Abortion - surgical

  • Definition
    • Surgical abortion is a procedure that ends an undesired pregnancy by removing the fetus and placenta from the mother's womb (uterus).

      Surgical abortion is not the same as miscarriage. Miscarriage is when a pregnancy ends on its own before the 20th week of pregnancy.

  • Alternative Names
    • Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical

  • Description
    • Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. Suction is used to remove the fetus and related pregnancy material from the uterus.

      Before the procedure, you may have the following tests:

      • A urine test checks if you are pregnant.
      • A blood test checks your blood type. Based on the test result, you may need a special shot to prevent problems if you get pregnant in the future. The shot is called Rho(D) Immune Globulin (RhoGAM and other brands).
      • An ultrasound test checks how many weeks pregnant you are.

      During the procedure:

      • You will lie on an exam table.
      • You may receive medicine (sedative) to help you relax and feel sleepy.
      • Your feet will rest in supports called stirrups. These allow your legs to be positioned so that your doctor can view your vagina and cervix.
      • Your doctor may numb your cervix so you feel little pain during the procedure.
      • Small rods called dilators will be put in your cervix to gently stretch it open. Sometimes laminaria (sticks of seaweed for medical use) are placed in the cervix. This is done the day before the procedure to help the cervix dilate slowly.
      • Your doctor will insert a tube into your womb, then use a special vacuum to remove the pregnancy tissue through the tube.

      After the procedure, you may be given medicine to help your uterus contract. This reduces bleeding.

  • Why the Procedure Is Performed
    • Reasons a surgical abortion might be considered include:

      • You have made a personal decision not to carry the pregnancy.
      • Your baby has a birth defect or genetic problem.
      • Your pregnancy is harmful to your health (therapeutic abortion).
      • The pregnancy resulted after a traumatic event such as rape or incest.

      The decision to end a pregnancy is very personal. To help you weigh your choices, discuss your feelings with a counselor or your health care provider. A family member or friend can also be of help.

  • Risks
    • Surgical abortion is very safe. It is very rare to have any complications.

      Risks of surgical abortion include:

      • Damage to the womb or cervix
      • Uterine perforation (accidentally putting a hole in the uterus with one of the instruments used)
      • Excessive bleeding
      • Infection of the uterus or fallopian tubes
      • Scarring of the inside of the uterus
      • Reaction to the medicines or anesthesia, such as problems breathing
      • Not removing all of the tissue, requiring another procedure
  • After the Procedure
    • You will stay in a recovery area for a few hours. Your providers will tell you when you can go home. Because you may still be drowsy from the medicines, arrange ahead of time to have someone pick you up.

      Follow instructions for how to care for yourself at home. Make any follow-up appointments.

  • Outlook (Prognosis)
    • Problems rarely occur after this procedure.

      Physical recovery usually occurs within a few days, depending on the stage of the pregnancy. Vaginal bleeding can last for a week to 10 days. Cramping usually lasts for a day or two.

      You can get pregnant before your next period, which will occur 4 to 6 weeks after the procedure. Be sure to make arrangements to prevent pregnancy, especially during the first month after the procedure. You may want to talk with your health care provider about emergency contraception.

  • References
    • Annas GJ, Elias S. Legal and ethical issues in obstetric practice. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 54.

      Jensen JT, Mishell Jr. DR. Family planning: contraception, sterilization, and pregnancy termination. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 13.