No. 360-Induced Abortion: Surgical Abortion and Second Trimester Medical Methods

J Obstet Gynaecol Can. 2018 Jun;40(6):750-783. doi: 10.1016/j.jogc.2017.12.010.


Objective: This guideline reviews evidence relating to the provision of surgical induced abortion (IA) and second trimester medical abortion, including pre- and post-procedural care.

Intended users: Gynaecologists, family physicians, nurses, midwives, residents, and other health care providers who currently or intend to provide and/or teach IAs.

Target population: Women with an unintended or abnormal first or second trimester pregnancy.

Evidence: PubMed, Medline, and the Cochrane Database were searched using the key words: first-trimester surgical abortion, second-trimester surgical abortion, second-trimester medical abortion, dilation and evacuation, induction abortion, feticide, cervical preparation, cervical dilation, abortion complications. Results were restricted to English or French systematic reviews, randomized controlled trials, clinical trials, and observational studies published from 1979 to July 2017. National and international clinical practice guidelines were consulted for review. Grey literature was not searched.

Values: The quality of evidence in this document was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology framework. The summary of findings is available upon request.

Benefits, harms, and/or costs: IA is safe and effective. The benefits of IA outweigh the potential harms or costs. No new direct harms or costs identified with these guidelines.

Keywords: Induced abortion; aspiration curettage; dilation and evacuation; family planning; second-trimester induction.

Publication types

  • Practice Guideline

MeSH terms

  • Abortion, Induced / methods*
  • Analgesia / methods
  • Anesthesia / methods
  • Antibiotic Prophylaxis
  • Canada
  • Female
  • Gestational Age
  • Humans
  • Postoperative Care / methods
  • Pregnancy
  • Pregnancy Trimester, Second*
  • Preoperative Care / methods
  • Risk Factors