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Early Surgical Abortions

Advanced technology along with increased experience, have made it possible to perform early surgical abortions as early as 2 days past a woman's missed period.

Early first trimester abortions are performed from 4 to 6 weeks from the last normal period.

The procedure begins with the gentle opening of the cervix using a series of narrow rods, or dilators; once the cervical opening is wide enough, a thin, flexible tube is inserted into the uterus. This tube, or cannula, is attached to an aspiration device that empties the uterus through gentle suction. After the uterus has been aspirated, a small spoon-shaped instrument called a curette is used to determine whether or not the uterus has been completely emptied.

Once the procedure is complete, you will be monitored in the recovery room. Most women who receive local anesthesia stay in the recovery room approximately 20 minutes; patients who opt for conscious sedation or general anesthesia stay in the recovery room approximately 25 to 35 minutes.

An early pregnancy must be documented by high quality vaginal ultrasound and a high sensitivity early pregnancy test.

Though infrequent, some patients who undergo an early pregnancy termination may require mandatory follow up appointments to ensure that the procedure is complete. You will be advised prior to leaving our facility whether follow up is required or not. Completion of an early pregnancy termination must be documented by ultrasound, visualization of pathology by an experienced examiner, and by surgical technique.

If an intrauterine pregnancy cannot be clearly identified through ultrasound examination, the possibility of an ectopic pregnancy must be recognized.

Patients who are at risk must be followed closely with a number of serial blood tests and ultrasound exams as ectopic pregnancies can be potentially life threatening. If detected early enough, some ectopic pregnancies can be treated with medication and will not require surgery.

Should an emergent procedure be required, our office will help coordinate an appointment with a nearby hospital.

First Trimester Pregnancy Termination (D&C)

First trimester abortions are performed from 7-12 weeks from the last normal period.

The procedure begins with the gentle opening of the cervix using a series of narrow rods, or dilators, each a little wider than the one before; the largest dilator is about as thick as a fountain pen. When the cervical opening is wide enough, a blunt tipped tube is inserted into the uterus. This tube, or cannula, is attached to an aspiration machine that empties the uterus through gentle suction. After the uterus has been aspirated, a small spoon-shaped instrument called a curette is used to determine whether or not the uterus has been completely emptied.

Once the procedure is complete, you will be monitored in the recovery room. Recovery times vary depending on many factors including type of anesthesia, complications and side effects from the procedure, as well as your own readiness to leave.

Most women who receive local anesthesia stay in the recovery room approximately 20 minutes; patients who opt for conscious sedation or general anesthesia stay in the recovery room approximately 25 to 35 minutes.

Early Abortion Comparison Chart

How far along in the pregnancy can I be?

Abortion Pill
(Mifeprex / RU486)
Medical Abortion
(Methotrexate)
Surgical Abortion
(Vacuum Aspiration)
Up to 8 weeks from last menstrual period (56 days).

The success rate of Mifeprex is about 95% to 97% effective.
Up to 6 weeks from last menstrual period (42 days).

The success rate of Methotrexate is about 92% effective.
Up to 12 weeks from your last normal menstrual cycle.

Success rate of a surgical procedure is almost 100% effective.

How long does it take for the procedure to be completed?

Abortion Pill
(Mifeprex / RU486)
Medical Abortion
(Methotrexate)
Surgical Abortion
(Vacuum Aspiration)
Usually 2-3 visits to the provider

Take Mifepristone orally on day one

Insert Cytotec between the cheek and gum within 24 hours.

The abortion process is usually complete within 2-4 days of taking Mifeprex

A follow-up visit is required within 2 weeks at the provider's office to determine that the procedure is complete.
Usually 2-3 visits to the provider

A Methotrexate injection is given on day 1

Insert Cytotec vaginally on day 7

50% of women usually abort within 4 hours of Cytotec insertion.

Some women require a second dose of Cytotec before the procedure is completed.

A follow-up visit between days 9 to 14 is required.
One visit to the facility.

Your stay at the office may require 3-5 hours from start to finish.

The procedure iteslf only takes about 8-10 minutes.

Follow-up visit with the clinic or your primary care physician for 2 week
check up.

How much pain will I experience?

Abortion Pill
(Mifeprex / RU486)
Medical Abortion
(Methotrexate)
Surgical Abortion
(Vacuum Aspiration)
From mild to very strong cramping off and on until the abortion procedure is complete. Motrin or pain pills are helpful. From mild to very strong cramping off and on until abortion procedure is complete. Motrin or pain pills are helpful. From mild to very strong cramping during abortion procedure. Pain medication is available during and
afterwards.

How much will I bleed?

Abortion Pill
(Mifeprex / RU486)
Medical Abortion
(Methotrexate)
Surgical Abortion
(Vacuum Aspiration)
Heavy bleeding and passing clots is common during the abortion procedure.

After the procedure is complete it is normal
to have light bleeding and spotting for up to
14 days.
Similar to Mifeprex. Usually light bleeding from 1-7 days, but may continue off and on for up to 2 weeks.

What if the abortion method I choose fails?

Abortion Pill
(Mifeprex / RU486)
Medical Abortion
(Methotrexate)
Surgical Abortion
(Vacuum Aspiration)
Success rate varies with the length of pregnancy and the protocol used.

When it fails a surgical abortion is necessary.
Very similar to Mifeprex. Almost 100% effective.

Very rarely does the surgical abortion fail and need to be redone.

Is the method safe? Can I still have children in the future?

Abortion Pill
(Mifeprex / RU486)
Medical Abortion
(Methotrexate)
Surgical Abortion
(Vacuum Aspiration)
Both medications have been formally studied and used successfully.

Possible complications are rare.

Childbearing at a later date will not be affected.
Same as Mifeprex. Surgical abortion has been formally studied for over 25 years.

Less than 1% complication rate, and is at least 10 times safer than childbirth.

Childbearing ability is not affected, barring rare serious complications.

What are the advantages?

Abortion Pill
(Mifeprex / RU486)
Medical Abortion
(Methotrexate)
Surgical Abortion
(Vacuum Aspiration)
May seem more natural, much like a miscarriage.

No shots, anesthesia, instruments, or vacuum aspirator unless procedure fails.

Bleeding at home instead of at the clinic may seem more private and comfortable.

Any support person can be there during your process.

It is completed more quickly than the medical abortion using methotrexate.
May seem more natural, much like a miscarriage.

No shots, anesthesia, instruments, or vacuum aspirator unless procedure fails.

Bleeding at home instead of at the clinic may seem more private and comfortable.

Support person can be there during your process.

Methotrexate will usually end an ectopic pregnancy as well as a normal pregnancy.
Quick -- over in a few minutes

Highly successful

Less bleeding than with either of the other methods.

Medical staff is present.

Counselor available before, during and after the procedure for support.

It can be done farther along in the pregnancy than with either Mifeprex
or Methotrexate.

What are the disadvantages?

Abortion Pill
(Mifeprex / RU486)
Medical Abortion
(Methotrexate)
Surgical Abortion
(Vacuum Aspiration)
It takes several days.

It is not completely predictable.

Bleeding can be heavy and lasts longer than the surgical abortion.

Cramping can be severe and lasts longer than with surgical.

Requires 2 visits, possibly more, to provider.

If hemorrhage occurs, the patient must travel to the hospital or the provider's
office.

It fails more often than the surgical procedure.

It cannot prevent tubal pregnancy.
Takes days and sometimes weeks to complete.

It is not completely predictable.

Bleeding can be heavy and lasts longer than the surgical abortion.

Cramping can be severe and lasts longer than with surgical.

2 visits, possibly more to provider.

If hemorrhage occurs, patient must travel to hospital or to provider.

Two visits or more are necessary to the provider's office.

It fails more often than both the surgical and the Mifeprex.
A clinician must insert instruments into the uterus.

Anesthesia and drugs to manage pain during the procedure may cause
side effects.

There are possible complications, although in less than 1% of cases.

The woman has less control over the abortion process and who is with her.

It cannot end the tubal pregnancy.
 
 
5301 F Street, Suite 10 • Sacramento, CA 95819   Phone: (916) 446-0222 or (800) 954-2464