Abortion means ending a pregnancy early. In some cases, a woman’s pregnancy ends on its own. This is called a miscarriage, or a spontaneous abortion. In other cases, a woman chooses to end her pregnancy by taking medicine (called medical abortion) or having surgery (called surgical abortion). These 2 types of abortion are usually done in the first trimester (the first 3 months) of the pregnancy. They are performed by a doctor and other health care professionals in the hospital, doctor’s office or health center.
A medical abortion is an abortion caused by medicine. It can only be done in the first 9 weeks of pregnancy. The most common type of medical abortion uses a medicine called mifepristone. This is a pill that blocks progesterone, a hormone needed for pregnancy. It causes the lining of the womb (uterus) to become thin.
For this procedure, a woman visits her doctor 3 times. During the first visit, the woman takes mifepristone. She comes back a few days later to take another medicine called misoprostol. Misoprostol makes the uterus contract and empty. Many women have bleeding for about 13 days after taking misoprostol. Light bleeding or discharge (called spotting) can continue for several weeks. After a couple of weeks, the woman will return to the doctor for a follow-up visit to be sure that the medicine was effective.
For most women, medical abortion feels like a bad menstrual period with strong cramps, diarrhea and upset stomach. These symptoms are normal. Acetaminophen (one brand name: Tylenol) or ibuprofen (two brand names: Advil, Motrin) can help relieve the cramps. However, the doctor will want to know if any of the following occur:
Mifepristone is about 97% effective. In rare cases when medical abortion doesn’t work, surgical abortion may be tried.
Surgical abortion is a procedure done by a doctor to remove the lining of the womb. There are 2 common procedures: manual vacuum aspiration (MVA), and dilatation and evacuation (D&E). They both use suction to empty the womb. MVA uses a handheld tool. D&E is done with a suction machine and tools.
MVA can be done in the first 12 weeks of pregnancy. D&E can be done after the first month of pregnancy and before the end of the 13th week.
For both procedures, medicine can be given to help the woman feel calm. Then the doctor injects around the opening to the womb (called the cervix) with medicine to make it numb. The cervix is stretched open with a tool called a dilator, and the doctor inserts a tube. The uterus is emptied through this tube.
For most women, surgical abortion feels like strong menstrual cramps. Women are usually given medicine to help with the pain and told to rest when they get home. Acetaminophen or ibuprofen can also help. Bleeding may continue off and on for a few weeks.
Surgical abortion is nearly 100% effective.
When done by health care professionals during the first trimester, both medical and surgical abortions are generally very safe. Serious complications are rare. Abortion generally does not reduce a woman's ability to get pregnant in the future.
Written by familydoctor.org editorial staff