Up until recently, surgery was the only option for women who wanted to terminate a pregnancy.
This changed in September 2000 when the Food and Drug Administration approved the controversial mifepristone pill Mifeprex, commonly referred to as the “abortion pill.”
By 2005, the number of U.S. women who had opted for the pill over surgery reached 460,000, according to Danco Laboratories LLC., the manufacturer of the drug.
Women’s preference for the medical method or the surgical procedure depends on many factors, including comfort, privacy and risks.
Surgical abortions, regardless of the method, are sometimes considered an “invasive” procedure, often requiring the use of general anesthesia.
“(General anesthesia) was the only thing I was scared about,” said a CSUN student, who asked for anonymity. “Going in and watching them put the IV in and knowing that I was going to go to sleep for a while made me nervous, but the surgical procedure was simple and you don’t remember it.
“The next thing I knew I was sitting in a wheelchair and I was done,” she said.
Surgery done in the first trimester, or first 12 weeks of pregnancy, generally uses the method of vacuum aspiration. This method “ends an early pregnancy by gently suctioning the lining of the uterus and removing all of the tissues of the pregnancy,” the Planned Parenthood Web site reports.
Abortions done in the mid-trimester, or 14th to 24th week of pregnancy, use dilation and curettage, “a two-part procedure requiring one or two days to (open) the cervix and a final visit to the clinic to empty the uterus.”
This type of abortion is rare, accounting for only 2.4 percent of abortions today because of the availability of medical and non-invasive methods, according to the Centers for Disease Control and Prevention.
While the common appeal of the abortion pill is that it does not require surgery, there are many other attractions.
In 1995, when the medical method was still in the clinical phase, the Guttmacher Institute, which tracks abortion statistics, reported that “in most trials that offered participants a choice between surgical and medical abortion, 60 to 70 percent of patients chose the medical method,” noting that “the most common reasons cited for choosing the medical method were greater privacy and autonomy, less invasiveness and greater naturalness than surgery.”
Furthermore, “approximately 95 to 98 percent of women will have a complete abortion when using mifepristone and misoprostol,” according to the National Abortion Federation, and both the FDA and the scientists at the Centers for Disease Control and Prevention said the risk of mifepristone is “low,” after they examined the facts behind the deaths of five American women who died after using the drug in 2005.
Nevertheless, medication abortions currently only accounts for 10 percent of abortions done in the U.S.
“People still prefer surgery because they want the general anesthesia, they want to go to sleep, they don’t want to feel the pain,” said a manager of Family Planning Associates, an abortion clinic in West Los Angeles that offers mifepristone. The manager asked for anonymity.
“Some women who take the pill go home and experience severe cramping, because their uterus is contracting to push everything out,” the manager continued.
Medication abortions generally use mifepristone, and the procedure usually involves three steps. In the first visit, the woman takes mifepristone pills, which block progesterone, a hormone needed to maintain pregnancy.
One or two days later, the woman completes the abortion by taking a final pill called misoprostol, which causes the uterus to contract and empty.
A few days later, a follow-up exam is done.
“Some people think swallowing a pill sounds easier,” she said. “But then you have to come back in two weeks. We have to do another ultra-sound if we determine you have any retained tissue, then we have to insert more tablets to try and make your uterus contract. If that doesn’t work, you still have to go through with the surgery.
“You could end up having to make up to six visits, so it is not as easy as it sounds,” she added.
The Guttmacher Institute report noted that many of those surveyed who took the pill frequently mentioned drawbacks.
These included “pain, the duration of bleeding, the number of visits, and the waiting time to know if the treatment (was) successful.”
“I chose to take the surgery as opposed to the pill,” said a 21-year-old CSUN student who asked to remain anonymous. “I was told by one of my good friends that with the pill, ‘You’d bleed everything out.’ That sounded horrible to me, seeing as how I don’t like the sight of blood.”
While some women find abortion through medication problematic, the majority do not, according to a 1998 clinical study by the Archives of Family Medicine.
The study reported that 96 percent of U.S. women in clinical trials said they would recommend medication to others who needed an abortion, and “even among women for whom the method failed, 69.6 percent would try it again, 84.9 percent would recommend it to others, and 51.9 percent found it very or moderately satisfactory.”