Therapeutic Abortion: Surgical
(Abortion; Vacuum Aspiration; Dilation and Curettage; Dilation and Evacuation)
Therapeutic abortion is the ending of a pregnancy on purpose. It is done before the fetus is able to survive on its own. A surgical therapeutic abortion is done using 1 of 3 methods:
- Manual vacuum aspiration (MVA)
- Dilation and suction curettage ( D&C)
- Dilation and evacuation (D&E)
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Reasons for Procedure
This procedure may be done to:
- Preserve the mother’s physical and mental health
- End a pregnancy that tests have shown would result in a child with severe abnormalities
It is best to do the procedure as early as possible. This will decreases the chance of complications.
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Allergic reaction
- Injury to the cervix or other organs
- Incomplete procedure
What to Expect
Prior to Procedure
The care team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
- Whether you need a ride to and from the procedure
- Tests that will need to be done before the procedure, such as an ultrasound to evaluate the stage of pregnancy
The doctor may give:
Description of Procedure
You may be given an antibiotic before one of the following procedures is done.
The doctor may inject a numbing agent in or near the cervix. Special tools will be used to stretch the cervix open. 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 to 20 minutes
Will It Hurt?
Bleeding and cramping is common after the procedure. Medicine and home care help.
At the Care Center
The medical staff will monitor you until you are able to go home.
It will take up to 2 to 6 weeks for bleeding and cramping to go away. Tampons and sex will need to be avoided. Counseling may be advised to help cope with the procedure.
Call Your Doctor
Call the doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Pain that you cannot control with medicine
- Vaginal bleeding that soaks more than one pad per hour
- Foul smelling vaginal discharge
If you think you have 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
Abortion. American Pregnancy Association website. Available at: https://americanpregnancy.org/unplanned-pregnancy/abortion. Accessed August 26, 2021.
American College of Obstetricians and Gynecologists (ACOG). Practice Bulletin No. 135: Second trimester abortion. Obstet Gynecol. 2013 Jun;121(6):1394-406, reaffirmed 2017
Induced abortion. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/induced-abortion. Accessed August 26, 2021.
Last reviewed July 2021 by EBSCO Medical Review BoardBeverly Siegal, MD, FACOG Last Updated: 8/26/2021