Therapeutic Abortion: Surgical
(Abortion; Vacuum Aspiration; Dilation and Curettage; Dilation and Evacuation)
by Beth Walsh, MA
Therapeutic abortion is a procedure to end a pregnancy. It is done before the fetus is able to survive on its own. A surgical therapeutic abortion is done using 1 of 3 methods:
Reasons for Procedure
A therapeutic abortion may be done to:
These procedures are safe. But, no procedure is free of risk. Problems resulting from abortion can include:
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 doctor. The earlier you find out, the more time you have to make an informed choice about the pregnancy. Early symptoms of pregnancy include:
What to Expect
Prior to Procedure
Your doctor may:
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to 1 week before the procedure
Description of Procedure
You may be given an antibiotic before the procedure.
The doctor may inject a numbing agent in or near the cervix. Special tools will be used to stretch the cervix opening. A tube will be inserted into the uterus. The tube will then remove the fetus and other products of conception.
The steps for an MVA will be followed. The doctor will then use 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. It will also require wider dilation of the cervix. The fetus and other products of conception are removed from the uterus with medical instruments and suction. This usually requires regional or general anesthesia.
How Long Will It Take?
About 5-20 minutes
How Much Will It Hurt?
Women report cramps similar to menstrual cramps. Talk to your doctor about medicine to help manage discomfort.
Acetaminophen or ibuprofen can reduce most of these symptoms. Do not take aspirin unless directed to by your doctor.
After a therapeutic abortion:
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.
Call Your Doctor
After arriving home, contact your doctor if any of the following occur:
In case of an emergency, call for medical help right away.
American Congress of Obstetricians and Gynecologists
Planned Parenthood Federation of America, Inc.
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
American College of Obstetricians and Gynecologists (ACOG). Practice Bulletin No. 135: Second trimester abortion. Obstet Gynecol. 2013 Jun;121(6):1394-406, reaffirmed 2017
Lohr P, Fjerstad M, DeSilva U, Lyus R. Abortion. BMJ. 2014;348:f7553
Induced abortion. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115505/Induced-abortion. Updated October 4, 2018. Accessed December 28, 2018.
1/11/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115505/Induced-abortion: Robson SC, Kelly T, Deverill M, et al. Randomised preference trial of medical versus surgical termination of pregnancy less than 14 weeks' gestation (TOPS). Health Technol Assess. 2009;13(53):1-124.
Last reviewed December 2018 by Michael Woods, MD
Last Updated: 12/31/2018
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