Patient education: Procedural abortion (The Basics)

What is procedural abortion? — 

Abortion is a way to end a pregnancy. It is also called "pregnancy termination."

With a procedural abortion, you go to a clinic or hospital. A doctor uses special tools to remove the pregnancy tissue from your uterus. They do this through the vagina. This is also called "surgical abortion," but it does not involve being cut open like in some types of surgery.

Other names for procedural abortion are "uterine aspiration," "suction aspiration," "vacuum aspiration," and "dilation and evacuation" ("D and E"). The terms used typically depend on how many weeks pregnant you are.

What happens during a procedural abortion?

●You will get medicines to help with pain and anxiety. Examples include:

•Medicines like ibuprofen (sample brand names: Advil, Motrin)

•A shot of numbing medicine in your cervix (figure 1)

•Medicine to help you relax

Having a support person talk to you during the procedure can also help with pain and anxiety. This could be a family member or friend, or it might be a nurse or other staff member.

●In some cases, you might have the option to get anesthesia to put you to sleep during the procedure.

●You might get medicines to open, or "dilate," your cervix. (The cervix is the opening to the uterus (figure 1).) Or the doctor might use devices called "dilators" instead. You might need to visit the clinic or hospital to have a dilator placed sometime before your abortion. Your doctor will tell you if you need to have your cervix dilated.

●The doctor will remove the pregnancy tissue from your uterus.

●The procedure usually only takes about 5 to 30 minutes.

What happens after a procedural abortion? — 

The staff will watch you closely as your anesthesia wears off. If you got medicines to help you relax, you will need to have someone else bring you home.

After an abortion, it is common to have:

●Pain and cramping in the lower belly

●Bleeding from the vagina – This can last for up to 2 weeks, sometimes longer.

Depending on how far along the pregnancy was, your breasts might feel full or leak milk. It can help to wear a supportive bra and use ice on your breasts until this goes away. Your doctor might also have other suggestions.

No cuts are made in your skin during a procedural abortion. So you will not have any new scars.

What are the risks of procedural abortion? — 

Your doctor will talk to you about all the possible risks, and answer your questions. Possible risks include:

●Infection

●Losing too much blood (hemorrhage)

●Injury to the uterus, cervix, or vagina

●Areas of scar tissue that form in the uterus

●Some of the pregnancy tissue being left behind

These risks are rare. But if any of these things happen, your doctor will tell you if any other treatments are needed.

When should I call the doctor? — 

After a procedural abortion, there are some problems to watch for. Call your doctor, nurse, or clinic for advice right away if:

●Your bleeding is heavy enough to soak through 2 pads an hour, for at least 2 hours, and you are still bleeding.

●Your pain is really bad (it makes you double over or makes it hard to move), and does not improve with pain medicines like ibuprofen (sample brand names: Motrin, Advil).

●You have a fever higher than 100.4°F (38°C) or chills.

●Bad-smelling discharge comes out of your vagina.

In some cases, procedural abortion does not work completely to get rid of all the pregnancy tissue. This is not very common. But if it does happen, you might need to take medicines or have a procedure to remove any leftover tissue. Signs that an abortion was not complete include:

●Still having pregnancy symptoms, such as nausea or tender breasts, 1 week or more after the abortion

●Bleeding that is heavy or not decreasing

●Not having a period in the first 2 months after the abortion (unless you are on hormonal birth control)

Call your doctor, nurse, or clinic if you have any of these signs. You should also call if you have a positive pregnancy test 4 weeks or more after your abortion.

What else should I know? — 

If you do not want to get pregnant again, talk to your doctor or nurse about birth control options. It is possible to get pregnant very soon after having an abortion, even before your next period. There are many different types of birth control. Your doctor or nurse can help you choose the right type for you.

More on this topic

Patient education: Deciding to have an abortion (The Basics)
Patient education: Medication abortion (The Basics)
Patient education: Choosing birth control (The Basics)
Patient education: Hormonal birth control (The Basics)
Patient education: Long-acting methods of birth control (The Basics)
Patient education: Intrauterine devices (IUDs) (The Basics)
Patient education: Permanent birth control for women (The Basics)
Patient education: Emergency contraception (The Basics)

Patient education: Abortion (pregnancy termination) (Beyond the Basics)
Patient education: Birth control; which method is right for me? (Beyond the Basics)
Patient education: Long-acting methods of birth control (Beyond the Basics)
Patient education: Emergency contraception (Beyond the Basics)