Comparison between medical and surgical abortion

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.