Surgical Abortion: Procedure, Recovery, What To Expect - Healthline

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HealthlineSubscribeAbortion CareEverything You Need to Know About Surgical Abortion

Medically reviewed by Carolyn Kay, M.D. — Written by Ana Gotter — Updated on June 30, 2022

Medical vs. surgical abortion
How it works
Cost
How to prepare
After your procedure
Potential risks
Takeaway

A surgical abortion is a medical procedure that ends a pregnancy. While the term “surgery” is often used, most abortions are minimally invasive and don’t require general anesthesia. Surgical abortions are a good option for people who want their abortion completed in a clinic or hospital setting.

Medical abortions, which are also an option for most people, take place primarily at home.

Most surgical abortions are completed with a gentle suctioning technique known as vacuum aspiration. While you may be at the clinic for a few hours, the procedure itself typically takes only 5 to 10 minutes to complete.

Surgical abortion is often an option longer into a pregnancy than medical abortion, or “the abortion pill.” But how late into pregnancy you can get an abortion depends on the laws in your state, and the policies of the clinic or hospital you go to.

Due to recent changes in abortion laws in the United States, it’s no longer possible to get a surgical abortion in some states. But you still have options: You can get abortion pills mailed to you. Keep reading to learn more about your options.

Stay informed

On June 24, 2022, the Supreme Court of the United States overturned Roe v. Wade, the landmark 1973 ruling that secured a person’s constitutional right to an abortion.

This means that individual states are now able to decide their own abortion laws. Many states will ban or severely restrict abortion access, and more states may follow suit.

The information in this article was accurate and up to date at the time of publication, but it’s possible the information has changed since. To learn more about your legal rights, you can message the Repro Legal Helpline via a secure online form or call 844-868-2812.

Medical vs. surgical abortion

It used to be that when you needed to end a pregnancy in the United States, you had a few options. Since Roe v. Wade was overturned in June 2022, pregnant people in many states have seen these options disappear. Surgical abortions are no longer available in some states, which means you may need to travel to get one.

Both medical and surgical abortions are safe and effective healthcare procedures. And medical abortion is now a more accessible option for a lot of people.

But there are several reasons people may choose surgical abortion over medical abortion. These include:

Gestational age: If it’s been more than 11 weeks since the first day of your last period, medical abortion won’t be as effective.
Procedure time: Surgical abortions are finished after a few hours at the clinic, while medical abortions can take up to 24 hours.
Medical staff: Some people prefer to have their abortion under the supervision of doctors and nurses, rather than at home.
Confirmation: After a surgical abortion, your doctor examines your uterus to make sure the procedure is complete.
Medical history: People with certain health conditions, like bleeding disorders, may feel safer in a hospital.

How they’re different

During a surgical abortion, doctors use gentle suction to remove the contents of the uterus. These procedures are very safe and are effective more than 99 percent of the time. In the rare event the procedure is unsuccessful, it can be repeated.

A medical abortion involves taking a combination of medications (mifepristone and misoprostol) that help end the pregnancy and push out the contents of your uterus.

The abortion pill is effective 94 to 96 percent of the time in people who have been pregnant for 9 weeks or less. It becomes slightly less effective in the following weeks. However, the dose can be adjusted if needed.

In the event a medical abortion is unsuccessful, it can be completed surgically.

Where to get abortion pills online

You can get abortion pills online, no matter where you live. But it’s important that you get them from a safe, reputable place. Here are a few options:

AidAccess (everywhere)
Plan C (options for all U.S. states)
Planned Parenthood: Telehealth (many U.S. states)
Abortion On Demand (20+ U.S. states)
Hey Jane (CA, CO, IL, NM, NY, and WA)
Just The Pill (WY, MN, MT)

What happens during a surgical abortion?

On the day of your procedure, you can expect to be at the hospital or clinic for 3 to 4 hours. While the procedure itself is quick, you’ll need to read and sign some paperwork, prepare for the procedure, and spend some time in the recovery room.

The preparation

Before your procedure begins, a doctor or nurse may give you some medication to help with cramping. They may also give you medication to help open your cervix, the passageway between your vagina and your uterus.

Sometimes, doctors insert small dilators into the cervix a few hours before your procedure, or even the day before. These dilators absorb fluid from your body. As they slowly grow bigger, they stretch open your cervix.

Before your procedure begins, you will typically be offered light sedation. Depending on the type of sedation the doctor uses, you might feel sleepy and calm but remain awake, or you might fall completely asleep.

The procedure

A vacuum aspiration, which is the most common type of abortion, takes about 5 to 10 minutes to complete.

During your procedure, the doctor and nurses will:

examine your uterus
insert a speculum into your vagina
stabilize and inject a numbing medication into your cervix
insert dilators to open your cervix
insert a tube through the cervix, into the uterus
use gentle suction to pull pregnancy tissue out of the uterus

Many people will feel cramping during the procedure, but the cramping typically decreases after the tube is removed from the uterus.

Immediately after your procedure, your doctor may check your uterus to ensure it’s completely empty. You’ll then be moved to a recovery area to rest.

If it’s been longer than 16 weeks or so since your last period, your doctor may perform a modified procedure known as a dilation and evacuation (D&E). These procedures typically involve stronger suction and additional surgical tools that help your doctor remove the pregnancy tissue from your uterus.

How much does a surgical abortion cost?

The cost of surgical abortions varies depending on several factors. According to Planned Parenthood, a surgical abortion can cost up to $750, but it often costs less. Factors that may affect cost include:

the state you live in
the facility where you get care
whether you can use health insurance
whether your insurance plan covers abortion
the type of abortion you get and week of pregnancy

Other things to think about include the cost of logistics like travel, child care, and time off work.

Cost should not stand in the way of your choice to end a pregnancy. If you’re worried about costs, you can contact the Planned Parenthood nearest you for information on financial assistance.

Need help with abortion costs?

You can also turn to the National Network of Abortion Funds for assistance. They can connect you with organizations that help cover the cost of abortions, as well as associated costs like lodging and child care.

Preparing for an in-clinic surgical abortion

Before your abortion, you’ll meet with a healthcare professional who will explain the procedure and let you know what to expect on the day of your appointment. They may give you some instructions on how to prepare for your procedure. It’s important that you follow these instructions carefully.

Some things you can do to prepare for your surgical abortion include:

arranging for someone to drive you home after the procedure
taking your pain or dilation medications as instructed
avoiding eating or drinking on the morning of the procedure, if directed to do so
following your doctor’s instructions about when to take (or stop taking) your regular medications, including over-the-counter (OTC) pain relievers like acetaminophen (Tylenol) and ibuprofen (Advil, Motrin)
avoiding alcohol the day before your procedure
buying some menstrual pads for post-procedure bleeding (doctors often recommend pads, but you can use whatever is most comfortable for you)
stocking up on OTC pain relievers to help treat cramping
getting a heating pad or hot water bottle to help ease cramping

Pain management

Avoid taking the OTC pain reliever aspirin, or medications that contain aspirin, because it can increase bleeding.

What to expect after a surgical abortion

It’s important to take it easy on the day of your abortion. Some people are able to return to their usual activities (except for heavy lifting) the next day, but others may need more time. It may feel like you have bad period cramps for a few days.

Many people experience bleeding and cramping after an abortion, but some don’t. You may experience heavier bleeding (like a period), including blood clots, or just spotting. Some people continue to have spotting for several weeks.

However, if you experience really heavy bleeding — bleeding that soaks through two pads an hour, for at least 2 hours in a row — call your doctor or the clinic where you got your abortion.

Your doctor will give you information about what to expect in the days following your procedure. This will include information on any medications you may need to take.

Your doctor may recommend an OTC pain reliever to help with cramping. They may also prescribe antibiotics to help prevent infection.

Continue to take your antibiotics until the bottle runs out. This is important, even if you feel fine.

Depending on your situation, some doctors will advise a follow-up appointment a few weeks after your procedure.

Sex and your period

Your period should return about 4 to 8 weeks after your abortion.

Because there is a small risk of infection after surgical abortion, doctors have different philosophies on when it is OK to resume sexual activity.

Some doctors and clinics advise waiting 2 weeks before inserting anything in your vagina, including tampons. Other doctors say you can have sex as soon as you feel ready and use tampons to control post-abortion bleeding if that is your preference. Be sure to discuss these particulars with your doctor.

You can get pregnant right after your abortion, so start using some form of birth control right away. Many doctors are willing to place an IUD in your uterus during your procedure, so you may want to take advantage of the opportunity.

Potential risks and complications

Surgical abortions are very safe procedures. Complications are rare. However, all surgeries involve some level of risk.

Possible complications from surgical abortions include:

infection
cervical tears or lacerations
uterine perforation
bleeding
retained pregnancy tissue
allergic or adverse reactions to medications

When to call your doctor

Complications from abortion are rare, but call your doctor or seek immediate medical attention if you experience any of the following symptoms:

passing blood clots that are larger than a lemon for more than 2 hours
bleeding that is heavy enough that you have to change your pad once an hour for 2 or more hours straight
foul-smelling vaginal discharge
fever
pain or cramping that gets worse instead of better, especially after 48 hours
pregnancy symptoms that persist after 1 week

Takeaway

Surgical abortion is a safe and effective way to end a pregnancy. People choose surgical abortion for a number of reasons, including their preferences and the length of time it’s been since their last period.

Surgical abortions typically involve a suction technique that removes pregnancy tissue from the uterus.

You will be given a sedative before your procedure to reduce any pain, but you may experience cramping during the procedure. Cramping can last a few days, but most people are able to resume their usual activities within a day or two.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Ajmal M, et al. (2021). Abortion.https://www.ncbi.nlm.nih.gov/books/NBK518961/
Aspiration versus medication abortion. (n.d.).https://www.ucsfhealth.org/education/medical_versus_surgical_abortion/
In-clinic abortion. (n.d.).https://www.plannedparenthood.org/learn/abortion/in-clinic-abortion-procedures
Surgical abortion (first trimester). (n.d.).https://www.ucsfhealth.org/treatments/surgical_abortion_first_trimester/index.html

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Medically reviewed by Carolyn Kay, M.D. — Written by Ana Gotter — Updated on June 30, 2022

Surgical Abortion: Procedure, Recovery, What To Expect - Healthline

Stay informed

Medical vs. surgical abortion

How they’re different

Where to get abortion pills online

What happens during a surgical abortion?

The preparation

The procedure

How much does a surgical abortion cost?

Need help with abortion costs?

Preparing for an in-clinic surgical abortion

Pain management

What to expect after a surgical abortion

Sex and your period

Potential risks and complications

When to call your doctor

Takeaway

How we reviewed this article:

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