor additionally performs curettage.

Vacuum operation is more reliable and affordable. After it, a woman may experience pain in the lower abdomen, accompanied by bleeding. In some cases, the doctor prescribes antibiotics.

Only a specialist after an examination can best advise you on which abortion to have at 6 weeks. If at 2-3 weeks it is obvious that the best choice for a woman is a medical termination of pregnancy, then at a later date it is up to the gynecologist to dot the i’s. If you decide to have a vacuum abortion at 7 weeks, make sure your doctor is experienced.