We know women from many different backgrounds and life situations face unplanned pregnancies. One option is abortion. We are aware that abortion is a difficult decision, but it’s important to be informed about all the options you have.

Continue to read for more information about abortion procedures. Information on this site is intended for general education and therefore is not a substitute for professional and/or doctor advice.

TRIGGER WARNING: The following descriptions, while medically accurate, may be disturbing for some readers. We also recognize that the topic of abortion can bring with it many different personal and emotional responses. If you would like to discuss this with someone, reach out to us, and we can connect you to the appropriate resources.

ABORTION PROCEDURES

There are two types of abortions- medical and surgical. 

MEDICAL

Medicinal abortions are usually performed up to the tenth week after the LMP (last menstrual period). According to Sarajevo Open Centre, “As a rule, medication abortion (abortion pills) is not performed in BiH because the medicine is not registered on the BiH market, although some healthcare facilities state that they also perform this type of abortion.”

How does the abortion pill work?

“The pill” is actually a two-step process. First, the pill mifepristone is taken by mouth. This medication stops pregnancy medicinally, but not surgically. This pill is made to block the progesterone hormone, which is the key hormone that keeps the embryo alive. 24 to 72 hours later, misoprostol pills will be taken either by mouth or inserted into the vagina. This medication will cause the uterus to cramp/contract in order to expel the pregnancy. 

Side effects of mifepristone include nausea, vomiting, muscle pain, and low-grade fever. Misoprostol will cause vaginal bleeding, which usually begins within 4-6 hours of taking it. Bleeding lasts from 1-45 days, and can be heavy with clots and fetal tissue. Cramping is expected, and can range from moderate to severe. Risks include heavy bleeding, infection, endometritis, and failure of chemical abortion requiring a surgical abortion.,

Learn more about fetal development from conception to week 10 on our “Information About Pregnancy” page.

SURGICAL

Surgical abortions, as the name implies, use surgical procedures to end the pregnancy. There are two main types:

  • ASPIRATION and DILATION AND CURETTAGE (D&C) is most common in the first trimester, but can be performed up to 16 weeks.

After the cervix has been opened using tapered “dilators” (a series of rods of progressively larger sizes being inserted), the surgical instrument, a "cannula", is inserted into the cervix. This instrument is connected to either a manual or vacuum pump which suctions out the fetus. The doctor will check to make sure all the fetal body parts have been removed, and the procedure is considered finished when the uterus is empty. Depending on technique used by the doctor and the baby’s age, tools may be used to scrape the uterus of all pregnancy-related tissues (“curettage”), though the WHO generally does not recommend this.

  • DILATION AND EVACUATION (D&E) is usually performed after 14+ weeks.

This is a two-step procedure:

  1. Expanding the cervix (usually 1-3 days before the surgery, using a variety of methods, but most commonly by inserting laminaria (dry algae)).

  2. Removing the fetus and pregnancy-related tissues surgically.

Depending on the age of the fetus, “feticide” medications are used to stop the heartbeat of the baby prior to surgery, usually by injection. The D&E involves disarticulation (separation of body parts at the joint) of the fetus to allow removal through the cervix using strong, extraction forceps. A variation of this procedure, called a D&X (dilation and extraction) removes the fetus’s body intact, but requires decompression of the calvarium (crushing the fetus’s head). Curettage is used after the procedure to ensure all tissues are removed, and the fetal body parts are counted to ensure complete removal. Special medications are used to control uterine bleeding before and after surgery. 

Side Effects for both types of surgical abortions are similar, and include the same post-surgery risks from any procedure (anesthesia complications, bleeding, infection, death), in addition to uterine perforation and the potential need for hysterectomy, bowel damage, and cervical damage. There is an increased risk for preterm birth for women who have had more than one aspiration abortion. 

Learn more about fetal development during this time on our “Information About Pregnancy” page.

MENTAL HEALTH

Mental health and abortion (both medical and surgical) is a hotly debated topic. While some say that abortion has no effect on a woman’s mental health, others say that it can be distressing or even cause PTSD-like symptoms. What’s important to know is that everyone is different, and while it’s impossible for any ethical study to definitively prove if abortion does or does not cause or increase mental health issues, many studies have shown connections between abortion and depression, anxiety, and post-traumatic stress syndrome, to name a few. If you’d like to know more about our post-abortion resources, including stories of real women who have had abortions, click here. 

Information on our Web page is intended for the purpose of general education and therefore cannot serve as a replacement for professional and/or doctor advice. Glas Za Zivot is not a medical provider and we do not provide medical diagnoses or medical advice.