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Medical Or Surgical Abortion: Which One Should I Have?

Medical Or Surgical Abortion: Which One Should I Have?

Considering abortion options is not something most women ever wish to undertake. However, around 185,000 women, aged between 15-44, have an abortion in the UK each year. For many it’s a difficult and emotionally fraught decision. Therefore, it’s important that once the decision to have an abortion has been made you have the right information and access to the best care possible. Knowing what termination options are best for you will ensure that you make the right choices during a difficult time.

There are two types of abortion; medical abortion with pill and surgical abortion. At the Gynae Centre we can administer both procedures. Ultimately it depends on which is best for you.

The main differences are the time at which each procedure can be administered in relation to the length of pregnancy, the method of treatment and the invasiveness of each treatment option. In order to help you consider your options, we have put together the main facts you need to know about each procedure.

Surgical Abortion

Surgical abortion is a very simple and safe operation which can be administered up to 24 weeks gestation (as per UK law). Depending on the length of your pregnancy, and according to your preference, you will be offered either local anaesthesia, sedation or general anaesthesia. The most common request is for the procedure to be carried out under local anaesthesia and this is most advisable before 10 weeks’ gestation and under sedation after.

“Although this termination is ‘surgical’, there are no cuts involved,” explains Dr Eskander. “The process, called MVA (manual vacuum aspiration) involves gaining entrance to the uterus through the cervix. MVA is a much gentler and less risky procedure than machine aspiration. For machine aspiration you would need a general anaesthetic as the force of the suction creates a significant amount of pain as well as carrying the risk of damage to the womb or to the bowel.”

MVA, instead, creates a gentle pressure with period or labour like pains which last around 15 seconds, 3-4 times during the procedure. As mentioned above, MVA, if performed early enough in the pregnancy, requires only local anaesthesia which minimises downtime and pain. Immediately after the procedure and a short observation period you can resume normal activities or return to work, as long as you are feeling fit and well.

What Does The MVA Surgical Abortion Procedure Involve?

  • Undressing from the waist down only – as per a smear/PAP test.
  • There is no need for fasting.
  • You will lie down on the bed with feet raised.
  • Your lower body will be covered with surgical drapes.
  • A speculum is inserted into the vagina.
  • A local anaesthetic is injected into the cervix with a very fine needle.
  • A small cannula is introduced to the uterus – you may feel a small cramp.
  • MVA suction is activated for up to 15 seconds and gentle curettage is carried out. During this step, bad period/labour pain is felt. Rest for 1-2 minutes, then procedure is repeated up to 3-4 times.
  • An ultrasound will be carried out to ensure that there is no remaining tissue.
  • Re-dress, followed by observation for 30-60 minutes.

What Are The Pros Of Surgical Abortion?

  • Only one visit to the clinic required.
  • The procedure takes a matter of minutes.
  • Downtime is limited, especially if performed under local anaesthesia.
  • Your medical staff are present throughout the whole procedure.
  • Less bleeding than with medical abortion.
  • Low risk and high success rates.

Are There Any Side Effects?

Surgical abortion is a very safe procedure with few side effects. Complications are very rare, less than 0.2%. and most women experience only moderate bleeding up to seven days after the termination. During this time, you should avoid using tampons or having sex to minimise your risk of infection.

Medical Abortion

Medical abortion is a non-invasive procedure which should be undertaken up to 10 weeks’ gestation. It involves oral consumption of one pill (Mifepristone), a second tablet administered vaginally (Misoprostol), at the same time or 24 hours apart.

Mifepristone blocks progesterone production which is necessary for a viable pregnancy, and Misoprostol encourages contractions. This is given vaginally to reduce risk of vomiting at the same time since most recent studies showed it does not affect the rate of successful miscarriage. The miscarriage will last around three to eight hours, starting around half an hour to two hours after the (Misoprostol) has been administered.

The intensity of the pain will be somewhere between period and labour pains but can be managed with strong pain killers and a hot water bottle. Bleeding is likely to continue for up to two to three weeks after the procedure.
Many women like that this method is non-invasive and that they can retreat to the comfort and privacy of their home surroundings. For some it’s a more natural procedure than the surgical termination.

For a lot more information about the medical abortion process, side effects and after care, please read our detailed blog, What To Expect If You Have A Medical Abortion (With Pill).

If you are considering terminating your pregnancy, it is of paramount importance that you receive the safest care possible from experienced and compassionate experts. The right to choose is yours, and here at The Gynae Centre we aim to provide you with the best available options when it comes to pregnancy termination. For further information or to book a consultation call 020 7580 8090