Medical vs. Surgical Abortion
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Reasons to Choose a Suction Curettage (Surgical) Abortion
- It can require fewer appointments
- The procedure takes a short amount of time
- It is more effective than medical abortion (less risk of an incomplete procedure)
- Patients 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 can let patients avoid surgery and 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
- It can sometimes be done via telehealth, instead of coming into the clinic
For more information and frequently asked questions, see the tables below.
Comparison of Methods for First-Trimester Abortion
| FAQ | 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? | Gentle suction is used to remove the pregnancy in an office, surgery center, or hospital setting. | You will take medications that allow you to pass the pregnancy at home. |
| How effective is the method? | 98 percent of suction curettage abortions are successful; only about 2 percent of patients 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 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? | At our facility, this is available from 5 weeks to 23 weeks and 6 days since the first day of your last period. If performed earlier than six weeks, the procedure may be less effective. | 4 to 10 weeks since the first day of your last menstrual period. Medical abortion can be performed as soon as a patient knows they are pregnant. It is more effective and leads to less bleeding at earlier gestations. |
| How many clinic visits are required? | Usually requires one to two visits, depending on if you opt to be awake or asleep for the procedure. A follow-up visit is typically done via telehealth. | Requires at least two visits -- one for health education, exam and medications and another to confirm that the abortion was successful. For many patients, these can both be done via telehealth. Medications can be mailed or picked up. |
| How long is each appointment? | If you are between 6 and 12 weeks pregnant, the appointment will take approximately 3-4 hours. Later abortions usually require longer or multiple visits. | Telehealth appointments are usually about 15-30 minutes; in-person appointments are typically 1-3 hours. |
| Is it painful? | Most patients experience some cramping during and/or after the short procedure. The intensity of these cramps can vary from patient to patient. | Most patients experience strong cramps. Some will also 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 are offered, including ibuprofen and Norco/Ativan, as needed to relax you and to control your discomfort. If you prefer, you can opt to have the procedure done under anesthesia (asleep) in a hospital setting. | Anesthesia is not required. Most patients are satisfied with over-the-counter pain medications like Ibuprofen and using heat packs. We recommend Ibuprofen, Tylenol and/or Norco for pain relief if needed. Anti-nausea medication may also be prescribed. |
| 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 an average of two weeks after starting the process. |
| May I bring a support person with me? | Yes, one friend, partner or family member may accompany you during the health education and explanation of the procedure. | Yes, one friend, partner or family member may accompany you during the health education and explanation of medical abortion. Ideally, you should have someone with you at home on the day you place the second medication in your vagina. If someone is not available to be physically with you the whole time, it is recommended that you have someone on standby who is able to help you if needed. |
| Must I have somebody with me? | No, but if you opt to take a narcotic or an anti-anxiety medication for the in-office procedure, you must have a ride home. It is preferable that you have someone pick you up. If you are unable to have someone take you home, let the clinic know in advance and they will work with you to figure out your options. | No, not during the clinic visit, but at home you should ideally have someone with you and access to a telephone in case of questions or emergency. |
Comparison of the Risks and Side Effects
| FAQ | 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 or concerns. |
| Will I be able to have children in the future? | There are no indications that suction curettage abortion affects a patient’s ability to have a baby when she is ready. | There are no indications that medical abortion affects a patient’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 doctor before consenting to having an abortion.
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.