Therapeutic Abortion: Surgical
(Abortion; Vacuum Aspiration; Dilation and Curettage; Dilation and Evacuation)
Therapeutic abortion is the intentional termination of pregnancy. It is done before the fetus is able to survive on its own. A surgical therapeutic abortion is either performed by one of three methods:
- Manual vacuum aspiration (MVA)
- Dilation and suction curettage ( D&C]]> )
- Dilation and evacuation (D&E)
Reasons for Procedure
A therapeutic abortion is done to:
- Preserve the mother’s health
- End a pregnancy that tests have shown would result in a child with severe abnormalities
Risk Factors for Complications During the Procedure
The earlier in a pregnancy the abortion is done, the better the chances of a procedure with no complications.
If you think you might be pregnant, see your physician. The earlier you find out, the more time you have to make an informed choice about the pregnancy. Early symptoms of pregnancy include the following:
- A missed period
- Tender, swollen breasts
- Nausea or vomiting
- Increased sensitivity to odors
- Food aversions
- Frequent urination
What to Expect
Prior to Procedure
Your doctor may:
- Manually examine you—to determine the stage of your pregnancy by assessing the size and texture of the uterus
- Do blood and urine tests—to confirm the pregnancy
- Use ultrasound—to give an accurate assessment of the stage of pregnancy
Talk to your doctor about your current medications. Before the procedure certain medications may need to be stopped such as:
Local anesthesia with sedation may be used.
Description of the Procedure
The doctor may inject a numbing agent in or near the cervix. Dilators are used to stretch the cervix opening. A tube is inserted into the uterus. The tube aspirates (sucks) out the contents.
The doctor may inject a painkiller into or near the cervix. Dilators are used to stretch the cervix opening. A tube attached to a suction machine is inserted into the uterus. The uterus contents are suctioned out. The doctor may use a curette (a narrow metal loop) to remove the tissue lining the uterine walls.
This procedure is similar to a D&C except that it is done during the second trimester. The fetus and other products of conception are removed from the uterus with medical instruments and suction.
You will spend some time in a recovery area.
How Long Will It Take?
The length will depend on the procedure. In general they are about 5-20 minutes.
Will It Hurt?
Women report cramps similar to menstrual cramps.
The procedures are very safe. Risks increase if you wait later in the pregnancy to terminate. Risks also increase if sedation or general anesthesia are used. Problems resulting from abortion include:
- An incomplete procedure
- An allergic reaction
- Blood clots in the uterus
- Heavy bleeding
- Injury to the cervix or other organs
Average Hospital Stay
Most cases do not require a hospital stay.
After a therapeutic abortion:
- You may have cramps, bleeding, and nausea.
- You should not douche or use vaginal medications for at least 24 hours.
- Do not have sex for at least one week.
- You should physically recover within a couple of days.
Sudden hormone changes may intensify natural feelings of guilt, anger, sadness, and regret. Most doctors can offer or refer you to follow-up counseling, if you choose.
American Academy of Family Physicians
American College of Obstetricians and Gynecologists
Planned Parenthood Federation of America
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
Abortion. Planned Parenthood website. Available at: http://www.plannedparenthood.org/pp2/portal/medicalinfo/abortion/main.xml . Accessed on December 9, 2008.
Surgical abortion. The Abortion Clinic Directory website. Available at: http://www.abortionclinic.org/topics/articles/article_99.asp . Accessed December 9, 2008.
The Women’s Health Centre: therapeutic abortion. Regina Qu’Appelle Health Region website. Available at: http://www.rqhealth.ca/programs/in_hospital_care/womens_health/therapeutic.shtml . Access December 9, 2008.
Last reviewed December 2008 by ]]>Ganson Purcell Jr., MD, FACOG, FACPE]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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