Abortion Incidence in the United States / Guttmacher Institute
Abortion Incidence in the United States / Image: Guttmacher Institute, 2014

Early Abortion Options

By OBOS Abortion Contributors | April 2, 2014

Abortion is a safe and legal way to end a pregnancy. There are two methods of abortion available to women in the first trimester of pregnancy. A medication abortion (also called medical abortion or abortion with pills) involves taking medicines to end a pregnancy. An aspiration abortion (also called surgical or suction abortion) is a procedure that uses medical instruments in the vagina and uterus to remove the pregnancy. The information below compares the two methods.

How far along in the pregnancy can I be?

Medication Abortion: Up to ten weeks from the first day of your last period.

Aspiration Abortion: Up to 12 weeks from the first day of your last period.

What will happen?

Medication Abortion: Generally, the abortion pill (mifepristone) is taken in person at the clinic or at a doctor’s office. Most women feel fine after taking mifepristone, though some experience nausea. At home, 6 to 72 hours later, a second pill, misoprostol, is taken bucally (placed in your cheek to dissolve) or vaginally, as instructed by your healthcare provider. The abortion starts one to four hours after taking the misoprostol. Heavy bleeding and cramps last for a couple of hours. You will have a follow-up appointment about a week later to be sure the abortion is complete.

Aspiration Abortion: The abortion takes place in the clinic or office. The actual abortion procedure takes five to 10 minutes. A physician uses medical instruments in your vagina and uterus to remove the pregnancy. A return visit is required only if you experience problems, or if you would like to see a healthcare provider.

How painful is it?

Medication Abortion and Aspiration Abortion: Expect mild to very strong cramps on and off during the abortion, which may be managed (or helped) with pain medication.

How much will I bleed?

Medication Abortion: Heavy bleeding with clots is common when you are passing the pregnancy. After that, lighter bleeding may continue off and on for one to two weeks or more.

Aspiration Abortion: Light bleeding generally lasts for one to seven days. Bleeding may continue off and on for a few weeks.

How much does it cost?

For both types of abortion, the exact costs depends on location, the facility, and timing. Planned Parenthood estimates that in the United States a medication abortion costs between $300 to $800 and an aspiration abortion (in the first 12 weeks) between $300–$950.

Can the abortion fail?

Medication Abortion: The pills work 98 to 99 percent of the time. If the pills fail, you will need to have an aspiration abortion.

Aspiration Abortion: It works 99 percent of the time. If it fails, you will need to have a repeat aspiration abortion.

Can I have children afterwards?

Yes. Neither type of abortion reduces your chances of getting or staying pregnant in the future.

Is it safe?

Medication Abortion: Both pills have been used safely since the late 1988 in Europe and since 2000 in the U.S. Major problems are rare. Medication abortion carries at least 10 times less risk of health complications than continuing a pregnancy.

Aspiration Abortion: Aspiration abortion is a safe and common procedure that has been done for more than 40 years. Abortion in the first eight weeks is the safest, and problems with any first trimester abortions are rare. Surgical abortion carries at least 10 times less risk of health complications than continuing a pregnancy.

What are the advantages?

Medication Abortion: No shots, anesthesia or medical instruments are involved. The abortion may feel more natural, like a miscarriage. It can be done earlier in the pregnancy than an aspiration abortion. You have the option to be at home or wherever you feel most comfortable. You can choose to have someone with you, or you can be alone.

Aspiration Abortion: The procedure is over in a few minutes. There is less bleeding than with a medication abortion. Medical staff members are with you during the abortion. It can be done later in the pregnancy than a medication abortion.

What are the disadvantages?

Medication Abortion: It takes one to two days to complete the abortion. Bleeding and cramps can be very heavy and can last longer than with aspiration abortion. It cannot be done as late in the first trimester of pregnancy as aspiration abortion.

Aspiration Abortion: It is more invasive; instruments are inserted through the vagina and into the uterus. Anesthetics and pain medication may cause side effects. You have less control over the procedure and perhaps over who can accompany you into the room. The vacuum aspirator may seem noisy. It cannot be done as early in pregnancy as medication abortion.

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