Matthew Reeves


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    Wondering how to manage second trimester medical abortion or dilation & evacuation in the setting of an abnormally implanted placenta?

    Looking for advice on advancing the gestational age at which you and your team provide? Have questions about cervical preparation, offering a choice of method, managing prolonged inductions, or anything else related to medical or surgical methods of abortion after the first trimester? Bring your questions along to this panel of five leading experts in second trimester abortion care. Experienced, new and curious providers are all welcome to contribute to what should be a lively and wide-ranging discussion.

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      Dilatation and evacuation (D&E) is one of the World Health Organization's recommend methods for abortion in the second trimester. In addition to its safety and effectiveness, advantages of D&E are that the procedure can be scheduled as a day case and operating times are short (about 10-15 minutes), as opposed to the unpredictable duration of a medical abortion (MA), which may require hospitalisation. The efficiency and predictability of D&E is also beneficial where women require an abortion for maternal medical conditions or complications of pregnancy which could deteriorate during the course of a lengthy labour induction. Lastly, D&E is an important back-up for failed second trimester MA. In many parts of the world multiple barriers prevent access to D&E. One important barrier is a lack of trained providers. Using a mixture of didactic and adult learning methods, this day long workshop will cover the practical requirements of D&E including pre-operative assessment and planning, instruments, cervical preparation, pain control, procedural steps, immediate post-abortion care, and identification and management of complications. We will also cover the next steps in developing a D&E service such as preparation of clinical teams, training, waste management, and infrastructure requirements.