By the end of the sixth week, the uterus will have grown to about the size of a small plum. The fast-growing embryo has a 4 mm length at this time.
Weeks 5 and 6: Abortion
Medical abortion using mifepristone plus prostaglandin is most effective when used at gestations less than seven weeks. Menstrual extraction can be used at this time, however menstrual extraction has been found to be most effective when effective when used at around 7 weeks.
Implantation inhibiting (progesterone blocking) herbs like Queen Anne’s lace or cotton root bark may prove effective during the fifth and sixth weeks. Implantation inhibiting herbs block progesterone causing the uterine lining to become a negative environment incapable of nourishing a fetus. When this happens, the chorionic villi separate from the uterine wall causing bleeding like a menstrual period. The os, the opening of the cervix, dilates due to the stimulation of the body’s hormonal system, and the uterine contents pass out the body.
In addition to implantation inhibiting herbs, other abortive herbs with uterine contracting (oxytocic) properties, like cotton root bark, papaya, and parsley are used to stimulate uterine contractions, which may help to expel the uterine contents. Hyperthermia, massage, yoga, homeopathy, and acupuncture may also help to abort at this stage of pregnancy.
Abortions during weeks five and six result in a normal to heavy period, usually with more clotting and cramping than usual.
Weeks 7 and 8: Making Decisions
The majority of women who obtain clinical abortions do so during the seventh and eighth weeks. During the seventh week, some physical signs of pregnancy may subside (like nausea), but other signs may become more noticeable to many women. The mucous plug begins to form in the cervical os during the seventh week. Vaginal secretions tend to be thick and acid.
The embryo’s arms and legs begin to form during the seventh week. From top of the head to the tail bone, the embryo grows to a 5 – 8 mm length during the seventh week. The facial features of the embryo form, and the heart becomes established and begins to beat in the tiny 8 – 15 mm embryo during the eighth week. The chorionic villi in the endometrium continue to proliferate and begin to form the placenta.
During the eighth week, the woman’s breasts become noticeably larger and may feel tighter and tense. The nipples may become more prominent and small bumps, called glands of Montgomery, may begin to develop on the breast in the area around the nipple and the areola.
Weeks 9 and 10: Marked Fetal and Placental Development
During the ninth week, the placenta begins to produce its own estrogen and progesterone. The corpus luteum, having produced estrogen and progesterone up until this time, begins to cease production in most women. The chorionic villi outside the placenta degenerate, and the chorion (the sac membrane) becomes smooth. The head of the fetus grows significantly due to the beginning of intense brain development during the ninth week. The nine week old fetus is now approximately 1.6 - 1.8 cm in length and weighs about four grams.
By the end of the tenth week, the placenta has grown to cover one-third of the uterine wall. The fetus now is 3 cm long and begins to take on a human appearance. The hands and feet are recognizable. Respiratory activity is evident, and weak fetal movements begin. The sac progresses to about the size of a small chicken egg. By the tenth week, the glands of Montgomery around the nipples become pronounced and begin to secrete sebum, which keeps the nipple soft and pliable in preparation for nursing.
Weeks 7 through 10: Abortion
Medical abortion continues to be the safest and most effective form of self-induced abortion during this time period. Menstrual extraction is more successful when used around the seventh week, however the procedure can be used in later weeks, if care is taken to dilate the cervix to accept the appropriate sized cannula. Herbal progesterone blockers may be useful to stimulate the placenta to detach after the seventh week, but the embryo has already implanted and the placenta has begun to embed, so the addition of strong uterine contracting emmenagogues like blue cohosh, papaya, or cotton root bark would probably assist in inducing abortion.
Most abortions and miscarriages before the tenth week are complete, meaning all of the uterine contents are expelled and the uterus clamps down to complete the abortion. The bleeding subsides after the small placenta is passed, and over the next few weeks, the signs of pregnancy disappear. Hyperthermia, massage, yoga, homeopathy, and acupuncture may also help to abort at this stage of pregnancy. However, the effort required to be successful at a self-induced abortion increases as the pregnancy becomes increasingly established. The chances of having negative side effects to herbs increases as cumulative dosage and length of time involved in herbal treatment increases. After the tenth week, the chances of having an incomplete abortion increase.
Weeks 11 to 14: Placental Formation
In the eleventh and twelfth weeks, the placenta and chorionic villi begin to form a compact network of connective tissue which is complete by the end of the fourteenth week. The placenta has a 6 cm diameter and weighs more than the 5 cm long fetus by the twelfth week. By the thirteenth week, the placenta is completely formed, and the circulation between the fetus and placenta is complete; the fetus has a 6 cm length. By the fourteenth week, the fetus grows to 10 cm long. Fingers and toes have more detail; nails form. Fetal muscles contract occasionally. The sex of the fetus may be determined after the fourteenth week. From the eleventh to the fourteenth week, the placenta continues to grow progressively larger and becomes more firmly embedded.
A woman’s body is changing, too. A woman pregnant during this time may notice less bladder pressure. Nipples on the breasts darken, and fluid colostrum may be expressed. Cardiac output is greater; blood volume starts to increase.
Weeks 11 – 14: Abortion
Medical abortion using mifepristone plus prostaglandin is officially used up until 63 days LMP. Menstrual extraction may be used up until the eighteenth week, as long as appropriate sized cannulas can be obtained and the woman’s cervix allows for adequate dilation. Pharmaceutical cervical dilation is utilized to assist the cervix in opening for the menstrual extraction procedure. Herbal abortion past the tenth week of gestation is usually not effective.
The majority of women who have incomplete abortions have them after the tenth week. The main cause of incomplete abortion is the firm attachment of the placenta. In an incomplete abortion, the thin umbilical cord breaks, and the fetus and enclosing sac expel, but the placenta remains adhered to the uterus. When this happens, bleeding continues, sometimes the bleeding is dangerously profuse. The cervical os remains dilated, and the uterus cannot clamp down to stop the bleeding because of the attached placenta. Incomplete abortion can be an emergency situation, because the woman can hemorrhage and lose a high volume of blood very quickly. It is for this reason that the products of abortion must be carefully examined to be certain that all products of conception have been expelled.
Part II Modern Self-Induced Abortion Methods
Introduction
Modern self-induced abortion methods are methods based on clinical abortion procedures, such as: medical abortion and manual vacuum aspiration (MVA). Modern self-induced abortion methods are believed to be more effective than alternative methods of self-induced abortion, such as: herbal, homeopathy, massage, and acupuncture.