Second Trimester Abortion Procedures in India

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Key points:

  • The Medical Termination of Pregnancy Act (MTP Act) allows abortion up to 20 weeks of pregnancy.
  • While undergoing an abortion during any trimester, the woman needs to fulfill at least one condition under the MTP Act.
  • According to the MTP Act, for abortion in India, in the case of any woman above the age of 18 years, the doctor does not need the consent of any other person other than the pregnant woman.

The period of the 13th to 28th week of pregnancy comes under the second trimester. It is the mid-pregnancy phase, the phase when your baby bump may begin showing up and feel the moves and kicks of your baby.

The abortion method is determined by how far the woman has been through in her pregnancy. During the first trimester, there is an option for both medicinal and surgical abortion, whereas, in the second trimester, surgical abortion remains the only option. However, it is important to go through detailed ultrasound for doctors to determine the best and most viable abortion methods during the second trimester.

Abortion during the second trimester is comparatively much more complicated than the first trimester. According to medical reports, abortions during the second trimester contribute to serious complications in two-thirds cases of complications out of all cases of abortions in India. But with the advancements in medical technology over the past few decades, it has become much easier to undergo abortion during the second trimester too.

Abortion methods during the second trimester

In India, abortion is basically done in two ways during the second trimester.

1. Dilation and Curettage (D&C) – D&C is the most commonly performed abortion method during the second trimester. In this method, the doctors perform the dilation method and then treat uterine conditions such as abortion, heavy bleeding, previous abortions, or remnants of previous miscarriage. The procedure is also knwon as dilatataion and curretage.

In this procedure, the doctor uses very small medical instruments or medications to dilate and open the cervix and then insert surgical devices to curette, remove or clean the uterine lining.

D&C is usually a very safe abortion method but is not performed by expert doctors, there is a chance that the procedure may cause perforation of the uterus, damage to the cervix, infection, and scar tissue on the uterine wall.

2. Dilation and Evacuation (D&E) – D&E includes a combination of dilation and curettage, vacuum aspiration, and the use of medical instruments (forceps) to terminate a pregnancy. It is another very common method for abortions during the second trimester. The procedure takes around 30-45 minutes to complete. The procedure is done in the hospital and requires a one-night stay. 

In this method, the woman is made to lie down in a lithotomy position. The doctor widens her vagina with a speculum and cleans it with an antiseptic solution. D&E is mostly done under spinal anesthesia. The doctor inserts a cannula, attached to a bottle, and pumps it into the uterus. The doctor inserts a curette to gently scrape the contents in the uterine lining and remove the tissues from the uterus. In the final step, the doctor may use suction to make sure all the uterine contents and remnants are completely removed.

What happens before abortion during the second trimester?

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Before performing the procedure, the doctor is likely to explain to the patient everything about the procedure, potential risks, and complications, if any, and how to recover after the abortion method. 

  1. The doctor may ask the patient to undergo some imaging tests to evaluate the possible risks and complications. 
  2. The doctor may place a speculum to view inside the vagina.
  3. The doctor cleans the cervix with gauze medications.
  4. The doctor may apply numbing medication to the cervix so that the patient does not feel any cramps or pain during the treatment.

After the diagnostic procedure is over, the patient may be asked to sit/ lie and rest for a while. There might be slight cramping and light spotting too. But that is normal and nothing much to worry about.

Is abortion during the second trimester safe in India?

Yes, second-trimester abortion in india is ideally very safe, if performed under the supervision of a trained, experienced and certified gynecologist.

But, since the procedure is very delicate, there might be certain risks and complications, including:

  • Infection
  • Perforation in the uterus that may lead to heavy bleeding and severe pain
  • Cevication laceration and perforation
  • Tear in the cervix

There are no major risks and complications associated with abortion during the second trimester. To make sure the abortion is complete and there are no risks and complications that may affect any future pregnancies for the woman, most of the patients are called for a doctor follow-up after the abortion procedure. During the follow-up, the doctor will check if there is any problem that may cause problems for the health of the woman in the future. 

Who can undergo an abortion during the second trimester in India?

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Under the Medical Termination of Pregnancy Act, 1971, abortion in India has been legalized and permitted under various circumstances:

  • When the continuation of the pregnancy poses risk to the health and life of the pregnant woman and could cause grave complications to her mental and physical health.
  • If pregnancy has a substantial risk for the child, or if there is a chance that the fetus may be born with serious mental and physical abnormalities.
  • If the pregnancy is an outcome of rape which is likely to cause serious mental trauma to the baby.
  • When the pregnancy is a result of contraceptive failure used by either the man or the woman.

Abortion is a very delicate procedure. A woman needs to make sure she is in safe hands. Things are a little more complicated for abortion during the second trimester. Thorough research to settle for the best gynecologist who can safely perform the procedure is extremely important. If you are looking for a medical service provider who can provide you with not just the safest abortion during your second trimester, but also confidential and compassionate care and counseling throughout the journey, you can get in touch with Pristyn Care Gynecologists. Pristyn Care is associated with licensed clinics and hospitals in India where certified and trained gynecologists provide extremely safe and confidential abortions for both the first and second trimester.

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