Second Trimester Abortion

Quality Compassionate Reproductive Health Care Personalized to Fit Your Needs

About Second Trimester Abortion

Second trimester abortions are performed between 14.0 to 23.5 weeks of pregnancy and require 1 to 3 visits. We use the dilation and evacuation procedure, also known as a D&E. After 15 weeks, in most cases, cervical dilators called Laminaria or Dilapan, are inserted into the cervix to gradually dilate it overnight before a doctor performs the procedure. Sometimes, early in the second trimester, we can use a medication to prepare the cervix instead of dilators.

The fee includes pregnancy testing, admitting, pre-operative history and physical, ultrasound, lab work, dilator insertion, most pre-operative medications, the D&E procedure, RhoGAM (if required), sedation, medications given on the day of procedure, most post-operative medications and your post-operative care as authorized by us.

Day 1

You can eat and drink normally, and drive yourself to and from the visit. This is the day the abortion begins – you must stay within one hour of the office for the next 1 – 2 days.

You will have an ultrasound and labs, the opportunity to ask questions, and consent for the procedure. Lastly, laminaria dilators will be placed in the cervix to prepare your body for the procedure.

Day 2

Depending on how much your cervix has dilated overnight and other medical considerations, you may have the surgical procedure to complete the abortion today.

If additional dilation and preparation is needed for the procedure, the first set of dilators will be removed and a second set will be placed in the cervix. You may be given medications to help with dilation as well.

Day 3

For your safety do not have anything to eat, drink or smoke for at least 8 hours before your surgery, including pain medications. You cannot drive after your procedure.

After IV sedation is provided, the dilators will be removed and the procedure will be completed. Be prepared to stay in our office for 3 – 6 hours today as the recovery time after the procedure can be lengthy.

Getting to the office and home safely

You may drive yourself to and from the office on the day(s) before your procedure. On the day of your procedure, you must have a reliable ride home from the office. If you cannot make arrangements for a ride after the procedure you may be able to use a cab or a ride share car service after an extended recovery period. Please note that we cannot accommodate children or guests in of our office at this time. This includes waiting areas. Your guest can wait in the car or we can give you a listing of public places near the clinic where they can wait for you.

Increasingly, patients are travelling from Indiana, Wisconsin, Michigan, Ohio, Tennessee, Kentucky and Missouri to obtain abortion care with FPA. If you are travelling to Chicago from out of the area and you need to make overnight accommodations, we have obtained a discounted rate at a hotel just a block away from our office. Click on the icon below for more information and to check rates.

Hotel info & rates

Preparation For the Procedure

When you arrive at the office, you will be asked to complete some paperwork. Many of these forms are available on this website. You can complete them, print them and bring them to your visit if you prefer. Your vital signs will be taken and we will collect a small sample of your blood to determine your Rh factor and iron level. You will have an ultrasound next. If you have had a cesarean section, you will be asked to have a full bladder for the ultrasound.

An admissions staff member will explain the procedure to you and assist you in completing additional paperwork.

A clinician will review your medical history, perform a physical examination, and insert the cervical dilators that will be used to prepare your cervix for the procedure. This procedure takes approximately 5-15 minutes. Most patients experience cramping, pressure and discomfort during the insertion. We will provide you with pain medication. After the insertion, the vaginal canal will be packed with sterile gauze to keep cervical dilators in place and to help prevent infection.

After this process we will give you post-insertion instructions so that you know how to take care of yourself until you return the following day. You will be given medications, and an appointment time for your second insertion or surgery.

If a second day of preparation for the surgery is needed, you will return the following day and the clinician will remove the first set of dilators then insert a second set for additional dilation. Again, this procedure will take approximately 5-15 minutes and you will likely experience cramping and discomfort similar to the the first day. You can take the pain medication provided by our facility, with a meal, before coming in for your visit to decrease your discomfort.

The Day of Procedure

Do not eat, drink, or smoke for eight full hours before your surgery, most often after midnight the day before your visit. This includes gum, candy, water, and any kind of food or drink. Your surgery will be delayed if you have anything at all to eat or drink -for your safety.

When you arrive at the office a staff member will escort you to a private area where you will change into a gown that we provide. A medical assistant will bring you to the surgical suite, and an IV will be placed in your hand or arm, in most cases.

You will be in the procedure suite for about 15 – 30 minutes. A licensed CRNA (certified registered nurse anesthetist) will administer sedation and a licensed medical doctor will perform the abortion by removing the pregnancy and aspirating the uterus. All of our physicians have specialized training in abortion care and are involved in training the family planning fellows at a local, prestigious hospital.

Patients are sedated for this procedure, which means that they will not feel any pain or discomfort.

Recovery and Discharge Information

You will be taken to the recovery room after the procedure is complete. Trained medical personnel, including registered nurses and medical assistants will care for you until you are ready to be discharged. Most patients spend about 1 – 3 hours in the recovery room depending on individual medical assessments. We have tablets that you can listen to music or watch a video on in our second stage recovery area, while having a light snack.

When you are ready to be discharged, our staff will explain your post-operative care and medications. Lastly, we will walk you to your driver.

FPA has a designated 24-hour emergency number. We encourage you to call with any questions or to discuss any problems that occur after your visit. You are welcome to return for a free follow up visit in 2 – 3 weeks, or sooner if needed.

After Your Visit

After you are discharged, you should go home and rest. You may eat and drink normally. If you have nausea or vomiting, we recommend eating something light such as rice, soup or toast.

You are able to go back to work or school within 1 – 2 days, unless the doctor has provided you special instructions. We can provide a confidential doctor’s excuse if needed.

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frequently asked questions

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Chicago | Downtown

312-707-8988
659 W. Washington Blvd.
Chicago IL  60661
Fax (312) 707-9223

If we are unable to reach you by telephone we will text you and ask that you call us when it is convenient for you. Unfortunately, due to an extremely high volume of online appointment requests we are unable to schedule and confirm visits via email only right now. We must speak with you directly. We still encourage you complete the online appointment request so that we can enter your information into our scheduling system. This will make the scheduling process faster for you.

What date did your period start?

Do you have any medical conditions or problems? Do you take any medications? Have you ever had a surgery or spent time hospitalized?

We will contact you by phone, text or email about your insurance coverage for the procedure you have requested. Keep in mind that you may be responsible for some payment if your insurance requires you to pay a deductible, copay or co-insurance amount. If you have an HMO insurance plan, you will need to get a written referral from your doctor. Please contact our insurance staff if you are having a hard time getting a referral for care from your physician.
Please provide your Illinois Medicaid Recipient ID so we can check your coverage, before your visit. If you are currently enrolled in Illinois Medicaid please bring in your picture ID and Medicaid card and we will be able to provide abortion care for you at NO COST. You will not have to pay anything for care related to your abortion including sedation, medications, lab testing, ultrasound, or RhoGAM if you have a negative blood type. You can also email the document(s) to FPA before your visit. The email address is: medicaid@fpachicago.com. For more information click here.
If you have applied for Illinois Medicaid coverage or plan to apply, we can provide abortion services at no cost to you once your application is approved. If you have not applied for coverage yet, go to www.abe.illinois.gov to apply TODAY. Remember: 1. Say you are pregnant 2. Ask that your coverage begin at the first of this month, or earlier if you have any other past medical bills 3. DO NOT WAIT start your application today 4. Write down and save all of your login information Email us proof of you have applied and proof of Illinois residency at medicaid@fpachicago.com. Call 312-707-8988 with questions. If you need urgent coverage, you can visit a Medicaid Presumptive Eligibility Provider and leave their office with coverage. Most hospitals are MPE providers and Erie Family Health Center is an MPE provider. You can call them at 312-666-3494 or 847-666-3494 if you live in the suburbs of Chicago. Once you are approved – you pay nothing for abortion services. For more information, or to access a link to the website where you can apply for coverage, click here.
We have reduced fees for patients who are uninsured. Please let us know if you need help with your payment. You may be eligible for financial assistance. If you have already been in contact with an abortion fund, and they have pledged funds on your behalf, please let our staff know. For more information click here.

Frequently Asked Questions

Call us today to speak with our staff or schedule your appointment.

312-707-8988

What is the difference between local anesthesia and sedation?

Local anesthesia is a cervical block (injection of numbing medication) performed before your surgery. While your cervix will be numbed, you will be awake during the procedure and it is normal to feel some strong cramping and discomfort.

Sedation is administered intravenously through an IV placed in your hand or arm in most cases. If you are sedated for your procedure you will not feel or remember any pain or discomfort.

Will it hurt?

If you have chosen to have sedation, you will not feel or remember any pain during your procedure. After the procedure you may experience mild to moderate cramping, if needed we will give you pain medication.

If you have chosen to have local anesthesia with your procedure we will numb your cervix but you will feel some cramping, pain and pressure from the uterus. Some patients describe the pain as minimal while some patients find the pain to be more severe. You will be offered pain medication, and in some cases we can provide you a medication to help you feel more relaxed.

Once you are discharged, in most cases ibuprofen (Motrin/Advil), naproxen (Aleve) or acetaminophen (Tylenol/Midol) will help with the cramping. If the cramping is not helped by these over the counter medications, you should call us immediately.

How long will I be under sedation?

You will be unaware for about 5-10 minutes with a first trimester abortion, or about 10-20 minutes with a second trimester abortion. The medications used for sedation work very quickly and wear off very quickly as well. Most patients are alert and oriented within 5 minutes of their procedure.

I am afraid I won’t wake up after having sedation. Can that happen?

The sedation that we offer is safe, effective and short acting. You will be asleep for 5-20 minutes depending on the procedure. There is always some degree of risk with any surgery. Serious complications with sedation are very rare in our facilities. Complications may occur if a patient has ingested any food or liquid within 8 hours of surgery. Tell our staff if you have had prior complications with anesthesia or if you have had anything to eat or drink within 8 hours prior to your surgery, including gum and water.

How long will I bleed after an abortion procedure?

In most cases, the patient experiences bleeding for up to 2 to 3 weeks after the abortion procedure. However, some patients do not experience any bleeding and other patients have spotting or bleeding off and on. If you have any questions about what is normal after your procedure, you can always call the office. A 24-hour on-call service is available for after hours.

How is the in-office abortion procedure performed?

The first trimester abortion is a simple procedure performed by aspiration (suction). This procedure is referred to as a D&C (Dilation and Curettage). This procedure generally takes about 3 to 5 minutes.

If you are over 13 weeks pregnant, you will first have your cervix dilated with medication and/or sterile product made specifically for cervical dilation (laminaria dilators). This procedure is referred to as a D&E (Dilation and Extraction), and lasts 1 to 3 days. In some cases, a patient will require one or two consecutive days of dilation and will return for the procedure on the second or third day. The dilation procedure takes just a few minutes and you will be in the clinic for a few hours on the day or days that your cervix is being dilated. In some cases, we can administer a medication on the morning of your procedure that will soften and dilate the cervix without the need for insertion of dilators.

When can I return to work?

The majority of our patients return to work or school the following day. The admitting and medical staff will explain the DOs and DON’Ts after surgery.

Can I have someone with me during the procedure or in the recovery room?

Your support person will not be able to join you during the medical parts of the visit, including the exam rooms and recovery room. We must protect the privacy of all of our patients, and for that reason we cannot allow guest in these areas.

We encourage your support person to wait for you in our reception area. If this is not possible, they can return for you upon completion of your appointment.

After an abortion, when can I have sex?

When bleeding has been light for 24 hours, you may have intercourse, if you feel emotionally and physically ready. You are the best judge of your feelings.

You should use contraception when you are sexually active, if you wish to avoid pregnancy. You can become pregnant again right away after having an abortion.

Can I take a taxi or public transportation home?

Taking public transportation after surgery is not recommended. If no other method of transportation is available, we require that an adult must accompany you.

Can I use tampons after my procedure?

When bleeding has been light for 24 hours, you may use a tampon.

How effective is a surgical abortion?

In most cases, a surgical abortion is nearly 100% effective. In less than 0.3% of cases, a pregnancy is not terminated on the first attempt. Such a failure is most common in pregnancies of less than six weeks’ duration. A very small percentage of surgical cases will require a re-aspiration if unusual bleeding occurs or if there is retained pregnancy tissue.

How will I feel after my abortion procedure?

Most patients feel very ‘normal’ when they leave the office after having an abortion. You will probably be hungry and maybe a little more tired than normal. We recommend that you have a full meal and then take it easy for the rest of the day. It is normal to experience some mild to moderate cramping. If the cramping is not helped by over the counter medications such as Tylenol, Advil or Aleve we ask that you call our 24-hour emergency number. The bleeding is usually comparable to a normal period and some patients do not have any bleeding at all. If at any point you soak one full maxi-pad in an hour or less you should call us immediately.

If you have had pregnancy symptoms such as nausea, fatigue or breast tenderness, these symptoms will start to go away within a few days of the procedure. If you still ‘feel pregnant’ after a few days, you should call us right away.

You may take a shower or tub bath after your procedure. Do not douche, use tampons, have intercourse, or place anything in the vagina for two weeks after having a surgical abortion. Avoid any products that contain aspirin or alcohol as they can promote heavier bleeding.

Why can’t I eat before having the abortion procedure?

When sedation is provided, gag reflexes are temporarily suppressed. If food or liquid remain in the stomach vomiting can occur, resulting in asphyxiation (choking). This can cause serious complications and in very rare cases death. Please inform our staff if you have had anything at all to eat or drink on the day of your procedure.

Is it a doctor who performs the procedure?

Yes. All of our doctors are licensed by the State of Illinois, are board certified in obstetrics and gynecology and specialize in pregnancy termination.

How will I know that the abortion was successful?

Our physicians at FPA are very thorough and take multiple steps to ensure that the abortion procedure is complete. First, the physician will examine the pregnancy tissue after the surgery. Second, a post-operative ultrasound can be performed at the request of the physician. Third, the pregnancy tissue that is removed during the procedure is sent to a pathology laboratory where it is weighed and examined, most often microscopically. A report, detailing this examination, is sent to our office within a week of the procedure. After reviewing the pathology reports the physician decides whether a follow up visit is needed. We will contact you if the physician requests that you come in for an evaluation. We want to ensure that your pregnancy hormones are falling at the appropriate rate and that you are recovering well. Lastly, in some cases if you are very early in the pregnancy at the time of your surgery, the doctor may request that you return to the clinic 2-3 days after your abortion for a blood test to ensure that the procedure was successful.

Can I exercise after an abortion procedure?

Most often you can go back to your regular activities the day after your procedure. Strenuous exercise can sometimes increase the amount of bleeding and cramping that you experience. If you notice an increase in your bleeding or cramping after exercising you may want to decrease your activity for a few days. Please do not hesitate to contact us if you have any questions or concerns. If at any point you fully soak a maxi-pad in one hour or less, after your procedure, you should call us right away.

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