Second Trimester Abortion

Second Trimester Abortion 14 to 25 weeks

The doctor will perform the abortion by using the Dilation & Evacuation “D&E” technique. This procedure is a more complex and involved procedure than a D&C during first trimester. Beyond 20 weeks gestation may require a two-day process.

We insist you should have someone with you throughout the night prior to your procedure. There is a hotel next door to our medical center for accommodations in the immediate area if you must travel.

You must review your Patient Rights and Responsibilities before you come in for your procedure.

What to Expect

One-Day Procedure

This will flow very similarly to the appointment and procedure of a D+C. The surgical evacuation of the pregnancy may take a little more time as it is more involved as the gestation increases; however, you will have the pre-op and procedure complete all in one day.

Depending upon the patient’s medical and obstetrical history, the use of dilators such as a laminaria, Dilapan, or foley may be necessary. This is usually feasible for patients in the second trimester up to 20 weeks.

This one-day procedure could result in the patient being in the office for up to 6 hours.

Two-Day Procedure 

Day 1

On the day of your procedure, you will need to register with the receptionist, who will gather information regarding your medical history, your personal information, and take care of insurance or payment. We accept most insurance programs as well as Maryland Medical Assistance.

You will be given a medication that stops the growth of the fetus and that softens and dilates your cervix. Our physician may decide to utilize a feticide if appropriate.

To take at home, a second medication will be given to you with specific instructions for when to take them and how.

Day 2

• You will use the medication as directed, starting on the morning of the second day until your cervix is dilated sufficiently for the procedure.
• You will return to our office in the morning where we can observe your condition.
• The evacuation procedure is performed when cervical dilation is achieved.
• Recovery post-procedure will be about 30-45 minutes.

*Ask us about our Private Office Experience service.

Two levels of anesthesia:

1. Local anesthesia is an injection given around the cervix, also known as a cervical block
2. Twilight (conscious) IV sedation, which puts you in a semi-conscious state where you are still breathing on your own and will quickly regain consciousness soon after the procedure is complete.

The choice of anesthesia is yours, and there is no difference in the price. We recommend IV sedation since it gives you more pain relief, and most likely you will not remember the procedure.

The Procedure and Post Procedure

• As part of the surgical procedure, all patients will receive the medicines Xanax and Cytotec. Xanax is an anti-anxiety medication, which will not only help you relax, but also contributes to the efficacy of the twilight sedation. Further, it reduces the amount of medication needed for anesthesia.
• If needed, the physician will dilate your cervix.
• Once the cervix is dilated, a combination of a suction curette and specially designed forceps are used to remove the products of the pregnancy.
• Your procedure will be performed by a board eligible/certified gynecologist.
• After your procedure, you will be accompanied to the recovery room where we will monitor your post anesthesia recovery for approximately 30-45 minutes.
• When you are ready to be discharged, our team will escort you out to your friend or family member who will take you home.
• You will be discharged with written and oral instructions on how to take care of yourself and what to do if you have a problem.
• We encourage and will assist you in exploring various family planning / birth control options
• Please return for a follow-up visit in 2-3 weeks

Surgical abortion reminders

• Do not eat or drink after midnight before your procedure
• Your driver MUST be with you at check-in if you are planning to have sedation during procedure
• Please wear underwear that support a pad
• Please wear loose fitting pants, avoid jeans and leggings
• Take your daily medications as prescribed unless directed by us otherwise

NOTICE: For the privacy and safety of all patients and staff we ask that you to be aware of the following. Thank you!

• No food allowed inside the center
• No backpacks allowed inside the center
• Guests are not allowed inside the center
• Private parking
• Protestors if any, are not allowed inside the parking lot

Gynemed Surgical Center is a state and national American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (QUAD A) licensed outpatient health facility with a uniquely comfortable and private atmosphere.

GUESTS
We truly understand and appreciate the support of the family and friends who accompany you during this difficult and emotional time, but out of respect and for the privacy of our other patients they will not be allowed to be with you during your pre-op examination and your procedure.

Our staff will gladly keep your guest informed of your progress and provide them with an estimated time for discharge. We will also call them by phone if they prefer to leave and come back when you are ready to leave.