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March 15, 2006

Illegal Home Abortions For Dummies

A blogger, saying she's disgusted by South Dakota's anti-abortion statute, has posted instructions for performing an abortion out of your own basement.

Start-up costs for such a business are kind of high -- $2000 at least, and of course you'll have to illegally obtain sedatives and antibiotics from Mexico and the like.

I was reading the instructions and I was pretty horrified. CONTENT WARNING past the jump.


The first step is to break the membrane holding the fetus inside. You can feel around with the forceps for it. To get an idea of what each part looks like -- and to see the texture so that you understand better how it will feel -- I recommend looking at books with photographs of first trimester fetuses (personal recommendation for its astonishing photographs: A Child is Born), The membrane should be easily broken with the forceps. Depending on how far along the pregnancy is, varying quantities of clear or pinkish fluid may come from the vagina. As you grasp the sac with your forceps, twist it away so that it detaches. You will now need to remove small pieces of fetal material and membrane from the uterus with the forceps. Some of these pieces will be distinctly identifiable as fetal material. Save the material until the end of the procedure on a piece of plastic, so that you can be sure the entire fetus has been removed....

This portion of the abortion procedure should not be particularly painful for the patient.

While you are removing fetal material, you will also be removing pieces of placenta. However, because the placenta is attached to the uterine wall -- and because it is the blood source for the baby -- bleeding may begin at this time. It is imperative that if bleeding begins at this point in the procedure, you do NOT stop. Stopping the procedure and attempting to stanch the bleeding will not work. The bleeding will stop on its own once the placenta is totally removed from the uterus. It may be scary, but keep going.

Once you have removed most of the material that is removable, you must move on to curettage. By now you will have felt the walls of the uterus with the forceps, and you must move on to using the spoon-shaped curettes. Find the spot on the uterine wall where placenta still clings -- the curette will make a sound much like metal on metal on a clean uterine wall, but will not make the same scraping sound on a place that still needs material removed. Scrape from the uterine walls, scraping material toward the cervix. Use the same general form of stroke you would use to scoop ice cream, and don't be afraid to scrape fairly hard. Scraping softly could leave tissue behind, and if there's anything you don't want, it's that. The other cue that will inform you the uterus is clean is that the patient will generally report feeling a cramp when the clean uterus is scraped, whereas a scrape of placenta will not feel as painful. Listen to your patient and listen to your curettes.

I don't know how this cuts, politically, for me, anyway.

On the one hand, I have a new, visceral appreciation for how grisly this all is.

On the other hand, I also appreciate that women are seriously going to try DIY abortions if they want one and no abortion-doctor is available.

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posted by Ace at 08:51 PM

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