Pregnant women who seek an abortion during second trimester are at higher risk than women seeking abortion in first trimester, even when the procedure adopted is safe and is done by a trained physician. Abortion can be done by taking medicine to terminate the pregnancy or it can be done by surgical method such as vacuum aspiration, dilation and curettage (D and C), or dilation or evacuation (D and E). Medical abortion is effective within the first 9 weeks of pregnancy. As pregnancy progresses into the late first trimester or second trimester surgical abortion is only the option. The risk of abortion in second trimester is relatively higher than in the first trimester. Problem with surgical abortion in the second trimester (weeks 13 to 27) include heavy blood loss, infection, and menstrual cramps. Pain associated with surgical abortion ranges from mild to severe and depends on each woman physical and psychological conditions.
Dilation and evacuation method is typically adopted if abortion is done in second trimester of pregnancy. D and E is done to completely remove all of the tissues in the uterus of pregnant women. It usually includes combination of vacuum aspiration and dilation and curettage with the help of surgical instruments. The risk factor associated with vacuum aspiration and D and E in second trimester of pregnancy includes incomplete abortion -- the embryo or fetus is not completely removed from the uterus; very heavy bleeding which can be fatal if untreated; and in extremely rare cases death from serious complications.
