Second Trimester Abortion
Quality Compassionate Reproductive Health Care Personalized to Fit Your Needs
About Second Trimester Abortion
Second trimester abortions are performed between 14.0 to 23.5 weeks of pregnancy and require 1 to 3 visits. We use the dilation and evacuation procedure, also known as a D&E. After 15 weeks, in most cases, cervical dilators called Laminaria or Dilapan, are inserted into the cervix to gradually dilate it overnight before a doctor performs the procedure. Sometimes, early in the second trimester, we can use a medication to prepare the cervix instead of dilators.
The fee includes pregnancy testing, admitting, pre-operative history and physical, ultrasound, lab work, dilator insertion, most pre-operative medications, the D&E procedure, RhoGAM (if required), sedation, medications given on the day of procedure, most post-operative medications and your post-operative care as authorized by us.
You can eat and drink normally, and drive yourself to and from the visit. This is the day the abortion begins – you must stay within one hour of the office for the next 1 – 2 days.
You will have an ultrasound and labs, the opportunity to ask questions, and consent for the procedure. Lastly, laminaria dilators will be placed in the cervix to prepare your body for the procedure.
Depending on how much your cervix has dilated overnight and other medical considerations, you may have the surgical procedure to complete the abortion today.
If additional dilation and preparation is needed for the procedure, the first set of dilators will be removed and a second set will be placed in the cervix. You may be given medications to help with dilation as well.
For your safety do not have anything to eat, drink or smoke for at least 8 hours before your surgery, including pain medications. You cannot drive after your procedure.
After IV sedation is provided, the dilators will be removed and the procedure will be completed. Be prepared to stay in our office for 3 – 6 hours today as the recovery time after the procedure can be lengthy.
Getting to the office and home safely
You may drive yourself to and from the office on the day(s) before your procedure. On the day of your procedure you must be accompanied by a trusted person in your life such as a family member, friend, or partner. It is very important that you have a reliable ride home from the office. If you cannot make arrangements for a ride after the procedure you may be able to use a cab or a ride share car service after an extended recovery period.
Increasingly, patients are travelling from Indiana, Wisconsin, Michigan, Ohio, Tennessee, Kentucky and Missouri to obtain abortion care with FPA. If you are travelling to Chicago from out of the area and you need to make overnight accommodations, we have obtained a discounted rate at a hotel just a block away from our office. Click on the icon below for more information and to check rates.
Preparation For the Procedure
Preparation For the Procedure
When you arrive at the office, you will be asked to complete some paperwork. Many of these forms are available on this website. You can complete them, print them and bring them to your visit if you prefer. Your vital signs will be taken and we will collect a small sample of your blood to determine your Rh factor and iron level. You will have an ultrasound next. If you have had a cesarean section, you will be asked to have a full bladder for the ultrasound.
An admissions staff member will explain the procedure to you and assist you in completing additional paperwork.
A clinician will review your medical history, perform a physical examination, and insert the cervical dilators that will be used to prepare your cervix for the procedure. This procedure takes approximately 5-15 minutes. Most patients experience cramping, pressure and discomfort during the insertion. We will provide you with pain medication. After the insertion, the vaginal canal will be packed with sterile gauze to keep cervical dilators in place and to help prevent infection.
After this process we will give you post-insertion instructions so that you know how to take care of yourself until you return the following day. You will be given medications, and an appointment time for your second insertion or surgery.
If a second day of preparation for the surgery is needed, you will return the following day and the clinician will remove the first set of dilators then insert a second set for additional dilation. Again, this procedure will take approximately 5-15 minutes and you will likely experience cramping and discomfort similar to the the first day. You can take the pain medication provided by our facility, with a meal, before coming in for your visit to decrease your discomfort.
The Day of Procedure
Do not eat, drink, or smoke for eight full hours before your surgery, most often after midnight the day before your visit. This includes gum, candy, water, and any kind of food or drink. Your surgery will be delayed if you have anything at all to eat or drink -for your safety.
When you arrive at the office a staff member will escort you to a private area where you will change into a gown that we provide. A medical assistant will bring you to the surgical suite, and an IV will be placed in your hand or arm, in most cases.
You will be in the procedure suite for about 15 – 30 minutes. A licensed CRNA (certified registered nurse anesthetist) will administer sedation and a licensed medical doctor will perform the abortion by removing the pregnancy and aspirating the uterus. All of our physicians have specialized training in abortion care and are involved in training the family planning fellows at a local, prestigious hospital.
Patients are sedated for this procedure, which means that they will not feel any pain or discomfort.
The Day of Procedure
Recovery and Discharge Information
Recovery and Discharge Information
You will be taken to the recovery room after the procedure is complete. Trained medical personnel, including registered nurses and medical assistants will care for you until you are ready to be discharged. Most patients spend about 1 – 3 hours in the recovery room depending on individual medical assessments. We have tablets that you can listen to music or watch a video on in our second stage recovery area, while having a light snack.
When you are ready to be discharged, our staff will explain your post-operative care and medications. Lastly, we will walk you to your driver.
FPA has a designated 24-hour emergency number. We encourage you to call with any questions or to discuss any problems that occur after your visit. You are welcome to return for a free follow up visit in 2 – 3 weeks, or sooner if needed.
After Your Visit
After you are discharged, you should go home and rest. You may eat and drink normally. If you have nausea or vomiting, we recommend eating something light such as rice, soup or toast.
You are able to go back to work or school within 1 – 2 days, unless the doctor has provided you special instructions. We can provide a confidential doctor’s excuse if needed.
After Your Visit
Frequently Asked Questions
Call us today to speak with our staff or schedule your appointment.
Local anesthesia is a cervical block (injection of numbing medication) performed before your surgery. While your cervix will be numbed, you will be awake during the procedure and it is normal to feel some strong cramping and discomfort.
Sedation is administered intravenously through an IV placed in your hand or arm in most cases. If you are sedated for your procedure you will not feel or remember any pain or discomfort.
If you have chosen to have sedation, you will not feel or remember any pain during your procedure. After the procedure you may experience mild to moderate cramping, if needed we will give you pain medication.
If you have chosen to have local anesthesia with your procedure we will numb your cervix but you will feel some cramping, pain and pressure from the uterus. Some patients describe the pain as minimal while some patients find the pain to be more severe. You will be offered pain medication, and in some cases we can provide you a medication to help you feel more relaxed.
Once you are discharged, in most cases ibuprofen (Motrin/Advil), naproxen (Aleve) or acetaminophen (Tylenol/Midol) will help with the cramping. If the cramping is not helped by these over the counter medications, you should call us immediately.
You will be unaware for about 5-10 minutes with a first trimester abortion, or about 10-20 minutes with a second trimester abortion. The medications used for sedation work very quickly and wear off very quickly as well. Most patients are alert and oriented within 5 minutes of their procedure.
The sedation that we offer is safe, effective and short acting. You will be asleep for 5-20 minutes depending on the procedure. There is always some degree of risk with any surgery. Serious complications with sedation are very rare in our facilities. Complications may occur if a patient has ingested any food or liquid within 8 hours of surgery. Tell our staff if you have had prior complications with anesthesia or if you have had anything to eat or drink within 8 hours prior to your surgery, including gum and water.
In most cases, the patient experiences bleeding for up to 2 to 3 weeks after the abortion procedure. However, some patients do not experience any bleeding and other patients have spotting or bleeding off and on. If you have any questions about what is normal after your procedure, you can always call the office. A 24-hour on-call service is available for after hours.
The first trimester abortion is a simple procedure performed by aspiration (suction). This procedure is referred to as a D&C (Dilation and Curettage). This procedure generally takes about 3 to 5 minutes.
If you are over 13 weeks pregnant, you will first have your cervix dilated with medication and/or sterile product made specifically for cervical dilation (laminaria dilators). This procedure is referred to as a D&E (Dilation and Extraction), and lasts 1 to 3 days. In some cases, a patient will require one or two consecutive days of dilation and will return for the procedure on the second or third day. The dilation procedure takes just a few minutes and you will be in the clinic for a few hours on the day or days that your cervix is being dilated. In some cases, we can administer a medication on the morning of your procedure that will soften and dilate the cervix without the need for insertion of dilators.
The majority of our patients return to work or school the following day. The admitting and medical staff will explain the DOs and DON’Ts after surgery.
Your support person will not be able to join you during the medical parts of the visit, including the exam rooms and recovery room. We must protect the privacy of all of our patients, and for that reason we cannot allow guest in these areas.
We encourage your support person to wait for you in our reception area. If this is not possible, they can return for you upon completion of your appointment.
When bleeding has been light for 24 hours, you may resume intercourse, provided you feel emotionally and physically ready to do so. You are the best judge of your feelings. You should use contraception when you decide to resume intercourse if you wish to avoid pregnancy. You are at risk for pregnancy right away after having an abortion.
Taking public transportation after surgery is not recommended. If no other method of transportation is available, we require that an adult must accompany you.
When bleeding has been light for 24 hours, you may use a tampon.
In most cases, a surgical abortion is nearly 100% effective. In less than 0.3% of cases, a pregnancy is not terminated on the first attempt. Such a failure is most common in pregnancies of less than six weeks’ duration. A very small percentage of surgical cases will require a re-aspiration if unusual bleeding occurs or if there is retained pregnancy tissue.
Most patients feel very ‘normal’ when they leave the office after having an abortion. You will probably be hungry and maybe a little more tired than normal. We recommend that you have a full meal and then take it easy for the rest of the day. It is normal to experience some mild to moderate cramping. If the cramping is not helped by over the counter medications such as Tylenol, Advil or Aleve we ask that you call our 24-hour emergency number. The bleeding is usually comparable to a normal period and some patients do not have any bleeding at all. If at any point you soak one full maxi-pad in an hour or less you should call us immediately.
If you have had pregnancy symptoms such as nausea, fatigue or breast tenderness, these symptoms will start to go away within a few days of the procedure. If you still ‘feel pregnant’ after a few days, you should call us right away.
You may take a shower or tub bath after your procedure. Do not douche, use tampons, have intercourse, or place anything in the vagina for two weeks after having a surgical abortion. Avoid any products that contain aspirin or alcohol as they can promote heavier bleeding.
When sedation is provided, gag reflexes are temporarily suppressed. If food or liquid remain in the stomach vomiting can occur, resulting in asphyxiation (choking). This can cause serious complications and in very rare cases death. Please inform our staff if you have had anything at all to eat or drink on the day of your procedure.
Yes. All of our doctors are licensed by the State of Illinois, are board certified in obstetrics and gynecology and specialize in pregnancy termination.
The pregnancy tissue that is removed during the procedure is sent to a pathology laboratory where it is weighed and examined, most often microscopically. A report detailing this examination is sent to our office within a week of the procedure. The tissue then disposed of in accordance with the mandates of state law–most often this means it will be cremated (incinerated).
Our physicians at FPA are very thorough and take multiple steps to ensure that the abortion procedure is complete. First, the physician will examine the pregnancy tissue after the surgery. Second, a post-operative ultrasound can be performed at the request of the physician. Third, the pregnancy tissue that is removed during the procedure is sent to a pathology laboratory where it is weighed and examined, most often microscopically. A report, detailing this examination, is sent to our office within a week of the procedure. After reviewing the pathology reports the physician decides whether a follow up visit is needed. We will contact you if the physician requests that you come in for an evaluation. We want to ensure that your pregnancy hormones are falling at the appropriate rate and that you are recovering well. Lastly, in some cases if you are very early in the pregnancy at the time of your surgery, the doctor may request that you return to the clinic 2-3 days after your abortion for a blood test to ensure that the procedure was successful.
Most often you can go back to your regular activities the day after your procedure. Strenuous exercise can sometimes increase the amount of bleeding and cramping that you experience. If you notice an increase in your bleeding or cramping after exercising you may want to decrease your activity for a few days. Please do not hesitate to contact us if you have any questions or concerns. If at any point you fully soak a maxi-pad in one hour or less, after your procedure, you should call us right away.