From the American College of Obstetricians and Gynecologists: D&E is accomplished by aspirating the amniotic fluid and removing the fetus with forceps through the cervix and vaginal canal. Usually disarticulation (or dismemberment) occurs as the physician delivers the fetal part grasped in the instrument and pulls it through the cervix. A final suction curettage is often performed to ensure that the uterus is completely evacuated.
Then you have the D&X procedure aka intact dilatation and extraction which involves pulling the fetus's legs and torso out of the uterus and then crushing its skull before removing it entirely.
Mutilation and crushing the skull is NOT humane!