To prepare for a D&E abortion, the abortionist uses laminaria, a form of sterilized seaweed, to open the woman’s cervix 24 to 48 hours before the procedure. The laminaria soaks up liquid from the woman’s body and expands, widening (i.e., dilating) the cervix.

When the woman returns to the abortion clinic, the abortionist may administer anesthesia and further open the cervix using metal dilators and a speculum. The abortionist inserts a large suction catheter into the uterus and turns it on, emptying the amniotic fluid.

After the amniotic fluid is removed, the abortionist uses a sopher clamp — a grasping instrument with rows of sharp “teeth” — to grasp and pull the baby’s arms and legs, tearing the limbs from the child’s body. The abortionist continues to grasp intestines, spine, heart, lungs, and any other limbs or body parts. The most difficult part of the procedure is usually finding, grasping and crushing the baby’s head. After removing pieces of the child’s skull, the abortionist uses a curette to scrape the uterus and remove the placenta and any remaining parts of the baby.

The abortionist then collects all of the baby’s parts and reassembles them to make sure there are two arms, two legs, and that all of the pieces have been removed.