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.
Medical Abortion Vs Surgical Abortion

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 practitioners, with up to 100,000+ women undergoing the procedure annuallyThis procedure is commonly 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 is 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 this removes 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 and recovery from the anaesthesia, going through a 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 as one of the safest operations carried out in USA and other parts of the world; however, any surgery does carry some risks 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:
1. 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
2. Ongoing pregnancy is uncommon (1 in 500) but is more likely in
procedures performed under 6 weeks.
3. Infection due to the procedure is uncommon (less than 1%). Appropriate Antibiotics will be prescribed with your procedure to reduce the risk.
4. Damage to the cervix is very uncommon and rarely has any longstanding effects.
5. 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.
6. 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!

Surgical 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 the 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 gestation. 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 medical 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.
1. 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.
2. 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 medicine. 
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 abortion?

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 risks:
1. 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.
2. 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.
3. Infection is uncommon (less than 1%).
4. 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 abortion?

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 $175 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.
To make an appointment or to discuss your options, contact
Mike Ross from States Pharmacy