Medical Abortion Vs Surgical Abortion


The experience of an
unwanted pregnancy and taking a decision to have an abortion can be taxing to
the female who undergoes this situation and above all choosing which type of
abortion procedure should one undergo can add to the confusion. We are here to discuss
the differences between surgical abortion and medical abortion, in order to help you
better decide and understand the choices available to you.

Surgical abortion
Surgical abortion is one
of the most
openly and commonly performed and safest surgical procedures across
the world as it is done under the supervision of doctors and medical
with up to
100,000+ women undergoing the procedure annuallyThis
procedure is
performed in the first trimester, up to 14 weeks’ gestation, surgical abortion
has a
very low
complication rate when
it is carried out during the first trimester. While surgical abortion can be performed in the second trimester (which
up to 20 weeks in most
and others depending on the state law); this does involve a more complex surgical procedure but
is a bit risky
A surgical abortion in
the first trimester is most often carried out under ‘twilight sedation’,
an option of a local
anaesthetic is
always available if one opts for it. Once the anaesthesia has taken effect, the doctor inserts a small tube into the uterus and applies gentle suction, doing
the contents and lining of the uterus. This is why a surgical abortion is
also called a ‘suction
The procedure takes
around 10
to 15 minutes; however, from the point of admission at the clinic, to OT preparation for the
surgery a
nd recovery from the anaesthesia, going
surgical abortion can take
upto 4 – 5 hours. You will need to be driven home once the effect of anesthesia wears
off and post operative care is done
The risks of
surgical abortion
Surgical abortion is considered
one of the safest
operations carried out
in USA and other parts of the world; however, any surgery does
along with the procedure. Some complications can occur in an estimated approx 2% to 3% of cases, major
complications are
a bit rare. Below is a comprehensive list of the risks associated with surgical abortion:
Incomplete or partial abortion is the most common complication (up to 2%)2, and occurs when a small piece of the fetus or uterine
lining remains in the
uterus. This may result in
heavy and problematic bleeding or cramping and procedure may be required to
be repeated which is a bit hassle
Ongoing pregnancy is uncommon (1 in 500) but is more likely in
procedures performed under 6 weeks.
Infection due to the procedure is uncommon (less than 1%). Appropriate Antibiotics will
be prescribed
your procedure to reduce the risk.
Damage to the cervix is very uncommon and rarely has any longstanding effects.
Perforation of the uterus or a hole in the wall due to a surgical device is potentially the most
serious complication
one can experience however, it is rare with an
experienced surgeon.
Haemorrhage following a surgical abortion in the first trimester is rare but
cannot be ruled out
Women who experience
heavy bleeding, fever or severe pain or discomfort following a surgical
abortion must
consult a doctor immediately.
Issues with
surgical abortion!
abortion is
considered a very safe and highly successful option for termination of pregnancy in
the first trimester
however it is very inconvenient and cannot be a
discreet option
. But,
some of t
advantages of choosing a surgical abortion are:
It can be performed later in the pregnancy than a medical
(later than 12 weeks as compared to medical
abortion which can be done max till 12th week of pregnancy)
The procedure takes 4 to 5 hours from admission till the complete
procedure is over;
It usually involves visits to the clinic;
There’s usually less bleeding and cramping than with a medical abortion
but its more painful as compared to medical abortion;
Medical staff are present to help throughout the procedure;
It can be performed under twilight sedation, which reduces awareness and
pain but pain returns post procedure;
It has a very low complication rate and a high success rate; which is also
the same with Medical Abortion
Its an expensive procedure
Medical abortion –
A Boon for Women Across the World
Medical abortion has been
more widely available worldwide now, and is a non-surgical abortion option
which is widely accepted by women all over, available to most women up to 84 days
. Choosing between a medical or surgical abortion is very much
dependent on your circumstances and personal preference. However, Medical
Abortion is preferred over Surgical procedure hands down.
For many women, the
availability of medical abortion means greater privacy and is a non invasive
process in accessing a termination. The more recent introduction of 
abortion via teleconsultation
has also made early termination more readily available to women living
in rural and regional areas or without access to an abortion clinic.
Medical abortion is
available up to 12 weeks (84 days) gestation. The abortion procedure is
completed  using a combination of two
medications Misoprostol
and Mifepristone
which work in tandem to terminate a pregnancy.
This procedure can be completed and you could take the medicine yourself
at the convenience of your home with privacy. This medication is an
anti-hormone, which acts by blocking the effects of necessary hormone
progesterone – this hormone is needed for a pregnancy to maintain and continue.
24 to 48 hours after taking the first medication, you take the second
medication buccally (which means you place the tablets between the cheek and
gum for 30 minutes before swallowing any remaining fragments with water) or
insert it in the vagina.
The second medication opens
the cervix and assists the uterus to expel the fetus. This should occur between
30 minutes to 24 hours after taking the second medication depending on individual
to individual, but most women can expect to experience some vaginal bleeding,
cramping and to pass some pregnancy tissue within 4 hours of taking the
Before being prescribed
the medication for medical abortion you must have an ultrasound to determine
that you are no more than 12 weeks (84 days) pregnant and to ensure the
pregnancy is not  ectopic (a pregnancy in
the tubes).
Almost all women are
suitable for a medical abortion, however, there are a few medical conditions
that may mean you are not suitable which is approx 2%. These medical conditions
are as follows: If you have a bleeding disorder or are on blood thinning
medications, if you have adrenal gland problems or are taking corticosteroid
medications, severe asthma, a medical abortion is unsuitable for you. You need
to consult your doctor in such cases where your doctor will take a medical
history  in consideration to make sure
that you are eligible for a medical abortion. You will also need to have access
emergency medical care during the time you are having the medical abortion just
in case you need it.
What are the risks
of medical
Medical abortion is the
most safe and effective method of terminating a pregnancy up to 12 weeks’
gestation; however, like surgical abortion, medical abortion carries some
Incomplete abortion is the most common complication (1-4%) and
occurs when the pregnancy is not completely expelled from the uterus, causing
cramping or heavy bleeding to continue even after the procedure is completed. A
surgical procedure may be required if the bleeding or cramping do not settle
but this is in 1% of the cases and is very rare.
Ongoing pregnancy occurs in less than 1% of cases. A surgical abortion is
recommended to compete the procedure and should be done to ensure there are not
complications later or new born could have some deformity.
Infection is uncommon (less than 1%).
Excessive bleeding severe enough to require a blood transfusion occurs
in around 1 in 1,000 cases.
What happens after
taking the second medication
Vaginal bleeding and
cramping is normal and usually starts within a few hours of taking the second
medication (misoprostol). The amount of bleeding and cramping varies from
patient to patient.
Bleeding lasts on average 10 to 16 days3 and it is usual for bleeding to
be heavier than a normal period for 2 to 3 days.
Side effects of the medication can also include nausea, vomiting,
diarrhoea and chills or fever but these are usually mild and short lived.
Contact the doctor
immediately if:
You are soaking more than 2 maxi pads per hour for more than 2 hours;
You have severe cramps or pain uncontrolled by pain medication;
You have fever, chills, severe pain or other side effects which continue
more than 24 hours after taking misoprostol;
You have any concerns after taking the medication.
If bleeding does not
occur, some patients may require a repeat dose of misoprostol, or another
method of termination may be suggested. You should contact your doctor as soon
as possible if this occurs.
Why to choose medical
If your pregnancy is
under 12 weeks’ gestation and you prefer to keep it discreet, not to undergo
surgery, do not have enough money for surgical procedure, want to do it at the
ease of your home, then a medical
abortion is the best option
. Other reasons women choose medical abortion
over surgical abortion include:
It does not requires anaesthesia;
The procedure is absolutely non-invasive;
There is absolute privacy than with a surgical abortion;
As a non-surgical procedure, there are no surgical risks associated with
medical abortion;
You are at the comfort of your home and can have the support of friends
and/or family if needed;
It feels ‘more natural’, as it has similar experience of having a heavy
period or miscarriage.
You know what’s
best for you?
Above all, the decision
to have a surgical or medical abortion is up to you and has to take into
account your particular circumstances, medical history and personal preference.
But looking at all the plus points the best option is MEDICAL ABORTION which
starts at meagre $170 where as you are sure to spend hundreds to thousands of
dollars in case of surgical abortion.
If you’d like to talk to
an experienced and supportive professional about your decision to have an
abortion, we provide free email 
decision-based counselling.
make an appointment or to discuss your options, 
Mike Ross from States Pharmacy

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