Second Trimester Procedures


Second trimester Dilation and Evacuation (D&E) procedures are performed beginning at 14-14.5 LMP (2.5cm BPD). Dilation of the cervix is achieved gently and gradually and appropriate dilation of the cervix must be obtained to reduce risks and complications.
The size of the pregnancy, as determined by the ultrasound done on the first day, and your medical history will be assessed to take the time needed for a safe process. Depending on the size of the pregnancy, the procedure will take two to three days.

14.0 weeks LMP - 19.5 weeks LMP

If you are between 14.0 and 15.0 weeks, a BPD measurement will determine the length of the procedure. If you are traveling from outside the Dallas, Fort Worth area, please contact our office for further information.

If you are 15.0 weeks to 19 weeks by ultrasound, counseling and lab work, will be performed on the first day. As well, laminaria will be placed to dilate your cervix gently and safely. Laminaria is sterile, compressed seaweed that is inserted into the cervical canal. The laminara rods expand by absorbing natural moisture in the cervix. At 20.0 weeks and above, an injection of Digoxin will also be administered to stop the fetal heart beat.

The evacuation of the uterus will be scheduled for the following day. No matter how long you have been pregnant, actual surgery only takes 5 to 25 minutes, depending on your medical condition.

Fees

Please call for current prices and information.

As you review them, keep in mind that abortion is a medical procedure involving your health, your body, and your mind.  Our fee includes necessary tests, counseling and sedation. Other clinics may not provide these additional steps, or include them in their stated fee. At Southwestern Women's Surgery Center, there are no hidden costs for comprehensive care. So before you make a decision solely on price, we encourage you to consider the importance of value.

20 weeks LMP -24 weeks LMP

At 20 weeks to 24 weeks, the abortion process will take three days. An ultrasound, counseling and lab work will be performed on the first day. Additionally, laminaria will be inserted to gently dilate the cervix.  

Laminaria is sterile, compressed seaweed that is inserted into the cervical canal. The laminara rods expand by absorbing natural moisture in the cervix. An injection of Digoxin will also be administered to stop the fetal heart beat.

A second day of laminaria will be used to further dilate the cervix and the evacuation of the uterus will then be scheduled for the third day.  Although rare, there may be an additional laminaria change on the morning of the third day and the procedure would be completed later in the afternoon. Because we can never anticipate exactly how well the cervix will dilate, you should be prepared to spend all day in our clinic on the day of your abortion as we work with your body for a safe procedure.

No matter how long you have been pregnant, actual surgery only takes 10 to 25 minutes, depending on your medical condition.

The dilation and evacuation method is one of the most medically safe manners in which to perform a second trimester abortion and it ensures the least amount of discomfort for the patient.

Fees

Please call for current prices and information.

As you review them, keep in mind that abortion is a medical procedure involving your health, your body, and your mind. Our fee includes necessary tests, counseling and sedation. Other clinics may not provide these additional steps, or include them in their
stated fee. At Southwestern Women's Surgery Center, there are no hidden costs for comprehensive care. So before you make a decision solely on price, we encourage you to consider the importance of value.

Postoperative Instructions

• After the abortion you may eat and drink normally. It is best to avoid strenuous activity, avoid lifting over 10 pounds, and avoid spending a lot of time on your feet. Be guided by how you feel.
• Please put NOTHING in the vagina for at least 7 days.
• Do not have intercourse.
• Do not use tampons- sanitary pads only.
• Do not douche, go swimming, or take a tub bath- showers are fine.
• Take your temperature twice a day for one week. If your temperature is over 100.4 degrees, please call us.
• For 7 days following your abortion, you will be taking Doxycycline (100mg) or another antibiotic. Take as directed and avoid heavy exposure to sunlight, antacids, iron and alcohol
• It is important that you make an appointment for a check-up two weeks after your abortion. You can return to our office or you can make arrangements with your own physician.

 Every woman bleeds differently. Your bleeding should be like a normal period or lighter. There may be no bleeding at all for 2-3 days. Then it may begin like a normal period for a week. Or you may begin bleeding immediately and this can last 7-10 days. A few women do not bleed at all which is also normal.

Your next normal period should begin in 4 to 8 weeks. If you do not have a period within 8 weeks from the procedure date, please call us. It is possible to get pregnant before your first period begins. Therefore, if you want to avoid another pregnancy now, you should use the means of birth control, which has been advised for you by our counselors and/or your physician. Hormonal birth control methods such as pills, the Depo Provera injection, the Nuva Ring, and the Ortho Evra Patch, may change your cycle. If you have questions please call the office.

Be sure to report if: