# Hysterotomy abortion

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Surgical procedure

Hysterotomy abortion Background Abortion type Surgical First use <1913 Gestation 2nd trimester and later Usage U.S. figures include both hysterotomy and hysterectomy. United States <0.01% (2016) Infobox references

**Hysterotomy abortion** is a [surgical procedure](/source/Surgery) that removes an intact [fetus](/source/Fetus) from the [uterus](/source/Uterus) in a process similar to a [cesarean section](/source/Cesarean_section). The procedure is generally indicated after another method of termination has failed, or when such a procedure would be medically inadvisable, such as in the case of [placenta accreta](/source/Placenta_accreta).[1]

In 2016, this method made up less than 0.01% of all [abortions](/source/Abortion) in the United States, with the CDC reporting only 51 having occurred due to the invasive and complex nature of the procedure, and the availability of much simpler and safer methods.[2] In 2022, scholars reported that in the aftermath of the overturning of *[Roe v. Wade](/source/Roe_v._Wade)* by *[Dobbs v. Jackson Women's Health Organization](/source/Dobbs_v._Jackson_Women's_Health_Organization)*, [Texas](/source/Texas) and other states where so called trigger laws immediately outlawed or heavily restricted reproductive healthcare, providers began performing hysterotomy abortions again. These providers have done so under the justification that such a procedure may not technically be considered an abortion under existing law.[3]

## Indications

As with other abortion procedures, the purpose of a hysterotomy abortion is to end a pregnancy by removing the fetus and placenta. This method is the most dangerous of any conventional abortion procedure, and has the highest complication rate.[1] The procedure is specifically indicated in the management of certain medical conditions including Cesarean Scar Pregnancy,[4] [bicornuate uterus](/source/Bicornuate_uterus),[5] [uterine fibroids](/source/Uterine_fibroid),[6] and in the case of failure of another method or methods.[7]

## Procedure

Illustration of a hysterotomy

[Hysterotomy](/source/Hysterotomy) is major [abdominal surgery](/source/Abdominal_surgery); it is generally only performed in hospitals and other advanced practice settings. The procedure is nearly identical to a cesarean section, with two main exceptions: the conduction of [foeticide](/source/Foeticide) guaranteeing compliance with various laws on the subject, and preventing an unintended live birth; and the size of the incision, which is generally smaller than that of a cesarean section, as the fetus is generally not full term. The size of the incision is not always smaller, however, as [late term](/source/Late_termination_of_pregnancy) hysterotomy abortions often remove a term fetus following foeticide.

## History

Scholarly sources place the use of this method since at least 1913.[8] Health officials in the [United States](/source/United_States) warned practitioners against performing hysterotomy abortion in an [outpatient](/source/Outpatient) setting after it led to the deaths of two women in [New York](/source/New_York_(state)) during 1971.[9][10] The rate of [mortality](/source/Death) of abortion by hysterotomy and [hysterectomy](/source/Hysterectomy) reported in the United States between 1972 and 1981 was 60 per 100,000, or 0.06%.[11]

## References

1. ^ [***a***](#cite_ref-roche_1-0) [***b***](#cite_ref-roche_1-1) Roche, Natalie E. (June 16, 2006). [Surgical Management of Abortion](http://www.emedicine.com/med/topic3312.htm). Retrieved July 1, 2007.

1. **[^](#cite_ref-2)** Jatlaoui, Tara C. (2019). ["Abortion Surveillance — United States, 2016"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289084). *MMWR. Surveillance Summaries*. **68** (11): 1–41. [doi](/source/Doi_(identifier)):[10.15585/mmwr.ss6811a1](https://doi.org/10.15585%2Fmmwr.ss6811a1). [ISSN](/source/ISSN_(identifier)) [1546-0738](https://search.worldcat.org/issn/1546-0738). [PMC](/source/PMC_(identifier)) [6289084](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289084). [PMID](/source/PMID_(identifier)) [31774741](https://pubmed.ncbi.nlm.nih.gov/31774741).

1. **[^](#cite_ref-3)** Arey, Whitney; Lerma, Klaira; Beasley, Anitra; Harper, Lorie; Moayedi, Ghazaleh; White, Kari (August 4, 2022). ["A Preview of the Dangerous Future of Abortion Bans — Texas Senate Bill 8"](https://doi.org/10.1056%2FNEJMp2207423). *[The New England Journal of Medicine](/source/The_New_England_Journal_of_Medicine)*. **387** (5): 388–390. [doi](/source/Doi_(identifier)):[10.1056/NEJMp2207423](https://doi.org/10.1056%2FNEJMp2207423). [PMID](/source/PMID_(identifier)) [35731914](https://pubmed.ncbi.nlm.nih.gov/35731914). [S2CID](/source/S2CID_(identifier)) [249956428](https://api.semanticscholar.org/CorpusID:249956428).

1. **[^](#cite_ref-4)** Doğru, Şükran; Akkuş, Fatih; Atci, Aslı ALTINORDU; Eren, Gülnur; Acar, Ali (19 Jan 2023). ["Cesarean Scar Pregnancies and Reproductive Outcomes: A Single Center Experience"](https://www.jcog.com.tr/article/en-cesarean-scar-pregnancies-and-reproductive-outcomes-a-single-center-experience-102344.html). *Journal of Clinical Obstetrics & Gynecology*. **33**: 36–42. [doi](/source/Doi_(identifier)):[10.5336/jcog.2022-93710](https://doi.org/10.5336%2Fjcog.2022-93710). [S2CID](/source/S2CID_(identifier)) [257643701](https://api.semanticscholar.org/CorpusID:257643701).

1. **[^](#cite_ref-5)** Lazenby, Gweneth B.; Huang, Christopher; Rahall, Ann M.; Fogelson, Nicholas S. (March 2007). ["Pregnancy termination via laparotomy in a woman with bicornuate uterus"](https://linkinghub.elsevier.com/retrieve/pii/S001078240600415X). *Contraception*. **75** (3): 241–243. [doi](/source/Doi_(identifier)):[10.1016/j.contraception.2006.10.007](https://doi.org/10.1016%2Fj.contraception.2006.10.007). [ISSN](/source/ISSN_(identifier)) [0010-7824](https://search.worldcat.org/issn/0010-7824). [PMID](/source/PMID_(identifier)) [17303497](https://pubmed.ncbi.nlm.nih.gov/17303497).

1. **[^](#cite_ref-6)** Gabrilovich, Sofia; Unsal, Aylin; Roche, Natalie; Barlog, Lauren (August 2019). ["Approach to Termination of Pregnancy in a Woman with Uterine Leiomyomas"](https://www.liebertpub.com/doi/10.1089/gyn.2019.0008). *Journal of Gynecologic Surgery*. **35** (4): 270–271. [doi](/source/Doi_(identifier)):[10.1089/gyn.2019.0008](https://doi.org/10.1089%2Fgyn.2019.0008). [ISSN](/source/ISSN_(identifier)) [1042-4067](https://search.worldcat.org/issn/1042-4067).

1. **[^](#cite_ref-7)** Baekelandt, Jan; Bosteels, Jan (May 2015). ["Laparoscopic Hysterotomy for a Failed Termination of Pregnancy: A First Case Report With Demonstration of a New Surgical Technique"](https://linkinghub.elsevier.com/retrieve/pii/S1553465015001788). *Journal of Minimally Invasive Gynecology*. **22** (4): 544. [doi](/source/Doi_(identifier)):[10.1016/j.jmig.2015.02.007](https://doi.org/10.1016%2Fj.jmig.2015.02.007). [PMID](/source/PMID_(identifier)) [25701623](https://pubmed.ncbi.nlm.nih.gov/25701623).

1. **[^](#cite_ref-8)** Bonney, Victor (October 1918). ["On Abdominal Evacuation of the Pregnant Uterus Before Viability"](https://zenodo.org/record/1910883). *The Lancet*. **192** (4964): 518. [doi](/source/Doi_(identifier)):[10.1016/s0140-6736(01)02878-1](https://doi.org/10.1016%2Fs0140-6736%2801%2902878-1). [ISSN](/source/ISSN_(identifier)) [0140-6736](https://search.worldcat.org/issn/0140-6736).

1. **[^](#cite_ref-9)** Berger GS, Tietze C, Pakter J, Katz SH (March 1974). "Maternal mortality associated with legal abortion in New York State: July 1, 1970--June 30, 1972". *Obstet Gynecol*. **43** (3): 315–26. [PMID](/source/PMID_(identifier)) [4814448](https://pubmed.ncbi.nlm.nih.gov/4814448).

1. **[^](#cite_ref-10)** Stroh G, Katz SH, Hinman AR (October 1975). "Performing second-trimester abortions. Rationale for inpatient basis". *N Y State J Med*. **75** (12): 2168–71. [PMID](/source/PMID_(identifier)) [1059921](https://pubmed.ncbi.nlm.nih.gov/1059921).

1. **[^](#cite_ref-grimes_11-0)** Grimes DA, Schulz KF (July 1985). "Morbidity and mortality from second-trimester abortions". *J Reprod Med*. **30** (7): 505–14. [PMID](/source/PMID_(identifier)) [3897528](https://pubmed.ncbi.nlm.nih.gov/3897528).

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Adapted from the Wikipedia article [Hysterotomy abortion](https://en.wikipedia.org/wiki/Hysterotomy_abortion) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Hysterotomy_abortion?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.