Surgical Abortion Procedures During First Second And Third Trimesters
132 Healthwise provides fast access to the highest level of diagnosis and care for patients who have concerns about their sexual health, including pregnancy termination (abortion). When considering your options, it is important to understand how surgical abortion works by trimester.
First Trimester (Week 1-12)
Medical abortions can be performed up to 9 weeks, but you may decide to have a surgical termination instead for medical reasons or due to your own preferences. The two options available in the UK are:
- Manual Vacuum Aspiration (up to 12 weeks): which uses gentle suction to remove the contents of the womb.
- Dilation and Curettage (from 9 weeks): which uses medication to relax the cervix and then clears the womb contents using special instruments.
Second Trimester (Week 13-26)
Several different surgical procedures may be available in the second trimester, depending on how far along you are and the clinic you choose for your abortion. Medical considerations in this period may include risks such as Uterine Rupture During Induced Abortion in the Second Trimester. The available methods include:
- Dilation and Vacuum Aspiration (up to 15 weeks): which uses medication to relax the cervix and then removed the womb contents using suction.
- Dilation and Curettage: during which the cervix is widened by medication and the womb contents are removed by instruments. Sedation or a general anaesthetic is required.
- Dilation and Evacuation (from around 15 weeks): uses forceps to remove the womb contents under sedation or a general anaesthetic.
The 24 week legal limit for abortions falls near the end of the second trimester. After this time, access to abortion is more limited.
Third Trimester (Week 27 on)
Abortions aren’t usually carried out in the third trimester unless the woman’s life is in danger or a severe foetal abnormality has been detected. If an abortion needs to be performed at this stage in pregnancy:
- Dilation and Extraction: during which the cervix is opened up using medication and the intact foetus is removed from the womb using forceps. A general anaesthetic is usually required.
Overview of Surgical Termination Methods
The following table summarizes the surgical procedures available based on the stage of pregnancy:
| Trimester | Weeks | Available Procedures |
|---|---|---|
| First Trimester | 1 - 12 | Manual Vacuum Aspiration, Dilation and Curettage |
| Second Trimester | 13 - 26 | Dilation and Vacuum Aspiration, Dilation and Curettage, Dilation and Evacuation |
| Third Trimester | 27+ | Dilation and Extraction |