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Methods of Abortion in Canada
There are many methods of abortion used in Canada. The method used depends mainly on the stage of the pregnancy and the size of the developing fetus. Other factors considered include the status of the woman’s health, personal preference, and where the abortion will occur.
Included in the following section are the methods reportedly used in Canada in 2004, the latest year for which statistics have been released.
Surgical Abortion Methods
Suction Aspiration (surgical aspiration, vacuum abortion, suction dilation and curettage (D&C))
Dilation and Evacuation
Surgical Dilation and Curettage (D&C)
Medical Abortion Methods
Methotrexate and Vaginal or Oral Misoprostol
Surgical abortion refers to abortion done using surgical instruments. Procedures vary due to the stage of the pregnancy and size of the fetus at the time of the abortion.
Suction Aspiration (surgical aspiration, vacuum abortion, suction dilation and curettage (D&C)
Suction aspiration was the method used for approximately 90% of all abortions reported in Canada in 2004 and is generally used between six and 14 weeks of pregnancy.
Suction curettage can be done under general anesthetic, but is usually done in a clinic with local anesthetic injected into the cervix to control pain. The cervix is forced open with a compressed seaweed preparation called laminaria that swells as moisture is absorbed, or a series of rigid rods. Sometimes the prostaglandin Misoprostol is used to soften the cervix and make it easier to dilate.
A hollow plastic tube is inserted into the uterus through the cervix and attached to a suction machine. The suction tears the fetus into small parts, which are sucked through the tube into a collection bottle. Often a sharp loop-shaped knife called a curette is then inserted into the uterus to loosen any remaining tissue so that it can be suctioned out. When the suctioning is finished, the abortionist must examine the fetal parts and tissue to see if the abortion is complete.
Dilation and Evacuation (D&E)
Statistics are not clear on how many D&E abortions occur in Canada each year. In 2004, the most recent year for which abortion statistics have been released, at least 11% of abortions in Canada occurred after 13 weeks’ gestation.
D&E abortion refers to an abortion done using forceps to dismember and extract the fetus instead of, or together with, suction. In reality, a combination of methods is generally used in abortion after 13 weeks. As the fetus grows larger and its bones become harder, the fetus becomes more difficult to extract. The cervix must be opened wider, and the head of the fetus is large and must be crushed before it can be removed. Bone fragments are sharp and must be carefully removed to avoid damage to the uterus and cervix. The fetal parts removed must be identified to make sure the abortion is complete and no parts are left in the uterus. Suction is used for a final clean out of any bits of fetal or placental tissue that may remain.
Sometimes medications such as digoxin or potassium chloride are injected into the fetus through the woman’s abdomen, to kill it before the D&E procedure. After 19 to 20 weeks, a solution of urea or saline is sometimes injected into the amniotic sac before the abortion. This kills the fetus and stimulates contractions. Urea also begins the breakdown of fetal bones and other tissue to make removal of the parts easier for the abortionist and less painful for the mother.
Surgical Dilatation and Curettage (D&C)
Approximately 6% of abortions reported in Canada in 2004 used this method.
Local or general anesthetic is given to the mother before her cervix is dilated. The cervix is dilated with laminaria or rigid dilators; sometimes, the prostaglandin Misoprostol is also given to soften and dilate the cervix.
A loop-shaped knife called a curette is inserted through the cervix. The curette cuts the fetus and its placenta from the uterine wall and breaks it up. Then the fetal parts and the placenta are scraped out of the uterus through the cervix and discarded.
In Canada in 2004, approximately 3% of reported abortions were done using pharmaceutical drugs. Medical abortion is considered successful if complete expulsion of the embryo and placenta occurs without the need for surgery to complete the abortion.
Medical abortion is not commonly recommended in pregnancies past the first 49-63 days because of the increase in incomplete abortion, heavy and prolonged uterine bleeding and ongoing pregnancy past this stage. When severe bleeding or pain is present, surgical techniques are used to complete the abortion.
Medical abortion takes longer than surgical abortion, is less effective, and requires more clinic visits. Medical abortion results in heavier, more prolonged bleeding, and more pain, nausea and vomiting than surgical abortion. Medical abortion has a 10 fold greater risk of serious infection and death than surgical (suction curettage) abortion.
Medical abortion is preferred over surgical abortion by some women because of its effectiveness in early pregnancy, or because it does not require anesthetics or use of surgical instruments. Other women prefer it because it is more private and possibly more accessible, and because it may more closely resemble natural miscarriage.
Most medical abortions involve the use of a combination of drugs that work together to bring about the abortion over a period of a number of days or weeks.
Methotrexate and Vaginal or Oral Misoprostol
In Canada, methotrexate and misoprostol are used together for medical abortion up to 49 days of pregnancy.
Methotrexate breaks down the cell layer that attaches the embryo to the wall of the uterus, depriving the embryo of essential nutrients and resulting in its death.
Misoprostol is a synthetic prostaglandin that causes the cervix to soften and dilate and the uterus to contract and expel the embryo or fetus.
Abortion with methotrexate and misoprostol requires several clinic visits. During the first visit, methotrexate is injected, followed at 2-7 days with misoprostol pills at home or at a clinic, either inserted into the vagina or taken by mouth. A follow-up visit is required after 1 to 3 weeks to determine if the abortion has occurred.
The methotrexate and misoprostol abortion regimen causes complete abortion in 70-97% of cases. While most of the abortions occur within the first hours or days after taking the misoprostol, 20 to 35% will take up to several weeks. A surgical abortion is scheduled to complete the abortion if it has not occurred by that point because the drugs used can cause birth defects.
Side effects of medical abortion using methotrexate and misoprostol include: significant cramping pain and heavy bleeding during the abortion, along with nausea, vomiting, diarrhea, headache, fever, and chills; prolonged bleeding for one to seven weeks afterwards, and infection; birth defects if the pregnancy is ongoing and the fetus survives.
Misoprostol is a synthetic prostaglandin that causes the cervix to soften and dilate, and the uterus to contract and expel the embryo or fetus.
Misoprostol is used vaginally in abortions up to 56 days since the first day of the last menstrual period.
When used alone, Misoprostol causes complete abortion in 22-94% of cases.
Early side effects are worse with this method than with other methods of medical abortion, and include pain, dizziness, nausea, vomiting, diarrhea, chills and rashes. Heavy and prolonged bleeding and infection are associated with medical abortion in general. Misoprostol is generally used with another drug because of the higher incidence of side effects and lower rate of effectiveness when it is used alone.
Misoprostol is commonly used in surgical abortions as well, to soften and dilate the cervix, and to reduce bleeding.
An abortion, intending to end the life of the child, never has to happen. It is never the only option. So why do people have abortions?
There are many reasons why women or couples decide to have an abortion. An internet search will yield various results, statistics, and percentages, citing socio-economic reasons, not wanting children or any more children, fear of health risks, and many others.Abortion takes an innocent human life, and the gravity of that fact cannot be mitigated, it is important remember that many factors can go into an abortion decision, such as fear, desperation, and ignorance (the person(s) have perhaps become convinced by others whom they trust that the preborn child is not a living human being).
For those people who wish to see Abortion, we provide the following information.This video is not pleasant, but it must be seen. Hundreds of innocent unborn children are torn to pieces every day in Canada because most people simply don't know what abortion actually does. With the exception of the final scene (a second-trimester fetus), all of the video you will see depicts children who were killed during first-trimester abortions.
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