Abortion

Choices: Surgical Abortion

A surgical abortion ends a pregnancy by surgically removing the contents of the uterus. Different procedures are used for surgical abortion, depending on how many weeks of pregnancy have passed.

Care before and after a surgical abortion includes a physical exam and lab tests, education about what to expect, self-care instructions, symptoms that indicate you should call your health professional, and birth control planning.

Surgical methods in the first trimester (3 to 12 weeks)

• Manual vacuum aspiration (MVA) or machine vacuum aspiration uses suction through a small tube to empty the uterus of all tissue.
• Dilation and curettage (D&C), which is more "surgical" than aspiration, uses a sharp instrument to clear the uterus. It is usually reserved for following up on medical or vacuum aspiration procedures that have not completely emptied the uterus.

Surgical method in the second trimester

• Dilation and evacuation (D&E) is typically done when an abortion occurs in the second 12 weeks (second trimester) of pregnancy. It usually includes a combination of vacuum aspiration, dilation and curettage (D&C), and the use of surgical instruments (such as forceps) to clear the uterus of fetal and placental tissue.

A D&E is most commonly used during the second trimester because it has a lower complication risk than induction abortion.

Nonsurgical method in the second trimester

• Induction abortion ends a second-trimester pregnancy by using medicines to start (induce) contractions, which expel (push) the fetus from the uterus. If the fetus has severe medical problems, a woman may choose to have an induction abortion. This method is used to minimize risk to the woman and so an autopsy can be performed to find out what is wrong with the fetus.

See the section What to Think About for a comparison between medical abortion and surgical abortion.

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Author:	Healthwise Medical Writer	Last Updated: October 6, 2006
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Lori A. Boardman, MD, ScM - Obstetrics and Gynecology
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