If you think that you’re pregnant and it’s not what you planned, you might be researching your abortion options. 

It’s essential to understand the types of abortion procedures, their potential risks and side effects, and when they can be performed. 

It is also crucial to know how far along you are in your pregnancy. Call (910) 947-6198 for a free, limited ultrasound. 

This knowledge equips you to make a well-informed decision about your next steps. Keep reading to learn more about first-trimester abortions and second-trimester abortions.

First-Trimester Abortion Procedures  

The first trimester spans from conception (around four weeks after the first day of your last menstrual period) to the end of week 13. During this period, abortion providers typically offer medical abortions and dilation and curettage (D&C) procedures. 

What Is a Medical Abortion?  

A medical abortion, commonly known as the abortion pill, uses two medications: mifepristone and misoprostol. It’s FDA-approved for use up to 10 weeks of pregnancy.[1]  

The first medication, mifepristone, interferes with progesterone receptors and prevents the pregnancy from developing. The second medication, misoprostol, causes the uterus to cramp and expel the pregnancy.[2] Both medications require a prescription from a qualified healthcare provider.

A woman takes mifepristone first, followed by misoprostol 24 to 48 hours later.[3] The bleeding and cramping will begin between 2 and 24 hours after taking misoprostol.[4] Most women expel the pregnancy within that timeframe,[5] symptoms can vary from a heavy period to more intense cramping and bleeding. 

What Is Dilation and Curettage (D&C)?  

A dilation and curettage (D&C) is a surgical abortion available up to 13 weeks of pregnancy.[6] It’s often completed in under 30 minutes.  

Hours before the procedure, small instruments or a medication open (dilate) the cervix.[7]

During the procedure, the abortion provider will use a spoon-shaped device called a curette to scrape out tissue from the uterus. They may also use a suction device at the end to remove any remaining tissue.[8]  

Second-Trimester Abortion Procedures  

The second trimester is from week 13 to week 27. During this stage, dilation and evacuation (D&E) becomes the standard procedure due to the pregnancy’s advanced development.  

What Is Dilation and Evacuation (D&E)?  

A dilation and evacuation (D&E) is a surgical abortion most often performed in the second trimester.[9] It’s more complex than a D&C due to the fetus’s size.  

Here’s how a dilation and evacuation works:

• Cervix Dilation: The day before, sponge-like sticks (laminaria) are inserted into the cervix to absorb moisture, gradually expanding and opening it. Medication may also be used overnight to soften the cervix.[10]  
• Procedure: Forceps remove the fetus, sometimes in pieces, and a cannula suctions out the uterine contents.[11]  

D&E procedures typically take 10-30 minutes and are often done under anesthesia. Cramping and bleeding can occur for up to two weeks.

Testing for an STI Before An Abortion 

Having an untreated STI (like chlamydia) during an abortion can increase the risk of complications like Pelvic Inflammatory Disease (PID), which may lead to infertility.[12]

So, before choosing abortion, speak to a qualified healthcare provider who can explain the risks but also assess your health for conditions that might complicate an abortion, such as ectopic pregnancy, drug allergies, blood disorders, an IUD, or other issues.[13] 

Risks and Side Effects of Abortion  

Every abortion type—medical or surgical—carries risks and side effects. Understanding these can help you weigh your options. 

Medical Abortion Side Effects and Risks  

After a medical abortion, expect vaginal bleeding or spotting for 9-16 days, though it can last 30 days or longer in some cases.[14] 

Other common side effects include[15]:

• Abdominal cramping (from misoprostol)  
• Headaches  
• Nausea and vomiting  
• Diarrhea and digestive discomfort  
• Chills or mild fever  

Severe risks to watch for:  

• Hemorrhaging: Bleeding that soaks two full-size pads per hour for two hours or more requires immediate attention.[16]  
• Incomplete Abortion: If tissue remains, emergency surgery may be needed to prevent infection.[17]  
• Infection: Persistent fever, nausea, or vomiting beyond 24 hours after misoprostol use may indicate an infection and may require antibiotics or surgery.[18] 

Surgical Abortion Side Effects and Risks  

D&C and D&E procedures carry risks such as:  

• Uterine Perforation: An instrument may accidentally puncture the uterus, possibly needing surgical repair.[19]

• Asherman Syndrome: Scar tissue inside the uterus from repeated procedures can impact future fertility.[20]  
• Pelvic Inflammatory Disease (PID): Bacteria introduced during surgery may cause infection in the reproductive tract.[21]  
• Intense Pain: Studies show second-trimester abortions like D&E can be more painful than expected.[22]  

Psychological Risks of Abortion

Everyone experiences abortion differently. The abortion procedures can be traumatic for some women, thus exacerbating emotions you may already be experiencing.[23] Other times, an abortion could cause new emotional or mental health conditions.[24] These could include:[25][26] 

• Depression
• Anxiety
• Low Self-Esteem
• Substance Abuse
• Suicidal Behaviors

If you’re having thoughts of suicide, call the Suicide and Crisis Lifeline at 988 immediately.   

What are the abortion laws in North Carolina?

Currently, abortion is legal in North Carolina until 12 weeks of pregnancy.[26] In North Carolina, the law requires an ultrasound before an abortion. Even if you plan on traveling out of state for an abortion, you should first receive an ultrasound. 

Frequently Asked Questions About Types of Abortion

1. How long does bleeding last after the abortion pill?

Vaginal bleeding typically lasts between 9 and 16 days after a medical abortion, though some women may experience bleeding for 30 days or longer. 

2. Can abortion procedures affect future fertility?

Repeated surgical procedures can potentially lead to Asherman's Syndrome, where scar tissue forms inside the uterus and may impact fertility. Additionally, complications like pelvic inflammatory disease or uterine perforation, though rare, could affect reproductive health. 

3. What pain management options are available during abortion procedures?

For medical abortions, abortion providers may recommend over-the-counter pain relievers to manage cramping.

For surgical procedures such as D&C and D&E, anesthesia options are typically available. Research shows that procedures like D&E can be more painful than some women anticipate.

4. What is an incomplete abortion, and how is it treated?

An incomplete abortion occurs when tissue from the pregnancy remains in the uterus after a medical or surgical abortion. This is a serious complication that can lead to infection if left untreated. 

Signs may include prolonged heavy bleeding, severe cramping, or fever. Treatment typically requires emergency surgery to remove the remaining tissue and prevent infection. 

5. How long is the recovery period after different types of abortion?

Recovery time varies by procedure type. After a medical abortion, bleeding may last two to three weeks. 

Following a D&E procedure, you may experience cramping and bleeding for up to two weeks. All abortion procedures require a follow-up visit to ensure the procedure was complete.

Have Questions About Abortion in Carthage, North Carolina? Get the Facts at Life Care Pregnancy Center.

If you’re exploring abortion, you don’t have to navigate it alone. The caring team at Life Care Pregnancy Center provides free, confidential guidance to help you make the best choice for your health and future.

Give us a call at (910) 947-6198 or schedule your appointment online today.

Please be aware that Life Care Pregnancy Center does not provide or refer for abortion services.

Sources

1. FDA. (2025, February 11). Questions and Answers on Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation?sm_guid=NTU1NzgyfDYzMDE1OTM2fC0xfGppbUBha2ZhbWlseS5vcmd8NTY4OTI4MXx8MHwwfDE5OTYwMDk4OHwxMDg2fDB8MHx8NTQ3NzI2fDA1
2. See source #1.
3. See source #1.
4. U.S. National Library of Medicine. (2024, November 15). Mifepristone (Mifeprex). MedlinePlus. https://medlineplus.gov/druginfo/meds/a600042.html 
5. Mifepristone (oral route). Mayo Clinic. (2025, February 1). https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123 
6. Cleveland Clinic. (2024, February 9). Dilation and Curettage (D & C). https://my.clevelandclinic.org/health/procedures/dilation-and-curettage 
7. Mayo Clinic. (2023, November 7). Dilation and curettage (D&C). https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910
8. See source #7.
9. Understanding Dilation and Evacuation (D&E). Saint Luke’s Health System. (n.d.). https://www.saintlukeskc.org/health-library/understanding-dilation-and-evacuation-de
10. See source #9.
11. See source #9.
12. Mayo Clinic. (2022, April 30). Pelvic inflammatory disease (PID). https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594 
13. FDA. (2025, February 11). Questions and Answers on Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation
14. See source #4.
15. See source #4.
16. Danco Laboratories, LLC & FDA. (2016, March). Mifeprex Label. FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf
17. Mayo Clinic. (2022, July 29). Medical Abortion. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687
18. See source #4.
19. U.S. National Library of Medicine. (2024, April 5). Abortion - Surgical. MedlinePlus. https://medlineplus.gov/ency/article/002912.htm
20. Mayo Clinic. (2024, July 6). Elective Abortion: Does it Affect Subsequent Pregnancies? https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/expert-answers/abortion/faq-20058551
21. Mayo Clinic. (2022, April 30). Pelvic Inflammatory Disease (PID). https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
22. Dzuba, I. G., Chandrasekaran, S., Fix, L., Blanchard, K., & King, E. (2022, May 12). Pain, Side Effects, and Abortion Experience Among People Seeking Abortion Care in the Second Trimester. Women’s Health Reports (New Rochelle, N.Y.). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9148646/
23. Fergusson DM, Horwood LJ, Boden JM. Abortion and mental health disorders: evidence from a 30-year longitudinal study. British Journal of Psychiatry. 2008;193(6):444-451. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abortion-and-mental-health-disorders-evidence-from-a-30year-longitudinal-study/59A90CBF3A58C58B342CBCFFBBFEBD2E  
24. Mota, N. P., Burnett, M., & Sareen, J. (2010, April). Associations Between Abortion, Mental Disorders, and Suicidal Behaviour in a Nationally Representative Sample. American Association of Pro-Life Obstetricians and Gynecologists. https://www.aaplog.org/wp-content/uploads/2011/11/Mota-et-al.pdf  
25. Fergusson, D. M., Horwood, L. J., & Ridder, E. M. (2005, September 22). Abortion in young women and subsequent mental health. Association for Child and Adolescent Mental Health. https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/j.1469-7610.2005.01538.x  
26. Coleman PK. Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009. British Journal of Psychiatry. 2011;199(3):180-186. doi:10.1192/bjp.bp.110.077230
27. North Carolina State Law as of April 2025.