Surgical & medical abortion

If you are thinking of having an abortion you will want to consider whether surgical or medical abortion is best for you.  They differ in the following ways:

Gestation age

Medical abortion works best in early pregnancy, up to 9 weeks, and can be done as soon as you miss your period .  Surgical abortion may sometimes fail in very early pregnancy, before 6 weeks, when the pregnancy is still deeply embedded within the womb wall. (www.fwhc.org). Both medical and surgical abortion can be done according to the laws in your country.



Location

A medical abortion can be done at home in private, at a time convenient to you, you can have your friends and family with you for support, whereas surgical abortion needs to occur in a health facility. 



Effectiveness

 Both methods are almost equally effective in early pregnancy.  98 out of 100 women will have a complete abortion if they take the tablets according to the instructions, whereas 99 out of 100 women will have a complete surgical abortion . If either of them fail, the abortion usually needs to be completed by a surgical evacuation.



Length of time

A medical abortion can take several hours to complete, with on-going spotting or bleeding for upto 45 days, whereas a surgical abortion is completed within a few  minutes.



Process

A medical abortion resembles a natural miscarriage.  Cramps can be severe and last longer than with a surgical abortion.  It does not require a health professional to administer it or anaesthesia or instrumentation.   Women may experience side effects from the medication used.


The service provider inserts instruments inside the uterus for a surgical abortion, which may cause trauma to the uterus or cervix.   Although women will not experience side effects from a surgical abortion,  they may experience side effects from the anaesthetics and pain medicines required.



Bleeding

Bleeding with medical abortion can be heavy and unpredictable and may last longer than with a surgical abortion. Heavy bleeding with passage of clots is common when the abortion is taking place.



Pain

In medical abortion, mild to very strong cramping off and on is common throughout the abortion process. Pain pills will need to be taken, as required.


In surgical abortion, mild to very strong cramping is common while the abortion is being done. Pain medication can be used during and after the procedure.


Follow up

Follow up is only required if the medical or surgical abortion was unsuccessful.  Surgical evacuation of the uterus may be required, in this instance.   



Post abortion contraception

Most hormonal methods of contraceptives can be started with the first dose of medical abortion.  Insertion of IUD and female sterilisation can occur once the abortion is confirmed as complete.


Almost all contraceptives can be started immediately after surgical abortion depending on which method is most appropriate for the client.