Abortion - surgical

Description

Surgical abortion uses a vacuum to remove the fetus and related pregnancy material from the uterus. The procedure is most often done 6 weeks after the woman's last menstrual period or soon afterward when possible.

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 Rhogam.
• An ultrasound test checks how many weeks you are pregnant.

During the procedure:

• You 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 the doctor can view the vagina and cervix.
• The doctor may numb the cervix so you feel little pain during the procedure.
• Small rods called dilators will be put in the cervix to gently stretch it open. Sometimes laminaria, or 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.
• The doctor inserts a tube into the womb and the vacuum is used to remove the pregnancy tissues.

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

Why the Procedure is Performed

Reasons a surgical abortion might be considered include:

• 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 health care provider. A family member or friend can also be of help.

Risks

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, with the need for another procedure

After the Procedure

You will stay in a recovery area for a few hours. The health care 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)

Complications (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 usually lasts for a day or two.

You can get pregnant before your next period, which occurs 4-6 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 health care provider about emergency contraception.

Alternative Names

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

References

Annas GJ, Elias S. Legal and ethical issues in obstetric practice. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 54.

Jensen JT, Mischell Jr DR. Family planning: contraception, sterilization, and pregnancy termination. In: Katz VL, Lentz GM, Lobo RA, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 13.

Update Date: 11/8/2012

Updated by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.