Abortion methods present women with choices

Editor's note: This is the third in a four-part series by Kylee Dalmata about the choices faced by women who find themselves pregnant before they are ready for the challenges of motherhood.

By Kylee Dalmata
Norwich Guidon Staff Writer

Rachel woke up for what seemed like the millionth time and made her way into the bathroom. She had just taken the second pill. The process would soon be over.

Rachel had two children already. She did not think she could handle a third without becoming an abusive mother.

Her body had been aching and uncomfortable for a few days, now, as it slowly rid itself of the embryo.

But when Rachel had entered the bathroom for the final time, she hadn't expected to look down into the toilet bowl and see her unborn baby.

"It seemed rude to flush it," Rachel said. "I should be having a burial or something." But then, Rachel recalls hearing her daughter waking up and thinking: "Well, you have to get on with your day."

Like millions of women worldwide, Rachel had made the difficult decision to terminate her pregnancy. Her decision was strongly influenced by the availability of a new option for women who do not want to carry a fetus to term.

Until recently, women who unintentionally became pregnant and did not want a child had only the option of a surgical abortion.

According to the Planned Parenthood web site (www.plannedparenthood.org), the three most common forms of surgical abortion are manual vacuum aspiration, dilation and suction curettage, and dilation and evacuation.

"The method used depends on how long you have been pregnant - the number of days since the first day of your last period," according to the web site.

During manual vacuum aspiration - or MVA, the uterus is emptied with gentle suction of a manual syringe.

"It is often used for very early surgical abortion," according to Planned Parenthood. "It can be done as soon as you know you are pregnant and up to 10 weeks after your last period."

Dilation and suction curettage - also known as D&C, or vacuum aspiration, empties the uterus with machine-operated suction.

"A curette (narrow metal loop) may be used to clean the walls of the uterus," according to the web site. "This method is used for early surgical abortion. It is performed from six to 14 weeks after your last period."

The third method commonly used late in a pregnancy, according to Planned Parenthood, is dilation and evacuation - also known as D&E. In this two-part procedure, the cervix is slowly opened and the uterine walls scraped and flushed.

"The procedure is completed with medical instruments, suction, and curettage," the web site says. "After 24 weeks of pregnancy, abortions are usually performed only for serious health reasons."

Each of these procedures is fairly quick and requires no hospital time for the patient.

According to Planned Parenthood, "MVA and D&C take about 10 minutes. A D&E takes between 10 and 20 minutes. Allow more time for the whole process, which also includes counseling, a physical exam, forms to read and sign, and a recovery period."

The web site claims that surgical abortion is nearly 100% effective.

"Surgical abortion fails to end a pregnancy 1 out of 500 times," the web site says. "This can happen due to unusual conditions: There can be more than one chamber in the uterus. Or the pregnancy may not be in the uterus."

The amount of discomfort reported by women on the Planned Parenthood web site varies according to what method of surgical abortion is used and how far along the fetus is.

"Most women feel pain similar to menstrual cramps," the web site says. "For others, abortion is more uncomfortable. Local painkillers are usually used. Some clinics offer general anesthesia so you can sleep through the procedure. This, however, increases the medical risks and how long you must remain at the clinic. Abortion with local anesthetic after 24 weeks of pregnancy is about as painful as labor during birth."

While the Planned Parenthood web site does list several possible complications that can occur following abortions, it also points out that "In the first 20 weeks, abortion is much safer than giving birth."

According to The Ultimate Pro-Life Resource List, www.prolifeinfo.org, surgical abortions are often painful and can leave scars.

The complications listed on the Planned Parenthood web site as occurring from early abortion include allergic reactions to the drugs, incomplete abortion (this occurs in less than 1 out of 100 D&C abortions and 1 out of 200 D&Es), blood clots in the uterus, infection, very heavy bleeding, a cut or torn cervix (this occurs in fewer than 1 out of 100 early abortions), and organ injury (in about 1 of 1,000 early abortions, an instrument goes through the wall of the uterus. In even fewer cases, this leads to infection, heavy bleeding, or both. In D&E this happens 3 of 1,000 times.

According to the web site, the most serious side effect, death, occurs in 1 of 100,000 abortions. Childbirth, it claims, carries seven times more risk.

One final question that may be asked by women considering abortion is how much they cost. According to Planned Parenthood, the fees associated with abortions depend on how long the woman has been pregnant and where the procedure is preformed.

"At health centers, the cost ranges from about $225 - $575 for abortion in the first trimester," the web site says. "Hospitals generally cost more."

D&E, also referred to as partial-birth abortion, has caused considerable controversy among pro-choice and pro-life activists.

This procedure is performed during the first 20 weeks. However, it can be used much later, as far as nine months into the pregnancy, according to the pro-life website.

In contrast to the description found on the Planned Parenthood web site, the Pro-Life Resource List provides a slightly more graphic description of the procedure.

According to the web site, during a partial-birth abortion an unborn child is partially extracted from the womb feet first. Before the head is removed, scissors are inserted into the skull and opened to widen the hole. The brain is then removed to collapse the head and the dead fetus is removed.

The National Right to Life committee claims to have built a strong case against this method through awareness of the procedure.

In a 1995 effort to pass a ban on partial birth abortions, clauses were built into the legislation that was submitted to the House Judiciary Constitution Subcommittee. The clauses allowed for abortions to be preformed in "right to life" cases. For abortion to be allowed in such cases, the mother's life would have to be in jeopardy from carrying the fetus to term.

Senator Peter Fitzgerald was among those in government who pushed for the ban on partial-birth abortions, according to the Pro-Life Resource List. Sen. Fitzgerald denounced such practices as "barbaric" and "cruel" methods of destroying life.

The opposition to the ban on partial-birth abortions fears the ban as a springboard for further legislation that they feel will restrict the right of women to choose.

Today, there are several alternatives to surgical abortions that both sides agree are preferable.

According to the Resource List web site, when protection fails, a 'morning-after pill' is the chosen remedy to prevent implantation of a possibly fertilized egg. This is accomplished by "skyrocketing a women's hormone levels," which causes the womb to reject any embryos that might be growing.

The morning-after pills are taken 12 hours apart, but are ineffective if used more than 72 hours after the incident, according the Cornell Daily Sun.

The newest option for women like Rachel is a combination drug that comes in pill form called RU-486, which has recently had its name changed to Mifepristone according to www.plannedparenthood.org.

Better know as the "abortion pill," RU-486 is actually a two-pill series of drugs. The first, mifepristone, is a steroid that makes it hard for the egg to implant. The second, misoprostol, triggers uterine contraction.

RU-486 is most effective within 49 days of pregnancy, but can be used safely up to day 63, according to www.prolifeinfo.org.

For Rachel, and more than 600,000 other women in Europe and China, RU-486 seemed like a better way to abort her pregnancy, according to www.prolifeinfo.org.

Only approved by the FDA since September of 2000, this relatively new drug has been in testing since 1994. The drug proved effective in 92% of its trials and was widely recommended by those who had used it, according to www.plannedparenthood.org.

The drug is as safe as an aspiration abortion and produces the same effects as those that result in a miscarriage according to www.plannedparenthood.org.

The problem with this series of pills is its side effects. "It can include extensive bleeding, cramping, nausea, and vomiting, according to www.prolifeinfo.org. But for some, that is exactly why they chose it."

When first created, there was no sign of the drug being marketed in the US, "it's manufactures have no intention of marketing the drug in the U.S. or any other country where the company perceived that political and social conditions were unreceptive to the drug," according to the planned parenthood site.

Since then, there have been movements to bring it into the country, and exclusive licenses have been granted. The drug is making its way into the US partly due to the fact that lower doses can prevent pregnancy and because it has been identified as useful against certain cancers and diseases.

These other uses do not, however, diminish the drug's initial and primary purpose, abortion. The nature of the process, although less invasive than older techniques, still brings pain to the imbiber.

For Rachel, the pain involved "served as a form of penance." According to Rachel, "it was like, if I'm going to do this, I have to take the responsibility and do it, myself, and I have to put myself through something hard. It would have been cowardly to have someone fix it for me."

The pills may cause pain now, but "it was just like having a miscarriage," Rachel said. "It might be painful, but it will be more natural, my body will be doing it to itself. I thought the least I could do was suffer a little."

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