by Our Bodies Ourselves Today, July 2022
This content is adapted from an earlier article by Our Bodies Ourselves Abortion Contributors
In the United States, abortion remains a safe way to end a pregnancy. There are two methods of abortion available to women in the first trimester of pregnancy (up to 14 weeks from the first day of the last period).
A medication abortion (also called medical abortion or the abortion pill) involves taking medicines to end a pregnancy. An aspiration abortion (also called surgical or suction abortion, or a dilation and curettage (D&C)) 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 10 or 11 weeks from the first day of your last period.
Aspiration Abortion: Up to 14 weeks from the first day of your last period.
What will happen?
Medication Abortion: A medication abortion is completed by taking two kinds of medicines to end the pregnancy. The medication Mifepristone is taken first. Most women feel fine after taking mifepristone, though some may experience nausea and bleeding. Later, anywhere from 6 to 48 hours later, a second medication called misoprostol is taken buccally (placed between your gum and your cheek to dissolve) or vaginally, as instructed by your healthcare provider.
Between 1 and 12 hours after you take the misoprostol, you will begin bleeding and cramping. The heavy bleeding and cramping generally lasts for 1 to 2 hours, but the length of time can be unpredictable and it is normal for them to last longer. You should have a follow-up appointment with the abortion provider 1 to 2 weeks later, to make sure the abortion is complete.
Aspiration Abortion: This type of abortion takes place in a clinic, surgical setting or office. The actual abortion procedure takes 5 to 10 minutes. The abortion provider uses medical instruments in your vagina and uterus to remove the pregnancy. There are a range of anesthesia options, depending on the facility and your needs. A return visit is required only if you experience problems, or if you would like to see your provider.
How painful is it?
Medication Abortion and Aspiration Abortion: Expect mild to very strong cramps on and off during and after the abortion. How strong the cramps are and how long they last varies from person to person. Most people can manage the pain with over-the-counter medications such as ibuprofen.
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 1 to 2 weeks or more.
Aspiration Abortion: Light bleeding generally lasts for 1 to 7 days. Bleeding may continue off and on for a few weeks.
How much does it cost?
For both types of abortion, the exact cost depends on whether you have insurance as well as your location, the facility, and timing. The range is anywhere from $0-$1500, with the average first-trimester abortion costing a around $650.
Can the abortion fail?
Medication Abortion: For women 8 weeks pregnant or less, the pills work about 94-98 out of 100 times. They are slightly less effective at 8- 11 weeks, working about 92-98 out of 100 times. If the pills fail to complete the abortion, you will need to either try the pills again or have a surgical abortion.
Surgical Abortion: It works 99% of the time. If it fails, you will need to have a repeat aspiration abortion.
Can I have children afterward?
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 1980s 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 50 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: A medication abortion can be completed in the privacy of your own home or location of your choosing. You can choose to have someone with you, or you can be alone. No shots, anesthesia or medical instruments are involved. The abortion may feel more natural to you, like a miscarriage.
Aspiration Abortion: An aspiration abortion is completed in just a few minutes, and there are varying degrees of pain control (you can be awake with some numbing medication on the cervix or you can potentially choose to be sedated with anesthesia so you do not feel the procedure). There is less bleeding than with a medication abortion. Medical staff members are with you during the abortion. An aspiration abortion can be done later in the pregnancy than a medication abortion. It is slightly more likely to work, and more predictable.
What are the disadvantages?
Medication Abortion: It takes one to two days to complete the medications and pass the pregnancy. Bleeding and cramps can be very heavy and can last longer than with surgical abortion. It cannot be done as late in the first trimester of pregnancy as aspiration abortion. You will need a follow-up blood pregnancy test or a vaginal ultrasound to make sure you are not still pregnant.
Aspiration Abortion: It is more invasive, because 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 if you are awake during the procedure.