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Abortion - surgical

Surgical abortion is a procedure that ends an undesired pregnancy by removing the fetus and placenta from the mother's womb (uterus).

Surgical abortion is not the same as miscarriage. Miscarriage is when a pregnancy ends on its own before the 20th week of pregnancy.

Description

Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. Suction is used to remove the fetus and related pregnancy material from the uterus.

Before the procedure, you may have the following tests:

  • A urine test checks if you are pregnant.
  • A blood test checks your blood type. Based on the test result, you may need a special shot to prevent problems if you get pregnant in the future. The shot is called Rho(D) immune globulin (RhoGAM and other brands).
  • An ultrasound test checks how many weeks pregnant you are.

During the procedure:

  • You will lie on an exam table.
  • You may receive medicine (sedative) to help you relax and feel sleepy.
  • Your feet will rest in supports called stirrups. These allow your legs to be positioned so that your doctor can view your vagina and cervix.
  • Your health care provider may numb your cervix so you feel little pain during the procedure.
  • Small rods called dilators will be put in your cervix to gently stretch it open. Sometimes laminaria (sticks of seaweed for medical use) are placed in the cervix. This is done the day before the procedure to help the cervix dilate slowly.
  • Your provider will insert a tube into your womb, then use a special vacuum to remove the pregnancy tissue through the tube.
  • You may be given an antibiotic to reduce the risk of infection.

After the procedure, you may be given medicine to help your uterus contract. This reduces bleeding.

Why the Procedure is Performed

Reasons a surgical abortion might be considered include:

  • You have made a personal decision not to carry the pregnancy.
  • Your baby has a birth defect or genetic problem.
  • Your pregnancy is harmful to your health (therapeutic abortion).
  • The pregnancy resulted after a traumatic event such as rape or incest.

The decision to end a pregnancy is very personal. To help you weigh your choices, discuss your feelings with a counselor or your provider. A family member or friend can also be of help.

Risks

Surgical abortion is very safe. It is very rare to have any complications.

Risks of surgical abortion include:

  • Damage to the womb or cervix
  • Uterine perforation (accidentally putting a hole in the uterus with one of the instruments used)
  • Excessive bleeding
  • Infection of the uterus or fallopian tubes
  • Scarring of the inside of the uterus
  • Reaction to the medicines or anesthesia, such as problems breathing
  • Not removing all of the tissue, requiring another procedure

After the Procedure

You will stay in a recovery area for a few hours. Your providers will tell you when you can go home. Because you may still be drowsy from the medicines, arrange ahead of time to have someone pick you up.

Follow instructions for how to care for yourself at home. Make any follow-up appointments.

Outlook (Prognosis)

Problems rarely occur after this procedure.

Physical recovery usually occurs within a few days, depending on the stage of the pregnancy. Vaginal bleeding can last for a week to 10 days. Cramping most often lasts for a day or two.

You can get pregnant before your next period, which will occur 4 to 6 weeks after the procedure. Be sure to make arrangements to prevent pregnancy, especially during the first month after the procedure. You may want to talk with your provider about emergency contraception.

Alternative Names

Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical

References

Lesnewski R, Prine L. Pregnancy termination: medical abortion. In: Pfenninger JL, Fowler GC, eds. Pfenninger and Fowler's Procedures for Primary Care. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 128.

Rivlin K, Westhoff C. Family planning. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 13.

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Review Date 10/4/2016

Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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