If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

What are the differences between surgical and medical abortions?

	Surgical abortion	Medical abortion
How it works	·         A doctor will gently open your cervix (the opening to the uterus or womb) with dilators that gradually get bigger. ·         A cannula (straw-like tube) is inserted through the cervix into the uterus. ·         Suction (like a vacuum) is used to remove the pregnancy from the uterus. ·         The procedure usually takes 3-10 minutes.	·         You take two medications. The pregnancy will end and the uterus will push out the tissue (like a miscarriage). ·         The first pill stops the pregnancy. The second pills are taken 24-48 hours (1-2 days) later, at a convenient time for you.
Advantages	•         Very low risk of continuing pregnancy (less than 1 in 100). •         High success rate (about 99%). •         Only needs one clinic visit. •         Procedure is finished within minutes. •         Sedation can be used if you wish. •         Can be used early or later in pregnancy.	•         High success rate (95-98%). •         The pregnancy is expelled (pushed out of the body) within 24 hours of using misoprostol in 90% of women. •         It is more private, since it is done at home. •         You can choose to have someone with you for support. •         Can be used very early in pregnancy. •         Similar to a natural miscarriage or a heavy menstrual period.
Disadvantages	•         Medical instruments enter the uterus. •         May feel less private. •         You can’t have someone with you for support, as partners and loved ones are not allowed in the clinic.	•         Uterine cramping may be very painful. •         About 2-5% of women will need a uterine aspiration procedure (D&C) after medical abortion. •         Bleeding after medical abortion may last longer than after uterine aspiration. •         You may see blood clots and pregnancy tissue. •         Needs 2 clinic visits. •         You may not know if the abortion was successful until the follow-up appointment 1-2 weeks later. •         Risk of continued pregnancy is 1 in 20.

What is a surgical abortion?

A surgical abortion uses suction to remove pregnancy tissue during a very short procedure, as described in the table above.

Am I eligible for a surgical abortion?

A surgical abortion may be performed if your pregnancy is up to 15 weeks and 6 days from the first day of your last menstrual period.

What happens during a surgical abortion?

If your pregnancy is between 6 to 12 weeks:

• The doctor will gently open your cervix (the opening to the uterus or womb) with dilators that gradually get bigger.
• Once the cervix is open, the doctor will insert a hollow straw-like tube (called a cannula) which is attached to an aspirator. This machine uses gentle suction (like a vacuum) to clean out the contents of the uterus, including the fetus and placenta.
• The doctor will then use a spoon-shaped instrument (called a curette) to check the walls of the uterus for any tissue that may remain. The procedure takes about 5 to 10 minutes.

If your pregnancy is between 13 weeks to 15 weeks and 6 days:

• You will be given a medication called misoprostol before the procedure. Misoprostol softens the cervix and makes dilation (opening the cervix) easier.
• Misoprostol takes 1½-2 hours to work. After this, you will have the procedure described above, which will last about 5-15 minutes.

What are the possible risks?

• Infection may occur in 0.1-2% of cases. You will be given antibiotics to help prevent this.
• There is a very low risk (less than 1 in 1000) of:
  • injury to your uterus
  • remaining tissue requiring a second aspiration
  • excessive bleeding

Looking for more health information?

Nova Scotia Women’s Choice Clinic
Tel: 1-833-352-0719
Hours: Monday to Friday: 8 a.m. to 3 p.m.
(Callers may also leave a message at any time and a nurse will return the call during these hours.)

Nova Scotia Health Authority, Library Services
http://library.nshealth.ca/PatientGuides