To lessen the chances of an unsuccessful abortion and increase the safety of abortion procedures, knowing what methods are considered safe for each gestational age is important.
Why Gestational Age Matters When Choosing an Abortion Method
Often, trimesters and the different gestational ages come up during discussions about pregnancy, but it’s equally important to have conversations about the different trimesters and appropriate abortion methods.
The most suitable abortion method for you will depend on the gestational age of the pregnancy and your specific needs, although the accessibility of most abortion methods is frequently expanding. The model, of course, is not a one-size-fits-all approach, and your situation will be unique based on your previous medical history, the nature of the pregnancy, your location, and the legislation in your country.
Generally, when deciding which abortion method is best, many factors should be considered, including whether:
- your pregnancy has implanted outside of the uterus;
- you have a bleeding disorder or take blood thinners;
- you are allergic to misoprostol or mifepristone;
- you have a severe liver, kidney, or lung disease;
- you have an intrauterine device (IUD);
- you routinely take corticosteroids; or
- you have a uniquely shaped uterus.
All these factors, including many others, could impact the type of abortion procedure that is right for you. It’s not required, but you can connect with a health-care practitioner or counsellor to get more information. You can also talk to a counselor via live chat at safe2choose.org. They will advise on the most appropriate abortion method for you and guide you on how to seek medical advice if you need it.
This post seeks to help you understand which abortion method is best suited for you based on your gestational age. We will walk you through how to determine your gestational age and then detail the various abortion methods suitable for the various stages of pregnancy.
How to Determine Gestational Age
Gestational age, or the age of the embryo, is calculated from the first day of the pregnant person’s last menstrual period. This is because the timing of the last menstrual period is a very good predictor of when a person will ovulate, or release an egg, and therefore it is also a good predictor of when fertilization may occur.
Available Abortion Methods by Pregnancy Stage
Abortion with pills (up to 13 weeks)
This typically involves a two-step process using mifepristone and misoprostol. You can also have a medical abortion using only misoprostol, although this is only done when there are limited resources and/or the patient is allergic to mifepristone as research suggests the combined method is more effective.
Misoprostol-Only
To safely induce an abortion using misoprostol-only, you will need 12 misoprostol pills, containing 200 mcg of the active ingredient. This adds up to a total dose of 2400 mcg, which should be taken in three separate doses of 800 mcg (4 pills), spaced three hours apart.
If you are between 10–13 weeks pregnant, it’s strongly recommended you use all 12 pills for the highest chance of success. If you can only access 8 pills, you can still proceed, but it will be less effective; it’s best to consult a counselor for additional support before starting the process.
If your pills are a different dosage, such as 400 mcg per pill, you will need to adjust the number of pills to ensure you are getting the correct total dosage. Accurate dosing and timing are essential, so ensure you’re in a safe, private place and take a pain reliever, like ibuprofen (800 mg) or diclofenac (50 mg), before each dose to help manage cramps.
Mifepristone + Misoprostol
To use mifepristone and misoprostol for a safe and effective abortion, begin by swallowing one 200 mg mifepristone pill with water. This medication blocks the hormone needed to maintain a pregnancy.
After taking mifepristone, wait at least 24 hours, but no more than 48 hours, before using misoprostol. Choose a time when you can rest and have privacy and easy access to a bathroom. About 30 minutes before using misoprostol, take a pain reliever, such as 800 mg of ibuprofen, to help manage the cramping that will follow.
To take misoprostol, place 4 pills (200 mcg each) under your tongue and let them dissolve for 30 minutes. Don’t eat or drink anything, but you can swallow your saliva. After 30 minutes, swallow any remaining fragments with water.
Cramping and bleeding typically begin within 4 to 6 hours but can take up to 24 hours to start. These are normal signs that the abortion process has begun. If you are less than 9 weeks pregnant and haven’t experienced bleeding like a period within 24 hours, you can take a second dose of 4 misoprostol pills in the same way.
If you are between 9 to 13 weeks pregnant, we recommend you take a second dose 4 hours after the first to improve effectiveness. Throughout the process, you can continue to take pain medication, as needed, but avoid aspirin as it can increase bleeding. Always check the dosage on your pills and adjust the protocol accordingly if they are not 200 mcg each.
If your pregnancy is more than 13 weeks, contact our safe2choose counselors for additional support. You can also read more about the abortion pills here.
Vacuum Aspiration (up to 16 weeks)
Manual vacuum aspiration (MVA) and electric vacuum aspiration (EVA) (up to 16 weeks)
This procedure is usually conducted for pregnancies with gestational ages less than 16 weeks.
A tube is inserted into the womb, through the cervix, and the pregnancy is removed using suction. The suction can either be manual or electric. Many local practitioners are opting for vacuum aspiration as it is quick, easy, and requires minimal equipment. Vacuum aspiration can also be used for postabortion care if a medical at-home abortion or miscarriage has not reached completion.
A vacuum aspiration can be used to end a pregnancy from as early as 2 weeks up to 16 weeks of gestation. Read the guide to a safe MVA abortion here.
Dilation and Evacuation (15–24 weeks)
This procedure is typically conducted for pregnancies that fall outside of the first trimester. Forceps are placed inside the cervix and into the womb to remove the pregnancy. The medical professional will administer a medication to dilate the cervix. This can be with common medical abortion pills, mifepristone or misoprostol, or with an osmotic dilator. Osmotic dilators are made from seaweed and when inserted into the vaginal canal, they help the cervix to open.
Following this, you will be given local or general anesthesia, depending on your gestational age, and the procedure will be completed in 15 minutes, on average.
A dilation and evacuation (D&E) is used for pregnancies from 15 to 24 weeks.
Navigating which abortion method is viable at the different gestational ages can be daunting, but our counselors at safe2choose are available for you at each stage of the process. Contact us via our live chat or e-mail info@safe2choose.org.
When to Seek Medical Advice
Get medical help right away if you:
- bleed so much that you soak 2 or more pads every hour, for 2 hours in a row;
- have a fever that starts 24 hours or more after taking misoprostol and doesn’t go down after taking ibuprofen;
- feel severe pain that doesn’t get better after taking pain medicine like ibuprofen;
- have vaginal discharge that smells bad or looks different from your normal period;
- feel very sick or weak;
- have redness, swelling, or itchiness on your face, hands, or neck (this may be an allergic reaction); or
- have trouble breathing.
If you have even one of these symptoms listed above, please seek medical attention as soon as you can.
Need Help Choosing a Method?
At safe2choose, our trained counselors are here to provide compassionate and confidential support to help you make informed decisions about your pregnancy. Whether you need assistance understanding your gestational age, guidance on safe abortion methods, or information on postabortion care, we’re here for you every step of the way. Your safety and well-being are our top priorities, and we ensure that you receive accurate information and access to safe abortion options. Visit our website: safe2choose.org.
