Vacuum Aspiration (6 to 9 weeks): The cervix is enlarged and a powerful suction tube is inserted into the uterus. The fetus is sucked into a collection bottle along with the placenta and amniotic sac. Since the doctor cannot actually see what he is doing, several possible complications can occur, including infection (if any portion of the fetus or placenta remains in the womb), uterine perforation (if the tube punctures the womb) and cervical laceration.
Medical Abortion / Abortion Pill (5 to 7 weeks): The drug mifepristone (RU-486) is administered orally. The drug blocks the action of progesterone, a naturally occurring hormone which sustains the nutritive uterine lining. As this lining withers, the embryo starves to death. Administration of mifepristone is followed 36-48 hours later by misoprostol, a synthetic prostaglandin, which causes uterine contractions that expel the unborn child. Some women will deliver while still at the clinic, while others will do so later, at home or at work. Bleeding can be quite heavy and lasts for an average of nine days. This method of abortion fails 5-10% of the time, and must then be followed by a surgical abortion.
Dilation and Curettage (8 to 16 weeks): The cervix is enlarged and a steel loop-shaped blade is introduced into the uterus. The blade is used to scrape clean the walls of the uterus, removing the fetus and placenta. As with the aspiration method described above, the doctor is working blind, and this procedure may be followed by suction aspiration. It carries an increased risk of uterine puncture, infection, and serious blood loss.
Methotrexate or "M&M" (5 to 9 weeks): Methotrexate is normally used for treatment of cancers, arthritis, and certain dermatological conditions. It is not approved for abortions by the FDA, although it is sometimes used for this purpose. This drug is given by injection; it interferes with the growth process of rapidly dividing cells. Like RU-486, it is followed by misoprostol (hence the "M&M" nickname) to expel the fetus. This method fails at least 4% of the time. Methotrexate can potentially cause serious side effects, including severe anemia, ulcers and bone marrow depression.
D&E (13 to 20+ weeks): In this late term abortion the cervix is dilated, either mechanically or with laminaria. The physician uses forceps to dismember the fetus, which must then be reassembled to confirm that no parts have been left inside. Possible complications include infection, cervical laceration and uterine perforation.
D&X (20 to 32+ weeks): The procedure is also called Intact D & X, Intrauterine Cranial Decompression, and Partial Birth Abortion. This late in the pregnancy it is more difficult to dismember the fetus in the womb. Therefore the physician begins, but does not complete, a breech (feet first) delivery, while leaving the head inside the uterus. The physician then punctures the base of the skull and suctions out the brains. The child dies, the head collapses, and the delivery is completed. Possible complications include damage to uterine lining or cervix, perforation of the uterus, infection, and blood clots.