For both procedures, you get an anaesthetic. This could be a general anaesthetic, so you’re asleep during the operation. You can also just have a local anaesthetic: an injection makes your cervix numb so you don’t feel anything, but you stay awake during the operation.
After a surgical abortion, you can feel sick and faint and have painful stomach cramps.
- Vacuum Aspiration (up to 15 weeks of pregnancy):
With this method, the fetal tissue is sucked out of the uterus through a tube. The procedure takes 3 to 10 minutes and you may have either analgesics (pain killers) or a local anaesthetic. The cervix may be opened or softened using another medicine a few hours before the abortion. You will be able to go home the same day. Bleeding usually last about 2 weeks, with a quite heavy bleeding for the first 2 to 3 days. This method is considered to be very safe.
- Surgical Dilatation and Evacuation (from 12-14 weeks of pregnancy):
Similar to vacuum aspiration, for surgical dilatation and evacuation (D&E), the cervix is usually softened to open it prior to the procedure. Depending on the stage of pregnancy, this might take anything from 2 hours to 2 days. Forceps and a suction tube are then used to remove the fetal tissue from the uterus. The procedure takes no more than 30 minutes, and you may be able to go home the same day. You may bleed lightly for up to three weeks afterward.
- Dilatation and Curettage (D&C):
With this method, the cervix is dilated and then the fetal tissues are scraped out of the uterus. Pain is expected and should be managed with analgesics (pain killers). This method of surgical procedures (D&C) should only be performed by a skilled doctor with appropriate supervision. The World Health Organisation recommends the vacuum aspiration method (described above), which is much safer.
In many places, you can have an abortion until you’re 24 weeks pregnant. After 20 weeks, you’ll have to go to the hospital and stay overnight, whether you have a medical or surgical abortion.
- Late Medically-Induced Abortion (20-24 weeks):
Typically, a prostaglandin is injected into the uterus, creating contractions similar to labour lasting 6 to 12 hours. This happens while you’re awake, but health care providers can give you analgesics (pain killers) for pain relief. Some providers do a dilatation and Evacuation (explained above) afterwards to ensure the uterus is empty.
- Late Surgical Abortion (20-24 weeks):
As described above, for surgical dilatation and evacuation (D&E), the cervix is usually softened to open it prior to the procedure. This might take anything from 2 hours to 2 days. Forceps and a suction tube are then used to remove the fetal tissue from the uterus. The procedure takes no more than 30 minutes, and you may be able to go home the same day. You will bleed more heavily for later abortions as to those done in the first trimester.