At the Cleveland Women’s Medical Group, second trimester surgical abortions are provided for women who are between 13 weeks and 24 weeks pregnant. There are several steps that you will take to ensure your safety and well-being.

PREGNANCY VERIFICATION

Every patient will have an ultrasound. This advanced diagnostic technique is used 3 weeks or more after the last menstrual period to determine the correct length of the pregnancy. It is an important procedure that improves the accuracy of the physician's preoperative diagnosis and further assures the safety of the patient and the procedure.

PREOPERATIVE EVALUATION

Further laboratory work is completed to screen all potential patients. Routine laboratory analysis includes hematocrit testing, urinalysis, Rh typing and tissue pathology.  Patients with Rh-negative blood type will receive an injection of Rhogam which is administered for an additional charge.

With the completion of the laboratory testing, the medical staff will evaluate your health.  Within this evaluation, your history and physical is completed and each patient is pre-screened for anesthesia risks. Our facility is concerned with the success of your termination and we want to make sure that your current health and size of your pregnancy will allow the safest of procedures.

COUNSELING

Individual counseling supplies important information and support for patients scheduled for a pregnancy termination. Each woman receives personal confidential attention and care throughout her visit. All counseling, under the direction of our social worker, is private and confidential.  Detailed information is provided about the abortion and birth control. Patient educators are there to help with feelings and concerns related to the termination and each patient is treated with warmth, understanding, and sensitivity.

DILATION AND EXTRACTION PROCEDURE

The Cleveland Women’s Medical Group performs abortions up to 24 weeks of pregnancy by the dilation and extraction method, the most common method of abortion available today. The procedure involves the gradual widening of the cervix followed by the removal of the uterine contents with forceps and suction.

On day one you will receive pre-op testing, counseling, and your ultrasound. You then return 24 hours or more later for your first day of your procedure.

The first day of your two day procedure you will have laminaria inserted into your cervix to help soften and dilate your cervix.  This will help ensure that the procedure will go safely and easily for you and the physician.  You will be given a local anesthetic to numb your cervix.  Then laminaria will be inserted.  If you are between 20-24 weeks pregnant you will receive an injection of Digoxin through your abdomen to the fetus to stop the heart beat.  You will go home or to your hotel with pain pills and our 24 hour number for you to call if you have any questions or concerns.  You will also be given an antibiotic to take with your last meal of the day.  This is to insure that you do not get a infection.  After midnight we do not want you to eat, drink, smoke or chew anything except for the pain pills if you need them.  You will be told what time to return to the clinic to finish your procedure.

 A patient who chooses to be totally asleep (if eligible) is given a monitored anesthesia care through an IV. You will not remember, see, or hear anything during the abortion procedure.

A patient who chooses to have Sedation anesthesia will also have medications given through an IV. Sedation anesthesia is conscious (“awake”) sedation. Patients are relatively pain-free and tranquil and yet still aware of their surroundings. Most of the time, a patient doesn’t remember what happened during the abortion procedure.

A patient choosing a local anesthetic is given an injection, which numbs the cervix. A Medical Assistant is present during the procedure and the doctor will be explaining what he/she is doing so that there are "no surprises".

The pregnancy verification, pre-operative evaluation, counseling and the abortion procedure are all performed on the same day. Patients with Rh-negative blood type will receive an injection of Rhogam which is administered for an additional charge. (See Fee Schedule)