Studying Cervical Dilation in Surgical and Medical Abortion

The neck of the womb or cervix needs dilation when preparing for an abortion. Now, you can either choose medical abortion or surgical abortion. For a pregnancy less than 9 weeks, abortion pills are a conducive alternative to invasive treatment of unexpected pregnancy. The latter is performed at a clinic by professionals.

It requires check-in to the clinic a few hours in advance so that the cervix can be softened to help with the procedure. Medicines as well as instrument-based dilators are available to widen the cervix. Let us understand the cervical dilation process in medical and surgical pregnancy termination.

Which Cervical Dilation Method Suffices for Medical Abortion?

When using abortion pills, keep in mind that the effective procedure is all about taking the combination of Mifepristone 200mg and Misoprostol 200mcg x 4 pills. Mifepristone is an anti-progesterone that does away with the advancement of pregnancy. It suppresses the pregnancy hormone progesterone to unlock the embryo from the uterus wall by breaking the endometrial lining. But that is the only job done, the rest happens after the administration of Misoprostol pills.

• The cervical dilation and softening occur after taking Misoprostol vaginally. Place a pill one after the other inside the womb and it will gradually relax and widen the cervix.

• The pills will melt over half an hour as you rest and get inside the uterus to cause contractions. Then heavy vaginal bleeding takes place to flush out the pregnancy contents.

• You can also take the medicine buccally by placing the pills under the tongue or both cheek pouches for 30 minutes. The pills dissolve and you intake the remains orally with a sip of water.

• You do not need anesthesia or hospitalization. Instead, take the pills at home by following the prescription and experience a spontaneous emptying of the uterus within a few hours of using Misoprostol medication.

• The benefit here is that you do not require any instrument for cervical dilation as medicines will do that for you. Thus, there is a lower risk of infection and no injury to internal organs. This is why several women prefer to use MTP Kit medicines than surgical abortion for pregnancy termination.

More about Surgical Abortion and Cervical Widening

Here, we will take you through two types of surgical abortion procedures, and how the cervix is widened in the same.

1.  Dilation and Evacuation

You may have to spend the whole day in the clinic. Or remain under observation for a few crucial hours. Nonetheless, cervical preparation is necessary. This method is valid from 14 to 24 weeks of gestation. If you are less than 18 weeks pregnant, then conscious sedation or general anesthesia is provided. If you are over 18 weeks, then general anesthesia is used. The surgeon uses suction equipment and instruments to remove the products of conception.

Widening of the cervix occurs a day before or on the day of the surgery. If it happens on the surgery day, then it may take at least 3 hours to numb and soften the cervix. After reaching the clinic and running through formalities, you will go to the treatment area. Then you will lie down on a bed where supports are provided for the legs. Sedation or anesthesia is given before the procedure begins.

The surgeon will perform a check-up of the vagina and insert a speculum in it. Then he will open and stretch the cervix with the assistance of dilators (rod-like structures). Gentle suction is applied to remove the pregnancy portions into the equipment. Additional instruments may be necessary. The procedure lasts for 10-20 minutes. After the pregnancy termination, you will be monitored for a few hours before discharge.

2.  Dilation and Curettage

D&C or Dilation and Curettage is another method to remove the pregnancy sections from the womb. Here, the surgeon uses a small instrument to open and dilate the cervix. Then, the utilization of a curette (a suction device or sharp instruments) assists to take out the pregnancy tissues, the embryo, the sac, and the remains from the uterus. On the exam table, stirrups will secure your heels so that the surgeon can examine the vagina and put a speculum inside.

Anesthesia is given depending on how further you are into pregnancy and your health. After finding the cervix, he will insert thick rods in the cervix. It will allow for cervical dilation until the part expands sufficiently to continue with the process. The dilator is thinner during insertion but gets thicker with time to open up the cervix better. On removal of the dilation rods, the surgeon will place a sharp-edged instrument (usually spoon-shaped) or a suction device to disengage/collect the uterine tissue and pregnancy sections.

Final Thoughts

For medical abortion, Misoprostol pills are used to dilate the cervix. While in surgical abortion, Misoprostol or dilator rods help with the same. Preparing the cervix for the non-invasive or invasive procedure does consume a few hours. But it eases the pregnancy termination procedure by softening the cervix enough that it is simpler to empty the uterus of all the pregnancy portions.