Surgical vs Medical Abortion

Facing an unwanted pregnancy and having made the decision to have an abortion, a woman now needs to choose between a medical versus a surgical abortion. Deciding which type of procedure is best for you can add confusion to an already stressful situation.

In this article, we will go over both the surgical abortion and the abortion pill, the differences between the two, and the benefits and risks associated with each. This should give you a better understanding of the choices available to you.

Abortion Counseling meeting

Surgical Abortion

How far along in pregnancy it can be performed
Surgical abortions can be performed 5 to 14 weeks after the first day of the woman’s last menstrual period. Women are often asked to wait until six weeks. If performed earlier than six weeks, the procedure may be less effective.

A surgical abortion involves the use of gentle suction to empty the uterus. First, the doctor will apply a local anesthesia to your cervix. (Oral medications can also be given to help you relax and to help control any discomfort.) Once the cervix is numbed, the doctor gradually widens the cervix and places a tube into the uterus. Suction is then created either by an electric machine or by a hand help syringe applied to the other end of the tube. The procedure takes less than ten minutes.

Appointments required
Most women require only one visit.

How long does it take?
The procedure takes less than ten minutes

Amount of bleeding
It is normal to have light bleeding at home after the procedure for up to two weeks.

Is it painful?
Most women experience some cramping during and shortly after the procedure. Mild cramps may continue for several days.

98% of surgical abortions are successful with only about 2% of women needing a repeat procedure or other medical intervention.

Possible complications
Surgical abortion has been studied for over 25 years. Complications and side effects are rare. In less than 1% of cases, re-suction may be required.

Side Effects
Some women will experience dizziness, nausea or vomiting.

Advantages of a surgical abortion

  • A surgical abortion is quick, effective, and safe
  • The entire procedure can be completed in less than ten minutes
  • It usually involved only one visit
  • It can be performed later in the pregnancy than medical abortion
  • Low complication and high success rate
  • Less bleeding than with a medical abortion
  • Involves minimal medication
  • Surgical abortion is performed by a doctor with the support of medical staff

Disadvantages connected with a surgical abortion
It is more invasive than a medical abortion. Anesthetics and drugs to manage pain during the procedure may cause side effects (serious problems are rare). There are possible complications, although they occur in less than one percent of cases. Some doctors recommend it not being done as early in the pregnancy as a medical abortion.

Future pregnancies
Having a surgical abortion does not affect fertility or future pregnancies.

Medical Abortion

How far along in pregnancy it can be performed
A medical abortion can be performed up to 9 weeks and 6 days after the beginning of the latest menstruation. 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).

A medical abortion is achieved through the use of two different medications which work together to terminate the pregnancy. These two medications taken to terminate a pregnancy are mifepristone and misoprostol.

Before being prescribed the medications, you will be given an ultrasound to ensure you are no more than 9 weeks pregnant and that you do not have an ectopic pregnancy (pregnancy in the tubes.)

The first medication, either given to you in your doctor’s office or taken by you at home, acts to block the effects of the hormone needed for your pregnancy to continue.

The second medication is taken 24 to 48 hours later. This one opens the cervix to help the uterus expel the pregnancy. This should occur between 30 minutes and 24 hours after taking the second medication.

A medical abortion requires at least two clinic visits. One visit is for health education, exam and medications and another is necessary to confirm that the abortion was successful. The first will last approximately one hour and the second usually lasts 20 to 30 minutes.

How long does it take?
Several days. The second medication is taken 24 to 48 hours after the first. Then, between 30 minutes and 24 hours after the taking of the second medication the uterus should expel the pregnancy.

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

Is it painful?
Most women experience strong cramps but over-the-counter medication is usually sufficient to help with the pain.

A medical abortion is effective in 92% to 98% of cases. The earlier in the pregnancy, the more likely the success. The higher failure rate is associated with taking the medication later in the pregnancy than the intended approval period.

Possible complications
Medical abortion is a safe and effective method of terminating a pregnancy up to 9 weeks’ gestation. However, there are some risks.

Incomplete abortion can occur in about 1-4% of cases and a surgical procedure may be needed to stop cramping and bleeding.

Ongoing pregnancy occurs in less than 1% of cases. In this case, a surgical abortion will usually be recommended.

Side effects
Bleeding lasts for about 10 to 16 days and it’s not unusual for it to be heavier than a normal period for 2 to 3 days.

Side effects of the medications can include nausea, diarrhea, vomiting, and chills or fever. These are usually mild and don’t last long.

Advantages of a medical abortion

  • It can be used in the earliest weeks of pregnancy
  • It requires no surgery and no anesthesia
  • The procedure is non-invasive
  • It can be done in the comfort and privacy of home supported by family or friends
  • Some women feel it gives them greater control over their bodies
  • It may feel more “natural” for some women as it is similar to a heavy period or miscarriage

Disadvantages connected with a medical abortion

  • Requires an additional office visit
  • Takes longer to complete
  • Not done under direct medical supervision
  • Heavy bleeding at home
  • Cannot be performed as late in the pregnancy

Future pregnancies
As with a surgical abortion, a medical abortion normally does not affect future pregnancies.

Abortion Pill vs Surgical Abortion
As you can see, these are two very different procedures each with its own advantages and disadvantages. Both are considered safe, so the choice between the two is a personal one.

Women who choose to have a surgical abortion frequently decide on this procedure because of the reassurance of having medical professionals with them when the abortion occurs and because it is quicker. There is also less cramping and bleeding than with a medical abortion.

On the other hand, many women prefer a medical abortion because it can be done in the privacy of their own home, with a partner or friend. Some women also feel it is less invasive and more natural.

The decision to have a surgical or medical abortion is up to you and must take into account your particular circumstances, medical history and preference. We are here to answer your questions and can help guide you in your choice.