the Risks and Costs of Abortion Procedures - Obstetrics and Gynecology

Dr. Chen Fuhao reply Obstetrics and Gynecology

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Hello, Miss Hsiao-Hui: I apologize for the delayed response as I was abroad for further studies.
Regarding the issues you mentioned, here is a summary:
Artificial abortion, commonly referred to as abortion, is the medical procedure used to terminate an unwanted pregnancy for various reasons.
In medical terms, abortion refers to the termination of a pregnancy within 20 weeks.
After 20 weeks, it is referred to as induction of labor.
The methods of artificial abortion that we currently know are as follows:
1.
Menstrual Regulation: This method can be used if menstruation is delayed by no more than two weeks.
It involves the use of a syringe, and the cervix must be dilated.
A suction tube is attached to the syringe to perform manual suction to remove the early pregnancy's fertilized egg.
Some believe this is not an abortion, which is incorrect.
The issue is that if this procedure is performed early in pregnancy, how can one be certain it is an intrauterine pregnancy and not an ectopic pregnancy? If it is an ectopic pregnancy, menstrual regulation is ineffective and poses risks.
Therefore, it is essential to confirm an intrauterine pregnancy before proceeding with an abortion; otherwise, one must monitor and be cautious of the potential for ectopic pregnancy.
2.
Vacuum Aspiration: After approximately six weeks of pregnancy, it is not possible to achieve abortion solely through menstrual regulation.
Therefore, after dilating the cervix, a motorized vacuum suction device is used to extract the pregnancy tissue.
Sometimes, a curettage procedure is also performed to ensure complete removal of the pregnancy material.
3.
Dilation and Curettage (D&C): This procedure is typically performed within 12 weeks of pregnancy.
After dilating the cervix, forceps are used to remove the fetus and placenta, followed by scraping the uterine lining.
This is commonly referred to as "curettage" or "scraping the uterus."
4.
Induction of Labor:
- Intrauterine Medication Administration: High-concentration saline or prostaglandin medications are injected into the uterus to induce contractions, facilitating the expulsion of the fetus and placenta.
- Intrauterine Device Placement: A special device is placed in the uterus to trigger contractions, promoting the expulsion of the placenta and embryo.
- Dilation and Evacuation (D&E): This method is used in mid-pregnancy cases, where the fetus is fragmented and removed after dilating the cervix, similar to curettage but specifically for later stages of pregnancy.
- Cesarean Section: If the fetus is too large (around 5-6 months) and the decision is made to terminate the pregnancy, a cesarean section may be necessary to extract the fetus.
- Vaginal Suppository Administration: Prostaglandin-containing vaginal suppositories are placed in the vagina to induce labor and facilitate natural expulsion.
While artificial abortion is a relatively straightforward procedure and does not significantly impact women's physical and mental health, it still carries considerable risks.
For instance, even the generally considered safest method, menstrual regulation, can lead to complications such as cervical injury, severe cramping, bleeding, infection, and incomplete evacuation.
The risks increase with the duration of the pregnancy, potentially resulting in injury to the intestines and more severe complications.
Currently, there is a popular oral abortion pill, RU486, which is another option; however, it should be used cautiously under the supervision of a qualified obstetrician-gynecologist.
I advise women to choose appropriate obstetricians for their medical care.
As for the costs, they vary depending on the type of abortion procedure, generally ranging from 3,000 to 40,000 TWD.

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Reply Date: 2002/03/12