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Medical Versus Surgical Abortion

Reasons to Choose a Suction Curettage (Surgical) Abortion
It requires fewer office visits The procedure takes a short amount of time It is more effective than medical abortion (less risk of an incomplete procedure) Women usually do not have heavy bleeding at home

Reasons to choose a medical 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 women feel it gives them greater control over their bodies It may feel more "natural" for some women For more information and frequently asked questions, see the tables below.

Comparison of Methods for First-Trimester Abortion

Suction Curettage Abortion Medical 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 tube 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?

98 percent of suction curettage abortions are successful; only about 2 percent of women need a repeat procedure or other intervention.

95 percent to 97 percent of women respond successfully to the medications. About 3 percent to 5 percent of women 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

Six to14 weeks since the first day of your last menstrual

Four to nine weeks since the first day of your last menstrual period.

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use this method?

period. Women are often asked to wait until six weeks of pregnancy to decrease the possibility of leaving all or part of the pregnancy behind after the surgical procedure. If performed earlier than six weeks, the procedure may be less effective.

Medical abortion can be performed as soon as a woman knows she is pregnant. 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.

Requires at least two visits -- one for health education, exam and medications and another to confirm that the abortion was successful. You may return to the clinic if you need further follow-up care.

How long is each appointment?

If you are between six and 12 weeks pregnant, the appointment will take approximately three hours. Later abortions usually require longer or multiple visits.

Two clinic visits are required; the first will last approximately one hour and the second is usually 20 to 30 minutes.

Is it painful?

Most women experience some cramping during or after the short procedure.

Most women experience strong cramps and some women 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, including Valium, Vicodin and/or Ibuprofen, also are used to relax you and to control your discomfort.

Anesthesia is not required. Most women are satisfied with over-thecounter pain medications like Ibuprofen. We recommend Ibuprofen, Tylenol and/or Vicodin for pain relief if needed.

How much will I bleed?

Women usually have light bleeding at home after the procedure for up to two weeks.

Women usually have heavy bleeding for several hours and bleed like a period for an average of two 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.

Yes, one friend, partner or family member may accompany you during the health education and explanation of medical abortion. You should have someone with you at home on the day you place the second medication in your vagina.

Must I have somebody with me?

No, but you must have a ride home if you opt to take Vicodin or Valium. It is preferable that you have a friend pick you up.

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.

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Please bring extra money if you need to take a taxi home.

Comparison of the Risks and Side Effects

Suction Curettage Abortion Medical Abortion

Is there a risk of injury to my body?

When instruments and suction are placed into your vagina and uterus, there is a 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 medical abortion. We usually do not recommend antibiotics to prevent infection.

What should I do 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, such as cramping or excessive bleeding, 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 for questions.

Will I be able to have children in the future?

There are no indications that suction curettage abortion affects a woman's ability to have a baby when she is ready.

There are no indications that medical abortion affects a woman's ability to have a baby when she is 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.

Reviewed by health care specialists at UCSF Medical Center. Last updated August 17, 2011 This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.

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