Second Trimester Procedure

Second trimester Dilation and Evacuation (D&E) procedures are performed beginning at 14.0 last menstrual period (LMP) (2.38 cm BPD). Dilation of the cervix is achieved gently and gradually, and evacuation of the uterus is done through all-natural openings. 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 gestation of the pregnancy, the procedure will take one to three days.

14.0 weeks LMP (2. 38 BPD) – 16.6 weeks LMP (3.60 BPD)

If you are between 14.0 and 16.6 weeks as determined by an ultrasound, we are able to offer a one day, one step process if you are scheduled first thing in the morning and have never had a Cesarean (CSection) delivery. An ultrasound, counseling and lab work will be performed. The medication Misoprostol is taken in the morning to soften the cervix, and after a number of hours following the Misoprostol, the evacuation of the uterus is complete. 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. Taking in to account your health history, the abortion procedure itself only takes 5 to 25 minutes. Moderate sedation is used and you will not be able to drive following these medications.

  • Please eat a light breakfast before your appointment.
  • Have someone available to drive you home after the procedure
  • If you are unable to arrive for an early morning appointment, or have a history of a Cesarean section delivery, the process will take 2 days. We will review your health history and can discuss more in- depth what to expect during your visits.

17.0 weeks LMP (3.61) – 19.6 weeks LMP (4.58 BPD)

If you are between 17.0 and 19.6 weeks, as determined by an ultrasound, the abortion process will take two days. If you are traveling from outside the Albuquerque area, please prepare to stay overnight in town within 15 minutes of our office.

If you are 17.0 weeks to 19.6 weeks by ultrasound, counseling and lab work will be performed and laminaria may be placed to dilate your cervix gently and safely on the first day. Laminaria is sterile, compressed seaweed that is inserted into the cervical canal. The laminaria expand by absorbing natural moisture in the cervix.

The evacuation of the uterus will be scheduled for the following day. Taking in to account your health history, the abortion procedure itself only takes 5 to 25 minutes.

20.0 weeks LMP (4.66 BPD) -23.6 weeks LMP (5.86 BPD)

At 20.0 weeks to 23.6 weeks, the abortion process will take two to three days. Prior to your arrival in Albuquerque, your basic health history and a recent hemoglobin or hematocrit, and a blood pressure will be obtained. If you are traveling from outside the Albuquerque area, it is important that you plan to stay in town for the entire process, within 15 minutes of our office.

  • We are able to offer a two day, two- step process if you are scheduled first thing in the morning on the first day and have never had a Cesarean (C-Section) delivery.
  • If you are unable to arrive for an early morning appointment on the first day, or have a history of a Cesarean section delivery, the process will take 3 days. We will review your health history and can discuss more in- depth what to expect during your visits.

An ultrasound, counseling and lab work will be performed on the first day. An injection of Digoxin will also be administered on the first day to stop the fetal heartbeat, and laminaria will be inserted to begin dilating 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.

On the second day of a two-day process, the evacuation of the uterus will be scheduled. 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 final day of your abortion, as we work with your body for a safe procedure. Taking in to account your health history, the abortion procedure itself only takes 5 to 25 minutes. Moderate sedation is used therefore you will not be able to drive following these medications.

For a three-day process, 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. Taking in to account your health history, the procedure itself only takes 5 to 25 minutes. Moderate sedation is used therefore you will not be able to drive following these medications.

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 vaginal intercourse.
  • Do not use tampons- sanitary pads only.
  • Do not douche, go swimming, or take a tub bath- showers are fine.
  • If your temperature is over 100.4 degrees, please call us.

Follow up appointments are generally not required, but are available as needed at no additional cost. Every woman experiences bleeding differently. Bleeding can range from a heavy period to none at all, and vary from day to day. An increase in activity may increase this bleeding, therefore we recommend women to slowly increase their activity back to their normal level. Your next normal period should begin in 4 to 8 weeks. A pregnancy test may still show a slight positive in this time as the pregnancy hormones leave your body. 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, you should use the birth control method 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, Nexplanon, Mirena, may change your cycle. If you have questions, please call the office.

Be sure to report to our office if:

  • Your bleeding is heavier than the heaviest flow of a normal period
  • You continue bleeding longer than two weeks (although it is normal to spot longer)
  • Your temperature is ever 100.4 degrees or more
  • You have any foul-smelling vaginal discharge
  • You have severe pain, or pain unlike menstrual cramps
  • You soak through a maxi-pad in 1 hour or less
  • If you pass clots that are golf ball-sized or larger

$ Please call our office updated pricing information

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