Medical, as well as surgical procedures, are effective, safe methods of abortion. Medical Vs surgical abortion is a tough decision for many women. These choices being available to have a safe abortion can make the decision-making be challenging. The type of abortion procedure to be chosen as the best suitable for given circumstances can make it more confusing. The decision to have a surgical or medical abortion is up to the conceived woman and has to be based on the particular circumstances, medical history, and personal preference. It is always best to talk to the doctor at an abortion clinic and know the right option. The following illustration of the comparison between surgical abortion and medical abortion can help better understand the choices available when being unsure.
- Gestational duration for Medical Vs Surgical abortion
Medical abortion can be performed as soon as a woman knows she is pregnant. Four to nine weeks since the first day of the last menstrual period is the duration of gestation that is eligible for medical abortion. The effectiveness of the abortion is better with less bleeding at earlier gestations of five to seven weeks compared to later gestations of eight to nine weeks. Pregnancy beyond 9 weeks of gestation cannot be effectively terminated through medical abortion.
Surgical abortion is suggested between 6 to14 weeks since the first day of the last menstrual period. If the procedure is performed earlier than six weeks, the abortion may be incomplete and less effective. Women seeking surgical abortion are advised to wait until six weeks of pregnancy to decrease the possibility of leaving behind all or some part of the pregnancy in the uterus after the procedure.
- Effectiveness of Medical Vs Surgical abortion procedure
A medical abortion consists of taking two different medications to end a pregnancy. 95% to 97% of women seeking medical abortion respond successfully to abortion medications. About 3% to 5% of women have been reported to need a surgical abortion due to continued pregnancy, prolonged or excessive bleeding, or patient choice. This is more commonly seen after incomplete medical abortions in longer gestational durations.
A surgical abortion is performed with the option of a local anesthetic being available. Once the anesthetic takes effect, a small tube is inserted into the uterus and by applying gentle suction, the contents and lining of the uterus are removed. This is the reason for a surgical abortion procedure also being called suction curettage. The success rate of surgical abortions is around 98%. The remaining 2% of women will require a repeat procedure or other intervention to complete the abortion.
- Clinic visits needed for Medical Vs Surgical abortion
Medical abortion requires at least two visits to the abortion clinic. The first one is for health education, exam and medications that takes about an hour and the other visit may take around 30 minutes to confirm that the abortion was complete and successful. Women may return to the clinic if they feel that they need further follow-up care.
Surgical abortion usually requires only a single visit that covers health education, exam, and procedure. To return to the clinic for further follow-up care is left to the woman’s personal preference. For a woman who is 6 to 12 weeks pregnant, the visit duration including the procedure usually takes approximately three hours. Late abortions often require longer and multiple visits.
- Risks of Medical abortion Vs Surgical abortion
- Medical abortion is a safe and effective method of terminating a pregnancy that can be applied up to 9 weeks gestation period but incomplete abortion happens to be the most common complication where the pregnancy is not completely expelled from the uterus, causing cramping or heavy bleeding.
Surgical abortion is one of the safest operations that can effectively terminate a pregnancy till 20 weeks of gestation. However, like in all surgical procedures, complications may occur. Incomplete abortion occurs when a small piece of the pregnancy or lining is left out in the uterus, causing problematic bleeding or cramping requiring a repeat procedure.
- Ongoing pregnancy has been reported in less than 1% of cases after an attempted medical abortion.
Ongoing pregnancy is extremely rare but the chances are higher in procedures performed under 6 weeks of gestation.
- Infection is an uncommon complication of medical abortion. Generally, antibiotics are not recommended to prevent infection in medical abortion.
Antibiotics are usually given or prescribed along with the surgical procedure to reduce the risk of infection. If they are taken as directed, the chances of infection are nil. Hence, there is only a small likelihood of infection after suction curettage abortion.
- In medical abortion, women usually have heavy bleeding for several hours and bleed like a period for an average of two weeks. Excessive bleeding due to hemorrhage that becomes severe after a medical abortion may require a blood transfusion. This severity occurs only in very few cases.
Hemorrhage following a surgical abortion in the first trimester is rare. After a surgical abortion procedure, women usually have light bleeding at home that may last up to two weeks.
- Medical abortion is non-invasive. No instruments or suction are used. So, there is no exposure to the chance of cervical injury and uterine perforation.
In surgical abortion, though damage to the cervix is uncommon and rarely has longstanding effects, instruments, and suction placed into the vagina and uterus can cause a small risk of cervical injury or uterine perforation that could require further care or abdominal surgery. Perforation of the uterus could be potentially the most serious risk of surgical abortion but fortunately is rare with an experienced surgeon.
- Medical abortion requires no anesthetic. After the second medication, Strong cramps are experienced that can be overcome by prescribed pain killers. Some women experience nausea or other side effects.
A numbing medication or local anesthesia is applied to the cervix during the surgical procedure. Some cramping during or after the short procedure is common. Oral medications are prescribed to relax and to control any discomfort.
Medical abortion and surgical abortion methods are safe and trusted. It is important to choose the procedure that is right for the respective gestational age, medical conditions if any, and personal preferences.