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What is it? A manual vacuum aspiration (MVA) abortion is a surgical procedure, and may also be called a menstrual extraction.  This abortion can be done between 3 and 8 weeks from the date of the first day of your period, although some doctors use the procedure up to the 12th week.  An MVA can be done at a physician's office, an abortion clinic, or a hospital setting, since it does not require any machinery. It should be noted that this procedure is rarely used since newer technology is available.


What happens? First a pregnancy test is given, a pelvic exam is performed, and an ultrasound may be done as well.  Once the pregnancy has been confirmed, you disrobe and lie on an examining table with your feet in stirrups.  You may be given something to relax, especially if you request it, and misoprostol may be given to help the cervix dilate. The doctor will then insert a speculum into your vagina and clamp it open so that your cervix is in plain view.  Your doctor may choose to inject your cervix with a numbing agent, and then a tenaculum (which looks a little like long, skinny pliers) will be used to grasp your cervix and hold it in place.










the syringe.  The process takes approximately 10 minutes once the syringe is inserted and assembled, and you can expect cramping throughout the procedure.  The cramping will lessen once the cannula is removed.  You may also feel nauseated or faint, and you may break out in a sweat.  Once the doctor has determined that everything has been removed, he or she will remove the cannula from your uterus and cervix and then remove the speculum.


The doctor will examine the contents of the tube to assess whether or not the lining, placenta, and baby are all present and accounted for. If he or she determines that not everything has been removed, you will have the cannula reinserted and the doctor will do the procedure again.  Your uterus will be inspected after the procedure to check for firmness and size.


Once the abortion is complete, you can expect to wait approximately 1 hour before being sent home.  Acetaminophen or ibuprofen will be given or recommended for use, and antibiotics may be prescribed to prevent infection from occurring.  You will most likely continue to bleed or spot for the next 2 weeks off and on, as well as experience cramping for the rest of the day and possibly for 2 to 3 days following the abortion.  You will be instructed to not have intercourse or use tampons for at least 1 week.  A follow-up exam will be scheduled for approximately 14 days after the abortion in order to confirm that the abortion has been completed and that there are no complications.  An ultrasound or a pelvic examination, as well as blood work, should be done to verify that everything was removed.


What does it cost? A manual aspiration abortion can cost anywhere between $200-600, but will be less expensive than a vacuum aspiration.


What should I consider?

  • A manual aspiration abortion is the only surgical abortion that can be done before the 6th week of pregnancy, and as a matter of fact, this abortion can be done as soon as a pregnancy test is positive (3 weeks after the first day of your last period in some cases).
  • This method may not be available everywhere.
  • It can be done without any anesthesia and in a doctor's office, making it easier to go through if you have a busy schedule or need to drive yourself.
  • Many women comment that this abortion causes less stress than other surgical abortions because there is no sound of a suction machine.
  • Manual aspiration is successful in ending the pregnancy 99% of the time, and if it should fail, it will simply be repeated if you agree.
  • This method is often used when a medical abortion has failed.
  • Verification of a successful procedure is easier with a manual aspiration abortion because the gestational sac holding the developing human is usually able to come out intact due to the gentle suction of the handheld syringe.
  • This method of abortion has been used since 1927, and since it does not require electricity, it is often used in third world countries.  Its use in the United States has grown of late because early pregnancy detection is now available.


What are the risks?  Side effects are common and normal, and consist of abdominal cramping and pain for 2-3 days following the procedure, as well as bleeding for up to 2 weeks.  True complications occur in approximately 2% of manual aspirations.

  • An injury to the cervix or uterus can occur if the cannula or tenaculum punctures or tears into the flesh, leading to infection and/or excessive bleeding.
  • Bacterial infection can occur during the procedure, while symptoms won't occur for 2 to 3 days after the procedure.
  • Hematometra (a uterine blood clot) can occur if the uterus does not contract (cramp) to expel all of the lining.  There will be severe abdominal cramping and nausea if this occurs.
  • An undiagnosed ectopic pregnancy can still occur after having a manual aspiration because of the early intervention before an ultrasound can be given to check for implantation placement.
  • An incomplete abortion, where the pregnancy has been terminated but the baby or other tissue does not get expelled, can occur in an additional 1% of cases, causing severe cramping and excessive bleeding that continues for over a week following the abortion.
  • Emotional or psychological distress can occur after the abortion, including depression, guilt, regret, anger, and/or sleep disturbance.
  • Maternal death occurs in a reported 1 out of every 100,000 abortions (this includes all types of abortion).

Manual Vacuum Aspiration Abortion


Once your cervix is open, the doctor will insert a tube, called a cannula, all the way into your uterus. The picture to the right shows two different sized cannulas (the 2 clear tubes), and the one that is used will depend on the size of your cervix and the age of the baby.  The doctor will then assemble the syringe (the white object in the picture) onto the cannula.  This syringe contains a vacuum-like pull, and when the product is assembled, suction will occur.  The doctor will then move the syringe from side to side and back and forth.  The lining of your uterus, the placenta, and the developing human will be suctioned into the syringe and collected in a tube attached to