This reference guide provides information and recommendations based on evidence for dilatation and evacuation (D&E), a form of abortion that utilizes a combination of specialized forceps and vacuum aspiration to evacuate the uterus at or after 13 weeks gestation, for women who need either induced abortion, treatment of incomplete abortion or postabortion care. Health-care providers with previous experience providing high-quality, first-trimester abortion services who want to expand their skills to care for women at or after 13 weeks gestation using uterine evacuation are the primary audience for this guide.