Comparison of Medical and Surgical Abortion

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Medical Abortion with Mifepristone or Mifeprex

Surgical Vacuum Aspiration Abortion

How far along in the pregnancy can I be?

Up to 8 weeks (49 days) for best success (97%).  Success rates decrease as the pregnancy advances.

First trimester is through 12 weeks.  A pregnancy less than 6 weeks may increase the chance of failed abortion.

How long does it take?

-Usually 2 visits to the provider.

-Take mifepristone on day 1.

-Take misoprostol pill buccally (allowing the pill to dissolve inside the mouth between the cheek and gum, or under the tongue) on day 2, 3, or 4.

-It usually takes several hours for the abortion to occur.

-Follow-up scheduled two weeks from first appointment.

-One 3-4 hour visit to the clinic.

-The abortion procedure takes 3 to 5 minutes.

-Follow-up visit at your doctor or clinic, or the providers in 3-4 weeks.

How painful is it?

From mild to very strong cramping off and on throughout the abortion (commonly a 1 to 3 hour period).  Pain pills are provided for use as needed.

From mild to very strong cramping during the abortion (commonly a 5 to 10 minute period).  Pain medication is available during and afterwards.

How much will I bleed?

Heavy bleeding and passing clots is common during the abortion.  Afterwards, lighter bleeding is common from 9 to 14 days or longer.

Usually light to moderate bleeding and may continue for up to 6-8 weeks.

Can the abortion fail?

97% successful.  When it fails, a surgical abortion is necessary.

Over 99% successful. Less than 1% of the time it fails and needs to be repeated.

Is it safe, and can I still have children afterwards?

-Both medications have been formally studied and used safely.  Possible complications are rare.

-Childbearing ability is not affected, barring rare serious complications.

-Surgical abortion has been formally studied for over 25 years.  First trimester abortion has a 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?

-It may seem more natural, like a miscarriage.

-No shots, anesthesia, instruments, or vacuum aspirator machine, unless it fails.

-The pregnancy can be ended earlier than with Surgical Abortion.

-Being at home instead of a clinic may seem more comforting and private.

-Any support person can be there during the abortion process.

-It's quick, over in a few minutes.

-It's highly successful.

-There's less bleeding than with Medical Abortion.

-There's less time spent cramping than with Medical Abortion.

-Medical staff is present.

-It can be done farther along in the pregnancy than Medical Abortion.

What are the disadvantages

-It takes several days.

-It is not completely predictable.

-Bleeding can be very heavy and lasts longer than with a surgical.

-Cramping can be severe and usually lasts longer than with a surgical.

-Two visits to the provider are necessary, and possibly more.

-It fails more often than a surgical.

-A clinician must insert instruments inside the uterus.

-Anesthetics 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.

-The vacuum aspirator may seem noisy.

-It can't be done as early in the pregnancy as Medical Abortion.

www.medicationabortion.com - a multi-language website provides accurate information about medication abortion to health service providers including physicians, nurse practitioners, physician assistants, counselors, and office staff as well as educational information for women considering the option of medication abortion. In English, French, Spanish, and Arabic.

"Our health depends on our ability to share love and pleasure. As women, our bodies have the capacity to create new life. This responsibility and privilege unites us with all our surroundings in an intimate relationship with the tides and the moon, with the family and community, with society and culture, and with the spiritual. The ability to choose how many children we wish to have, and what time in our lives we wish to dedicate to their care, assures us a healthy future for all. Precisely because we value so highly the sacred seed of life, we take so seriously the conditions for life's unfolding. We want to share with all women how to care for our bodies in a way that's clear and informed, taking into account all the respect our most vital decisions merit."

- Excerpt from the book Nuestros Cuerpos, Nuestras Vidas

No Confusion: Do not confuse Medical Abortion with the "Morning After" Emergency Contraception Pills (brand name Plan B). They are completely different medications taken for different purposes.

  • Emergency Contraception Plan B contains the same hormones as in regular birth control pills; Plan B prevents pregnancy after sex when taken within days after unprotected intercourse. Emergency Contraception will not harm an existing pregnancy.
  • Medical Abortion pills cause pregnancy termination and are used after pregnancy is established.

more about medical abortion:

  • www.womenonweb.org - will mail medications to women in countries where abortion is legally restricted (run by Rebecca Gomperts of Women on Waves)
  • Gynuity - http://www.gynuity.org/pub_b.html#q5 - Instructions for Use of Misoprostol for Women's Health in Arabic, English, French, Portuguese, Russian and Spanish
  • www.medicationabortion.com - In English, French, Spanish, and Arabic - a multi-language website provides accurate information about medication abortion to health service providers including physicians, nurse practitioners, physician assistants, counselors, and office staff as well as educational information for women considering the option of medication abortion. Sponsored by Ibis.
  • www.earlyoptions.org - the new early options abortion pill, Mifeprex, was approved by the FDA in October 2000 and will be available soon throughout the USA.
  • Feminist Majority Foundation's info on RU 486.
  • New York Times Magazine article on RU-486, The Little White Bombshell by Margaret Talbot, July 11, 1999, regarding mifepristone and misoprostol.
  • UCSF - University of CA at San Francisco patient education page - medical vs surgical abortion

last update: October 5, 2010


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