A surgical abortion is a procedure done by a trained medical professional in a clinical setting like an abortion clinic or, sometimes, a hospital.
There are two main types of surgical abortion: vacuum aspiration and dilation and evacuation (D&E). Vacuum aspiration is most often used up to 16 weeks after your last period, while D&E is used up to 24 weeks.
Vacuum aspiration
Vacuum aspiration is the most common type of in-clinic abortion, according to provider women for women Kenya
This procedure uses gentle suction to empty your uterus. It isn’t typically painful, but you may feel some cramping because your uterus will contract as the tissue is removed.
The procedure lasts about 5–10 minutes. You may need to stay at the clinic for up to a few hours afterward to ensure the abortion is complete.
Safety, side effects, and risks
Like other forms of abortion, vacuum aspiration is extremely safe. A large body of evidence suggests that less than 1% of people who have a vacuum aspiration procedure experience major complications.
Side effects after a vacuum aspiration procedure can include:
- bleeding or spotting
- cramps
- nausea
- sweating
- dizziness
As with any surgery or procedure, vacuum aspiration abortion has a small risk of infection. The chance of experiencing an infection from a vacuum aspiration abortion is likely a bit higher than it is from medical abortion.
Your provider may prescribe you an antibiotic to help reduce infection risk.
Despite myths and misinformation, there is no evidence that having any kind of abortion affects your fertility, prevents you from becoming pregnant in the future, raises your risk of breast cancer or miscarriage, or affects your mental health in the long term.
Dilation and evacuation (D&E)
D&E is often used a bit later on in pregnancy. It uses a combination of vacuum aspiration, forceps, and dilation and curettage (D&C).
To start, the provider dilates (or widens) your cervix to make it easier to remove the pregnancy tissue. They may have you take misoprostol and/or mifepristone, medications that help soften the uterus and cause it to contract, to help with that.
Then, they will use forceps to remove the fetus and placenta, a tube to suction out the uterus, and a scoop-like instrument called a curette to scrape out the uterine lining.
You’ll have this procedure in a hospital or a clinic. A D&E can be somewhat painful, but your provider can give you numbing medicines or local anesthesia to prevent discomfort and will likely send you home with prescription pain medication.
The procedure generally takes less than 30 minutes. You can go home the same day, but as with many surgeries, you may need to wait at the clinic for a while to ensure you’re doing OK.
Safety, side effects, and risks
D&E is a safe and common abortion method, and it’s the preferred choice for ending a pregnancy that has progressed to the second trimester.
That’s because it’s associated with the lowest risk of complications, compared with other methods of ending pregnancies in the second trimester.
Side effects from a D&E may include:
- bleeding
- cramping
- breast engorgement or lactation
- nausea, diarrhea, or vomiting
- chills
Some complications are possible but unlikely. These include infection, perforation, and excessive bleeding or hemorrhage.
Efficacy
Vacuum aspiration and D&E are extremely effective for ending your pregnancy.
These abortions are successful about 98% of the time, with just 2% of people needing to return to a clinic for an additional procedure or a pill to complete the abortion.
Some sources suggest that surgical aspiration is somewhat more likely to be successful than medical abortion, but more research is needed to confirm whether and why that’s the case.
