Surgical Abortion

Manual vacuum aspiration (MVA) empties the uterus with gentle suction of a manual syringe. It is used for very early surgical abortion. It can be done as soon as you know you are pregnant and up to eight weeks after your last period.

Dilation and suction curettage, also known as D&C, or vacuum aspiration, gently empties the uterus with machine-operated suction. A curette (narrow metal loop) may be used to clean the walls of the uterus. This method is used for early surgical abortion. It is performed from six to 13.3 weeks after your last period.

Although less common and not available at UHPP health centers, surgical abortion is possible after 13.5 weeks of pregnancy. Contact one of our health centers to find out more information.

How Long Does it Take?
The MVA and D&C procedures take about 10 minutes to complete. Allow four hours for the entire appointment, which also includes counseling and education, a physical exam, forms to read and sign, and a recovery period.

How Effective is it?
Surgical abortion is nearly 100 percent effective. It fails to end a pregnancy one out of 500 times. This can happen when there is more than one chamber in the uterus or the pregnancy did not occur in the uterus (ectopic or tubal pregnancy).

What Do I Need to do to Get a Surgical Abortion?
You will need to:

• Have counseling
• Sign a consent form
• Give a medical history
• Have laboratory tests
• Have a physical exam -- which will include an ultrasound

How Does it Feel?
Most women feel pain similar to menstrual cramps. For others, abortion is more uncomfortable. Local pain medications are usually used.

How is MVA Performed?

• Your vagina is washed with an antiseptic.
• The doctor will inject an anesthetic into or near your cervix.
• The opening of the cervix will be slightly stretched with dilators.
• A tube is inserted through the cervix into the uterus. A hand-held pump gently empties the uterus.

How is a D&C performed?

• Your vagina is washed with an antiseptic.
• The doctor will inject an anesthetic into or near your cervix.
• The opening of the cervix is stretched with dilators.
• A tube is inserted into the uterus. This tube is attached to a suction machine.
• The suction machine is turned on. The uterus is emptied by gentle suction.
• A curette (narrow metal loop) may be used to clean the walls of the uterus.

What are the Health Risk of Surgical Abortion?
In the first 20 weeks, abortion is much safer than giving birth. Complications from early abortion include:

• Allergic reactions to the drugs--Tell your clinician what medications or recreational drugs you take. It will be strictly confidential.
• Incomplete abortion--This occurs in less than one out of 100 D&C abortions.
• Blood clots in the uterus may occur.
• Infection--Usually antibiotics clear up the infection. In rare cases, a repeat procedure, hospitalization, or surgery is needed.
• Very heavy bleeding--You may need medication, a D&C, or, rarely, surgery. Very rarely, blood transfusions are required.
• A cut or torn cervix--This occurs in fewer than one out of 100 early abortions.
• Organ injury--In about one of 1,000 early abortions, an instrument goes through the wall of the uterus. In even fewer cases, this leads to infection, heavy bleeding, or both. Surgery, or very rarely, hysterectomy, may be needed.
• Death is rare, it occurs in one of 100,000 abortions. Childbirth carries seven times more risk.

After the Abortion
After very early and early abortions, you will rest in a recovery room for about an hour. If you have an Rh-negative blood type, you will receive an injection to protect future pregnancies. You will receive written after-care instructions and a 24-hour emergency phone number. Call your doctor if you have heavy bleeding, pain, or fever. You can discuss birth control with your counselor. You will make a follow-up appointment in two to four weeks.

How Will I Feel Later?
You may have cramps. You may want to relax for the rest of the day. You may shower as soon as you wish. Do not take baths, douche, or use vaginal medications. You can usually return to work or other normal activities the next day. Recovery after later abortions may take longer.

Will I Bleed For a Long Time?
You may bleed off and on for a couple of weeks. Some women have cramps and pass a few large blood clots for up to 10 days. Use sanitary pads--not tampons.

When Will I Get My Period?
Abortion begins a new menstrual cycle. You should have a regular period in four to eight weeks.

When Can I Have Sex Again?
Don't have vaginal intercourse or insert anything into the vagina for one week after the abortion. You can get pregnant very soon after the abortion. Discuss birth control options with your clinician.