Comparison of First Trimester Abortion Options—Medical vs Surgical

If you are 9 weeks pregnant or less, there are 2 options for ending a pregnancy. This sheet compares the surgical and medical abortion options. More information is available – please ask a staff person.

Medical Abortion (“The Abortion Pill”)

(200 mg mifepristone, 800 mcg misoprostol) /

Surgical Abortion

(vacuum aspiration)

How far along in the pregnancy can I be?

Up to 9 weeks (63 days) / Up to 12 weeks
How long does the process take?
  • 2 or more visits to the clinic are needed.
  • Take 200mg mifepristone orally on Day 1.
  • Insert 800mcg misoprostol vaginally at home,
24 – 48 hours later (Day 2 or 3).
  • It usually takes several hours for abortion to occur.
  • Follow-up visit is at the clinic through Day 14 (must be at least 24 hours after misoprostol insertion and start of bleeding).
/
  • 1 – 2 visits to the clinic are needed.
  • Procedure takes 5 to 10 minutes.
  • Follow-up visit is at the clinic in 2 to 3 weeks.

How much pain is there?

From mild to very strong cramping occurs off and on throughout the abortion. Medication helps with the cramping. / With local anesthesia, there is mild to strong cramping during the abortion. With general anesthesia or conscious sedation, you feel and remember little or nothing. There may be some cramping after the surgery.

How much will I bleed?

Heavy bleeding and passing of clots is common during the abortion. Lighter bleeding is common through Day 14, and may last longer. / Light bleeding may occur for 1 – 7 days, and may continue off and on for 2 or more weeks.
How effective is this method?
Usually about 95% successful. Success rates vary with the length of pregnancy. If it fails, surgical abortion is necessary. / Over 99% successful.

Is it safe? Does it affect fertility?

  • This method has been studied and used safely.
  • Possible complications are rare.
  • Childbearing ability is not affected, barring rare serious problems.
/
  • Surgical abortion has been formally studied and performed for more than 25 years. First trimester abortion has less than a 1% complication rate, and is 10 times safer than childbirth.
  • Childbearing ability is not affected, barring
rare serious complications.

What are the advantages?

  • It may seem more “natural,” like a miscarriage.
  • No shots, anesthesia, instruments, or vacuum aspirator machine, unless the abortion fails.
  • Avoids the need for instruments in the uterus.
  • Some women feel more in control, or more a part of the process.
  • Being at home instead of a clinic may seem more comforting and private.
  • Any support person can be with you during the process.
  • Much of the wait time that may occur in a clinic setting is avoided.
/
  • It is over in a few minutes.
  • It is highly successful.
  • There is less bleeding than with medical abortion.
  • There is less cramping time.
  • Medical staff are present during the abortion.
  • Staff is with you before, during, and after the abortion, for support.
  • Depending on choice of anesthesia, you do not feel or remember anything.
  • Surgical abortion can be performed farther into pregnancy.

What are the disadvantages?

  • The process takes several days.
  • The timing of the actual abortion is not completely predictable.
  • Medical staff are not present during abortion.
  • Bleeding can be very heavy, and usually lasts longer than with a surgical abortion.
  • If hemorrhaging occurs, you must travel to the clinic or to a hospital.
  • Cramping can be severe, and usually lasts longer than with surgical abortion.
  • Two visits to the clinic are necessary, and possibly more.
  • Medical abortions fail more often than surgical abortions.
  • Medical abortion cannot end an ectopic pregnancy.
/
  • Requires insertion of instruments into your uterus.
  • Anesthetics and other necessary medications may cause side effects.
  • There are serious risks, which increase with the level of anesthesia you choose.
  • You are less in control over the abortion process.
  • A clinic setting may not offer the level of privacy or comfort you desire.
  • There may be long periods of waiting in the clinic.
  • Only clinic staff can be with you during the abortion procedure.
  • Surgical abortion cannot end an ectopic pregnancy.

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