Different Types of Abortion, Costs and Risks
There are several different types of abortion procedures, such as Medical (Pill) (typically used for up to 10 weeks gestation) or Surgical (post 10 weeks) – each with different risks, side effects, and financial costs.
A medical abortion or “The Abortion Pill” uses drugs, instead of surgical instruments, to end a pregnancy. Early Medical Abortion – up to 10 weeks from the last menstrual period (LMP) “The Abortion Pill” (mifepristone plus misoprostol) is the most common form of medical abortion. It was approved by the Food & Drug Administration (FDA) for use in women up to 10 weeks after LMP.1 It is done by taking a series of pills that disrupt the embryo’s attachment to the uterus, and cause uterine cramps which push the embryo out.5
Things to consider:6
- Bleeding can be heavy and lasts an average of 9-16 days.
- One woman in 100 need a surgical scraping to stop the bleeding.
- Pregnancies sometimes fail to abort, and this risk increases as pregnancy advances.
- For pregnancies 8 weeks LMP and beyond, identifiable parts may be seen.7
- Methotrexate is FDA-approved for treating certain cancers and rheumatoid arthritis but is used off-label to treat ectopic pregnancies and to induce abortion.8,9 Given by mouth or injection, it works by stopping cell growth, resulting in the embryo’s death.
COST: Depending on the facility, city, state of acquiring the abortion pill it can cost between $500-900.
Surgical Abortion
Surgical abortions are done by opening the cervix and passing instruments into the uterus to suction, grasp, pull, and scrape the pregnancy out. The exact procedure is determined by the baby’s level of growth.
Aspiration/Suction23,24 – Up to 13 weeks LMP. Most early surgical abortions are performed using this method. Local anesthesia is typically offered to reduce pain. The abortion involves opening the cervix, passing a tube inside the uterus, and attaching it to suction device which pulls the embryo out.
Dilation and Evacuation25,26 (D&E) – 13 weeks LMP and up. Most second trimester abortions are performed using this method. Local anesthesia, oral, or intravenous pain medications and sedation are commonly used. Besides the need to open the cervix much wider, the main difference between this procedure and a first trimester abortion is the use of forceps to grasp fetal parts and remove the baby in pieces. D&E is associated with a much higher risk of complications compared to a first trimester surgical abortion.
COST: Depending on the facility, city, state, and development of fetus, acquiring this can cost between $1,500-2,500.
D&E After Viability27-29 – 24 weeks LMP and up. This procedure typically takes 2–3 days and is associated with increased risk to the life and health of the mother. General anesthesia is usually recommended, if available. Drugs may be injected into the fetus or the amniotic fluid to stop the baby’s heart before starting the procedure. The cervix is opened wide, the amniotic sac is broken, and forceps are used to dismember the fetus. The “Intact D&E” pulls the fetus out legs first, then crushes the skull in order to remove the fetus in one piece.
COST: Depending on the facility, city, state, and development of fetus, acquiring this can cost between $3,000+.
NOTE: Insurance coverage depends on each plan by each employer. Medicaid coverage dependent on each state.
Risks of Abortion
Side effects may occur with induced abortion, whether surgical or by pill. These include abdominal pain and cramping, nausea, vomiting, and diarrhea. Abortion also carries the risk of significant complications such as bleeding, infection, and damage to organs. Serious complications occur in less than 1 out of 100 early abortions and in about 1 out of every 50 later abortions.
Women who undergo one or more induced abortions carry a significantly increased risk of delivering prematurely in the future. Premature delivery is associated with higher rates of cerebral palsy, as well as other complications of prematurity (brain, respiratory, bowel, and eye problems).
There is evidence that abortion is associated with a decrease in both emotional and physical health. For some women these negative emotions may be very strong and can appear within days or after many years. This psychological response is a form of post-traumatic stress disorder. Some symptoms are:
- Eating disorders
- Relationship problems
- Guilt
- Depression
- Flashbacks of abortion
- Suicidal thoughts
- Sexual dysfunction
- Alcohol and drug abuse