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The choice of second trimester abortion method: evolution, evidence and ethics
1Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA. dagrimes@mindspring.com
Reproductive Health Matters
|September 17, 2008
Summary
Dilatation and evacuation (D&E) is a safer and more effective second-trimester abortion method than labor induction. Gynecologists should overcome barriers to universally offer this evidence-based procedure.
Area of Science:
- Medical Science
- Obstetrics & Gynecology
- Bioethics
Background:
- Dilatation and evacuation (D&E) is a key procedure for second-trimester abortions.
- D&E is not universally offered by all gynecologists providing this service.
Purpose of the Study:
- To present evidence supporting D&E as the preferred method for second-trimester abortion.
- To address the barriers preventing the routine offering of D&E.
Main Methods:
- Review of evidence from cohort studies and randomized controlled trials over 30 years.
- Analysis of ethical principles (beneficence, autonomy, justice) in reproductive healthcare.
Main Results:
- D&E is consistently shown to be safer and more effective than labor induction abortion.
- The uterus is anatomically better suited for D&E than for medically induced labor in the second trimester.
Conclusions:
- D&E should be routinely offered by gynecologists for second-trimester abortions based on medical and ethical evidence.
- Barriers to D&E availability, including lack of information, equipment, training, or motivation, should be addressed to improve patient care.
