How to abort during second Trimester?

Legal or not:

Abortion is legal only until 20 weeks of pregnancy under specific conditions and situations in India.

The conditions are:
Only if the continuation of pregnancy might have a risk to the life of the pregnant woman or might cause a grave injury to physical or mental health to the pregnant woman.

And also if there is a risk such as a child might suffer from physical or mental abnormalities as to be seriously handicapped.

Methods:

Second Trimester Abortion can be done in 3 methods. They are Dilatation and Evacuation, Intrauterine instillation of abortifacients and Administration of systemic abortifacients.

Dilatation and Evacuation:

Efficiency:

It is 99% successful way to do abortion.

Safety:

There are not many complications in earlier gestation. Cervical Dilatation is usually carried out by using Multiple Osmotic Dilators.

Complications:

Some complications can occur like Hemorrhage, infection, incomplete abortion requiring to repeat evacuation(like 1st-trimester surgical abortion), uterine perforation, and cervical laceration.

Intrauterine instillation of abortifacients:

Efficiency:

It has a successful abortion rate of 93%.

Safety:

In order to prevent intravascular or intramyometrial infusion, a small amount of amniotic fluid is withdrawn. This procedure confirms the location of the needle once it’s been inserted.

Complications:

Some complications can occur like Gastrointestinal side effects, Hypernatremia, Fluid overload and Transient fetal survival.

Administration of Systemic Abortifacients:

Efficiency:

It has a successful abortion rate of 97%.

Safety:

It has been shown that combined mifepristone and misoprostol regimen can shorten the induction to delivery time and decrease procedure-related pain when compared to prostaglandin only regimens.

Complications:

Some complications can occur like Gastrointestinal discomfort, Fever and retained products of conception requiring surgical evacuation.

Instillation of abortifacients seems to have twice the rate of serious complications when compared to Dilatation and Evacuation.

These are the three methods used for abortion in the second trimester.

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