Medical vs. Surgical Abortion

Figuring out which abortion method is right for you.

We believe that compassionate, personal, safe abortion care is a vital part of healthcare for women. We specialize in this unique area of medicine and possess a remarkable level of expertise. Our Whole Woman’s Health clinics lead the nation in abortion care for your body, your mind, and your heart.

While you may have heard of medical abortions and/or surgical abortions, knowing which one is right for you can be a difficult decision. Let’s take a look at these two, very common abortion methods.

Both medical (the “abortion pill”) and surgical procedures are excellent, safe methods. Some patients prefer the convenience of the surgical procedure because in 1-day they know their abortion is complete and can return to regular activities. Some women prefer completing the abortion in the comfort of their own home and setting the timing of their abortion around their work, childcare or life-demands schedule. The fees for both are comparable and insurance and funding sources can help cover either choice.

Some women prefer completing the medical abortion in the comfort of their own home and setting the timing of their abortion around their work, childcare or life-demands schedule. The fees for both are comparable and insurance and funding sources can help cover either choice.

Medical Abortion

Medical abortion (sometimes called the abortion pill) is available to women up to 10 weeks of pregnancy (this varies from clinic to clinic, so please call our Empower Line at 877-835-1090 for specific information).

A medical abortion consists of taking two different medications to end a pregnancy. The first pill, mifepristone, will be given to you at a clinic by a doctor. This pill will block a necessary hormone needed for pregnancy and detaches the pregnancy from the uterine wall.

The second medication, misoprostol, will be taken at home, 24-48 hours after you’ve taken the first medication. You will put the tablets into your mouth between your cheek and gums and let them dissolve; if they have not dissolved after 30 minutes you may swallow what remains of the pills with water.

Misoprostol will cause your uterus to contract and your cervix to open slightly, allowing your body to expel the pregnancy, and can be accompanied by mild to intense cramping and heavy bleeding. This pill it what empties the uterus, and the process is often described as a heavy period with cramps.

When completing a medication abortion, you will be required to:

  • Be at home or in the home of someone who knows what is happening
  • Have a phone
  • Be within one hour of an emergency room
  • Have no other obligations including small children to care for
  • Have with you, or “on call,” a support person who knows what is happening and who has a car.

Surgical Abortion

While every surgical procedure involves some risk, the truth is that abortion is one of the safest and most common out-patient surgeries in the U.S. – 10 times safer than carrying a pregnancy to term and delivering vaginally.

  • Early Surgical Abortion: Specialized surgical abortion care for 3 – 5 weeks of pregnancy.
  • First Trimester Abortion Care: 1-2 Day abortion procedures with optional IV Sedation (same day surgical consult in our Twin Cities location).

After the anesthesia of your choice is administered, the physician will perform a pelvic exam to determine the exact position of your uterus. This is done by inserting two fingers in the vagina and putting one hand on the lower abdomen and gently pressing on the abdomen so the size and position of the uterus can be determined.

Then the physician places a speculum inside the vagina to keep the vaginal walls apart. S/he will hold the cervix, the opening to the uterus, with an instrument called a tenaculum. The physician will then insert several narrow rods, called dilators, into the cervix to further open it. The physician uses suction canula and other specialized instruments to remove the pregnancy from the uterus.

The entire process can take 5 minutes. A staff person will be in the room along with you and the doctor to help you through the procedure. Please ask about including your support person in the process as well.

  • Second Trimester Abortion Care: 1-2 Day surgical abortion procedures (appointment time and accepted length of pregnancy vary from clinic to clinic due to state laws. Please contact our Empower Line at 877- 835-1090 for specific information).

To perform an abortion in the second trimester, the cervix must be dilated more than in the first trimester. This process takes time and is safest for you when done slowly. There are two ways to achieve cervical dilation: dilating your cervix overnight with laminaria or using a medication called misoprostol (Cytotec) to soften and dilate your cervix. Our physician will review your ultrasound and medical history and will recommend the method that s/he believes will be safest and most comfortable for you. Many times the physician will recommend both methods of dilation. Our primary concern is your safety and comfort.

Laminaria are made from sterile natural materials that absorb moisture from your body and slowly expand over several hours. The physician will use a speculum (a clean metal instrument used to open the vagina) to help see inside your vagina. When the speculum is inserted and opened, you will likely feel a lot of pressure in your pelvis which may feel uncomfortable but should not hurt.

The doctor will look for your cervix, which is the end of your uterus, much like during a pap smear. S/he will then insert the laminaria into your cervix and allow it to expand overnight so the abortion can be done safely the next day. The number of laminaria depends on the length of pregnancy and the discretion of the physician performing the abortion, usually only 2 or 3 are necessary. After the laminaria insertion you may go home and relax for the evening.

Although it is not our intention that you pass the pregnancy as a result of dilation alone, there is a small chance this may happen, in which case you should call the nurse. This method requires two visits on two consecutive days; you can expect to be here about 3-4 hours on the first day and 1-2 hours on the second day. The physician will do a pelvic exam to ensure that your cervix is sufficiently dilated and then will complete the abortion procedure.

While both methods – medical abortion and surgical abortion – are safe and trusted, it’s important you choose the procedure that’s right for you. Please call our Empower Line at 877-835-1090 for specific questions, additional information, and to make an appointment at any of our clinic locations.