Medication vs Surgical Abortion
Why might a patient choose surgical abortion?
- It requires one office visit
- The procedure takes a short amount of time
- It may be more effective than medication abortion (less risk of an incomplete procedure)
- Patients usually do not have heavy bleeding at home
Learn more about surgical abortion
Why might a patient choose medication abortion?
- It can be used in the earliest weeks of pregnancy
- It requires no surgery
- It requires no anesthesia
- It has the potential for greater privacy
- Some patients feel it gives them greater control over their bodies
- It may feel more “natural” for some patients
Learn more about medication abortion
Comparison of Methods for First-Trimester Abortion
Surgical Abortion |
Medication Abortion |
|
|---|---|---|
| What is it? | A doctor uses suction to empty your uterus. | A combination of medications ends the pregnancy and causes your uterus lining to shed. |
| How does it work? | During a visit to the clinic, a doctor places a speculum into your vagina. The doctor numbs the cervix and then gradually widens, or dilates, your cervix. Then, a small tube (similar to a straw) is placed into your uterus. Suction, created by an electric machine or by a hand-held syringe, is applied on the other end of the tube and empties your uterus. | You will first swallow a medication that causes your pregnancy to stop growing. One to three days after swallowing the first medication, you will place into your vagina another medication. Your uterus will contract and you will have bleeding and cramping at home. You will return to the clinic to confirm that the abortion was successful. |
| How effective is the method? | 99 percent of suction curettage abortions are successful; only about 2 percent of patients need a repeat procedure or other intervention. | 95-97 percent of patients respond successfully to the medications. About 3-5% of patients will need a suction curettage abortion due to continued pregnancy, prolonged or excessive bleeding, or patient choice. |
| How far along in my pregnancy can I use this method? | This method is used up to 22 weeks since the first day of your last menstrual period. | Five weeks four days to nine weeks since the first day of your last menstrual period. It is more effective and leads to less bleeding at earlier gestations (five to seven weeks compared to eight to nine weeks). |
| How many clinic visits are required? | Usually requires one visit – for health education, exam, and procedure. You may return to the clinic if you need follow-up care. After 12 weeks of pregnancy, a second visit is required to prepare the cervix. | Requires at least two visits – one for health education, exam, and medications and another to confirm that the abortion was successful. Up to four visits may be required. You may return to the clinic if you need further follow-up care. |
| How long is each appointment? | Approximately 2 hours | Approximately 2 hours for the first visit and 30 minutes for the second visit. |
| Is it painful? | Most patients experience moderate to strong cramping during or after the short procedure. | Most patients experience strong cramps and some patients experience nausea or other side effects. |
| What kind of anesthesia (pain relief) will I receive? | The doctor will apply numbing medication (local anesthesia) to your cervix. Oral medications to relax you and to control your discomfort are also used. | Anesthesia is not required. Most patients are satisfied with over-the-counter pain medications like ibuprofen. We recommend ibuprofen, Tylenol and/or Vicodin for pain relief if needed. |
| How much will I bleed? | Patients usually have light bleeding at home after the procedure for up to two weeks. | Patients usually have heavy bleeding for several hours and bleed like a period for two to three weeks. |
| May I bring a support person with me? | Yes, one friend, partner, or family member may accompany you during the health education, explanation of the procedure, and the procedure itself. We typically allow a support person for only first-trimester procedures (up to 12w). | Yes, one friend, partner, or family member may accompany you during the health education and explanation of medication abortion. We typically allow a support person for only first-trimester procedures (up to 12w). You must have someone with you at home on the day you place the second medication in your vagina. |
| Do I need to bring somebody with me? | No, but you must have a ride home if you opt to take sedating medications. | No, not during the clinic visit, but at home you must have someone with you and access to a telephone in case of questions or emergency. |
Comparison of the Risks/Side Effects
Surgical Abortion |
Medication Abortion |
|
|---|---|---|
| Is there a risk of injury to my body? | When instruments and suction are placed into your vagina and uterus, there is a very small risk of cervical injury or uterine perforation that could require further care or abdominal surgery. | No instruments or suction will be used, so you will not be exposed to the chance of cervical injury and uterine perforation that rarely occur with surgical abortion. |
| Is there a risk of infection? | There is a small likelihood of infection after suction curettage abortion. You will be given antibiotics, which, if taken as directed, will reduce the chance that you will get an infection. | There is a very small likelihood of infection after medication abortion. You will receive antibiotics to reduce the chance of infection. |
| What if I have pain during the procedure? | A member of our staff will be with you during your whole procedure and will monitor you during the recovery. The doctors and medical assistants will manage your side effects immediately as they occur. | Since you will be at home during the actual abortion process, you take on more responsibility for your own care. We will give you written instructions on managing side effects and phone numbers to call with questions. |
| Will I be able to have children in the future? | Suction curettage abortion appears to have no effect on a patient’s ability to have a baby when they are ready. More than one-third of patients in the U.S. have had a suction curettage abortion. | Medication abortion appears to have no effect on a patient’s ability to have a baby when they are ready. |
Risks and side effects will be explained to you in detail during your appointment. You will be able to address your concerns with your health educator and doctor before consenting to having an abortion.