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Photo credit: Dr. Russell Saco

Suction Aspiration
Dilation and Curettage (D&C)
Dilation and Evacuation (D&E)
Salt Poisoning (Saline Amniocentesis)
Prostaglandin Abortion
Hysterotomy
Partial Birth (Brain Suction) Abortion
RU486 & Methotrexate

Suction Aspiration
Used in most (90%) abortions during the first 12 weeks of pregnancy. Anesthesia, general or local, is given to the mother. There is no fetal anesthetic. The mouth of the womb (cervix) is dilated. During pregnancy the cervix is closed tightly to protect the baby and can be easily damaged by forcible dilation. A suction curette (hollow tube with a knife-like edged tip) is inserted into the womb. A strong suction tears the baby to pieces, drawing them into a container. Great care must be used to prevent the womb from being perforated by this procedure. Sometimes, in a very early suction abortion, a smaller tube can be inserted and the cervix does not have to be dilated so severely; this is called a “menstrual extraction”. Often, however, the tube does not remove all the pieces and infection will result, requiring the cervix to be fully dilated and a “D&C” performed.

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Dilation and Curettage (D&C)
Similar to the suction method except for insertion of a looped knife (curette) which cuts the baby apart, without fetal anesthetic, and scrapes the pieces out through the cervix. This abortion should not be confused with a therapeutic D&C done for reasons other than pregnancy. In such cases, neither the cervix nor the lining of the womb are physiologically as susceptible to damage from the curette.

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Dilation and Evacuation (D&E)
Similar to D&C, this method is used up to 18 weeks gestation without fetal anesthetic. Instead of a loop-shaped knife, a grasping forceps (similar to pliers with teeth) is inserted into the womb to grasp part of the fetus. Because the developing baby already has calcified bones, the part must be twisted and torn away. This process is repeated until the baby is totally dismembered and removed. Sometimes the head is too large and must be crushed in order to remove it. Bleeding is profuse. Finally, the placenta (afterbirth) is cut away from the wall of the uterus.

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Salt Poisoning (Saline Amniocentesis)
Though outlawed in Japan and other countries because of its inherent risk to the mother, abortions are done by salt poisoning in the U.S. This method is sometimes referred to as Saline Amniocentesis, and is done for late second or third trimester abortions. A concentrated salt solution is injected into the amniotic sac by needle through the mother’s abdomen. The baby breathes and swallows the solution, and usually dies 1 to 2 hours later from salt poisoning, dehydration, hemorrhages of the brain and other organs, and convulsions. The baby’s skin is often stripped or burned off by the salt solution. The mother goes into labor and a dead or dying baby is delivered 24-48 hours later.

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Prostaglandin Abortion
Prostaglandins are hormones needed for birth. Injecting them into the sac induces violent labor and premature birth of a child usually too young to survive. This method is generally used for abortions done during the second half of pregnancy. Salt is sometimes injected first to kill the baby before birth and make the procedure less distressful for the mother and the staff.

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Hysterotomy
Similar to Cesarean Section, though its purpose is to kill rather than to save the child. Hysterotomy is used if the salt poisoning or prostaglandin method has failed or when a hysterectomy tubal ligation is done at the same time. Almost all these babies are born alive. The abdomen and womb are opened surgically; the baby is lifted out and the cord is clamped. The child often struggles before expiring. Before a 1979 Court decision doctors were known to smother the child with his/her own placenta or quickly drown him/her in a bucket of water to insure not being held liable for a “wrongful death” lawsuit if the child was born alive. Since that decision, these methods are unnecessary. However, some babies who were not encouraged to die have occasionally survived and are subsequently accepted by their natural mothers or adopted.

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Partial Birth (Brain Suction) Abortion
After 3 days of dilating the cervix, the abortionist reaches up the birth canal, grasps a leg and pulls it down and out, then the other leg, body, shoulder and arms. At this point with a gentle pull he could deliver the final 3 or 4 inches (the head) and send the baby to the nursery. Rather, he inserts scissors into the base of the baby’s skull, separates the blades, inserts a suction tube into the skull and sucks out the brains. This kills the baby who is then removed.

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RU486 & Methotrexate
These are abortion drugs. Used with a prostaglandin drug, they are “effective” 90-95% of the time when used between one and three weeks after she has missed her first period. They function by depriving the tiny embryo a vital nutrient hormone, progesterone (RU486), and by direct toxic action (methotrexate). They kill a developing baby after his or her heart has begun to beat.

These procedural descriptions and abortion images with permission, Handbook on Abortion, Jack Willke, M.D., Hayes Publishing Co., Cincinatti, OH

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