Second trimester treatment (dilation and evacuation)

In the case of pregnancies from 13 weeks (calculated from the first day of the last period), an abortion is performed with the aid of instruments.


Recent research has shown that cervical priming by means of misoprostol limits the chance of premature of birth in the next pregnancy (pregnancies) and reduces complications following abortion. It is necessary to prepare the cervix for the operation. Administering misoprostol can sometimes lead to stomach cramps.

2 tablets of misoprostol (Cytotec) must be administered sub-lingually (under the tongue) between 2 and 3 hours before the treatment.
Vaginal priming may also be done, for example, if there is an indication of more advanced pregnancies as from approximately 17 weeks.

This is how the second trimester treatment works:

  • The treatment takes place in a gynaecological chair. You will be given medicines (prostaglandins) that will soften the cervix before the treatment.
  • The cervix is first made visible with a speculum (duck-bill shaped medical instrument), disinfected and anaesthetised locally). You can opt for sedation (in which case, you will sleep for a while). Please note: in the case of sedation, clients wearing coloured lenses must remove them.
  • The opening in the cervix is widened with the aid of instruments.
  • The foetus is removed, and the uterus is emptied by means of a plastic suction tube.

The treatment is performed by an abortion specialist, assisted by one or two nurses and lasts about 30 minutes. Most women experience pain during the treatment. This pain can be compared to (intense) menstrual pain. You may suffer from stomach cramps until a few days after the treatment and there may be some blood loss, which is comparable to menstruation.

There is always a small chance of infection, which is why you are given antibiotics in the clinic

After the operation, you may still suffer from pregnancy symptoms, such as nausea or tender breasts.