Dilation and evacuation

This abortion method is performed at 15 weeks of pregnancy. It is a more complex procedure than vacuum aspiration with a longer recovery period.

The procedure involves opening up the neck of the womb (cervix) before using forceps and a small suction tube to remove the foetus. This procedure takes around 30 minutes to complete and providing there are no complications you will be able to return home on the same day.

What is the procedure in detail?

The dilation and evacuation procedure

This procedure is always carried out under a general anaesthetic. You will have been given instructions about this beforehand which include when to have your last meal and what to expect afterwards.

A general anaesthetic can make you feel tired, woozy and disorientated afterwards. In some cases you may also feel nauseous.

So, ask someone to drive you to the clinic or hospital and home again, and if possible, to stay with you for the first 24 hours after the abortion. Make sure that you do not have any legal documents to sign after your procedure or have to operate any machinery or perform any tasks which require you to concentrate.

The doctor will use an instrument called a ‘speculum’ which enables him/her to stretch the cervix. A slim rod shaped instrument called a ‘laminaria’ is also inserted into your cervix to help keep it open.

The doctor will use forceps and a ‘curette’ (curvy instrument) to remove the foetus and scrape away the lining of the womb. A suction tube is also used to remove any surrounding tissue.

The tissue that has been removed is carefully examined to ensure that all signs of your pregnancy have been removed. This is then disposed of in a sensitive and respectful manner.

This procedure takes around 20 to 30 minutes in total. Once you have recovered from the anaesthetic and the medical staff are pleased with your progress you will then be able to return home.

You will experience some bleeding following this procedure which will feel like a menstrual period. It is a good idea to wear sanitary towels during this time, which normally last for 14 days following your abortion. Remember to bring those with you to the clinic or hospital on the day of your procedure.

After dilation and evacuation

Once you have undergone this procedure your progress will be carefully monitored. This is to ensure that you have no serious side effects from the general anaesthetic. Once you have recovered from this you will be able to go home.

You may be given an anti-D injection afterwards if your blood group is rhesus D negative. What is this?

Anti-D injection

The reason for this injection is this: if you decide to have any future pregnancies then there is a risk of anaemia developing in your baby. This occurs if you produce antibodies (type of protein produced by your immune system) because of a conflict between your partner’s blood group and that of your baby’s. If one of these is rhesus positive and the other rhesus negative then your immune system will produce antibodies as a reaction to this. These can enter your baby’s bloodstream and cause damage.

So, this injection will stop you from producing antibodies and prevent this from happening if you decide to have another pregnancy.

Recovery from dilation and evacuation

Once you arrive home, make sure you get plenty of rest and take painkillers if you need to. Ibuprofen or Paracetamol are fine and can be purchased over the counter at your local pharmacy.

Wear sanitary towels throughout this two week timescale to deal with any bleeding. Do not start wearing tampons again until at least a month after your abortion to prevent the risk of an infection.

Once this bleeding has stopped you can resume normal sexual relations.

You will have been given an appointment for a follow up check up which will occur in the first couple of weeks after your abortion. This is designed to check on your health and to see how you are coping after this procedure. This can be carried out by the doctor at the abortion clinic or if you prefer, your GP.

In most cases recovery will be straightforward but contact your GP or doctor at the clinic if you notice any of the following symptoms:

• Severe lower abdominal pain and/or swelling
• Heavy bleeding which contains blood clots
• Smelly or dark vaginal discharge
• Fever
• Nausea
• Severe pain�

These are symptomatic of an infection and need to be treated as soon as possible.

An abortion is a commonly performed and safe procedure but like any form of surgery, it does come with side effects and complications.

Side effects refer to the temporary effects from having a general anaesthetic. These include nausea, tiredness and disorientation. You can also expect vaginal bleeding in the first two weeks following your abortion which will be accompanied by stomach pains and cramping.

However, these do disappear after the first two weeks.

Complications are rare but they do occur in a small percentage of cases. These are covered in detail in our risks of abortion section.

Ensure that you use contraception such as birth control pills or condoms as soon as you resume sexual relations. Doing so will prevent the risk of a sexually transmitted disease but more importantly, will prevent you from becoming pregnant.

The time after an abortion is when you are at your most fertile so take steps to prevent this from happening. Arrange which type of contraception you will be using before you have your abortion.