By Marie- Simone
Often, trimesters and the different gestational ages come up during discussions about pregnancy expectations, but equally important is the conversation surrounding the different trimesters and appropriate abortion methods.
The most suitable abortion method for you will depend on the gestational age of your 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, and your situation will be unique based on your previous medical history and the nature of your pregnancy, your location, and the legislation in your country. Generally, when deciding which abortion method is best, multiple variables have to 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;
- you have a uniquely shaped uterus; .
All these factors, including many others, could impact the type of abortion procedure that is right for you. You should seek the advice of a health-care practitioner or counselor to get the best information. The live chat option on the safe2choose.org website enables you to speak to a counselor who will provide you with the options available to you. She will also guide you through the best course of action with regards to seeking medical advice, should it be possible for you.
This post seeks to help you understand what abortion method is best suited for you based on your gestational age. To begin with, 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 woman’s last menstrual period. This is because the timing of the last menstrual period is a very good predictor of when a woman will ovulate, or release an egg, and thus it is also a good predictor of when fertilization may occur for a pregnancy.
Depending on your locale, medical abortions involve either the use of Misoprostol only or both Mifepristone and Misoprostol. For Misoprostol-only abortions, for women below 9 weeks, one would typically take 8 pills of Misoprostol, each containing 200mcg, and for those between 9 and 11 weeks, 12 pills of Misoprostol, each containing 200mcg to complete an abortion.
The process for the Misoprostol and Mifepristone abortions is slightly different, with one initially taking a 200mg Mifepristone tablet, which blocks progesterone, one of the main hormones at work during pregnancy. This tablet is usually taken at home, or at a hospital or clinic, and you’ll be able to continue your normal activities after taking it. After this, 24 to 48 hours later, you take four tablets of the second medicine, Misoprostol (200mcg), by placing it under your tongue. Depending on your gestational age, this medication can be taken at home or at the clinic. Within a few hours of taking the second medicine, the lining of the womb breaks down causing pain, bleeding, and loss of the pregnancy. It is important to note that each medical abortion will be different for every woman and should you find yourself unsure of what to do, reach out to our safe2choose counselors.
Medical abortions, generally, are viable for the gestational age of 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks and 11 weeks  As is the case for Misoprostol-only abortions, combination-pill abortions for gestational ages beyond 11 weeks should be conducted in a clinical setting. Our safe2choose counselors offer support for medical abortions at home up to 11 weeks and you can read more about it here.
Manual or Electric Vacuum Aspiration (MVA or EVA)
This procedure is usually conducted for pregnancies with gestational ages less than 15 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, and this is where the differentiation lies between the two. Many local practitioners are opting for vacuum aspiration as it is quick, easy, and requires minimal equipment. Vacuum aspiration can also be used for post-abortion care, should you find yourself in a situation where a medical at-home abortion, or miscarriage, has not reached completion .
Vacuum aspiration can be used on pregnancies at a gestational age of 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, 8 weeks, 9 weeks, 10 weeks, 11 weeks, 12 weeks, 13 weeks, 14 weeks and 15 weeks. Read the guide to a safe MVA abortion here.
Dilation and Evacuation (D&E)
This procedure is typically conducted for pregnancies that fall outside of the first trimester. It involves the use of forceps that are placed inside the cervix and into the womb to remove the pregnancy. The medical professional will begin by administering a medication that will induce dilation of the cervix. This can be in the form of the common medical abortion pills, Mifepristone or Misoprostol, or in the form of an osmotic dilator. Osmotic dilators are made from seaweed, and when inserted into the vaginal canal, will help the cervix to open to allow for the entry of the forceps .
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.
D&E is a method used for pregnancies in the gestational ages of 15 weeks, 16 weeks, 17 weeks, 18 weeks, 19 weeks, 20 weeks, 21 weeks, 22 weeks, 23 weeks, and 24 weeks.
Navigating which abortion method is viable at the different gestational ages can be daunting for many, but our counselors at safe2choose are available for you at all stages and will assist in getting you through the necessary steps. Contact them through our live chat or e-mail at firstname.lastname@example.org.
 “Medical versus Surgical Abortion.” “Medical versus Surgical Abortion.” University of California San Francisco Health, www.ucsfhealth.org/education/medical-versus-surgical-abortion. Accessed October 2020.
 “Manual Vacuum Aspiration.” Women’s Health Matters,www.womenshealthmatters.ca/health-centres/sexual-health/abortion/manual-vacuum-aspiration/#:~:text=Manual%20Vacuum%20Aspiration%20(MVA),anxiety%20may%20also%20be%20offered. Accessed October 2020.
 “Cervical Osmotic Dilator” My Health Alberta https://myhealth.alberta.ca/health/Pages/conditions.aspx?hwid=tn9810&lang=en-ca. Accessed October 2020