What is it? A vacuum aspiration abortion is a surgical procedure, and may also be
called a suction aspiration, suction abortion, vacuum curettage, vacuum abortion,
suction curettage, uterine aspiration, suction D&C, and is what is commonly referred
to when speaking of a first trimester surgical abortion. This abortion can be done
between 6 and 12 weeks from the first day of your last period, although some doctors
use the procedure up to the 14th week. A vacuum aspiration abortion is usually done
at an abortion clinic or a hospital setting since it does require machinery.
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. Misoprostol may be given to help the cervix
dilate, and oxytocin may be given to make the uterus contract. The doctor will then
insert a speculum into your vagina and clamp it open so that your cervix is in plain
view. He or she will then swab your vagina with an antiseptic to prevent infection.
Your doctor will most likely inject your cervix with a numbing agent, which will
feel like a pinch with each injection. A tenaculum (which looks a little like long,
skinny pliers) will be used to grasp your cervix and hold it in place.
The cramping will lessen once the cannula is removed. You may also feel nauseated
or faint, and you may break out in a sweat. The doctor will then stop the suction
and examine the contents of the bottle on a tray to be sure that everything has been
removed. If something is missing, he or she may continue with more suction or may
use a tool called a curette (a thin metal rod with a sharp loop at the end) to sweep
around the surface of the uterus a few times. Once the doctor has determined that
everything has been removed, he or she will remove the cannula or curette from your
uterus and cervix and then remove the tenaculum and speculum. Your uterus will then
be inspected by pelvic examination 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. You can return to normal activities the next day if you feel up
to it. 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 at this
appointment to verify that everything was removed.
What does it cost? A vacuum aspiration will cost between $350-650, and will depend
on anesthesia used, if any, and the size of the baby.
What should I consider?
A vacuum aspiration abortion can be done safely between the 6th and 12th weeks of
pregnancy. If done before the 6th week, there is a higher chance of a failed abortion,
and if done after the 12th week there is a higher risk of complications.
This method is the most common abortion procedure.
You should plan on taking the remainder of the day to relax and recover after having
a vacuum aspiration abortion done.
Many women comment that they do not like the sound of the suction machine. For many
women, this sound may trigger memories of the abortion at future dental and doctor
Vacuum aspiration is successful in ending the pregnancy 98% of the time, and if it
should fail, either another vacuum aspiration or a D&C will be done with your approval.
If, upon hearing the abortion has failed and the baby is still developing, you do
not want another abortion, contact a local pregnancy center to help you find an OB/GYN
to examine you. As always, the decision to abort is up to you.
This method is often used when a medical abortion has failed.
There is less bleeding with this procedure than with a medical abortion, since most
of the blood is suctioned out.
A vacuum abortion can only be done after the 6-7th week from the first day of your
last period, so if you want an abortion any earlier than that you will either have
to wait or choose a different form of abortion (RU-486, methotrexate, or manual aspiration).
As with any abortion procedure, there is a chance that you could become pregnant
immediately following the abortion, so take precautions to prevent another unplanned
You can request to have anesthesia for a vacuum aspiration abortion, and if you choose
to do so you must bring someone to the clinic to drive you home.
What are the risks? Side effects are common and normal, and consist of abdominal
cramping, pain, nausea, sweating, and feeling faint during the procedure, cramping
and pain for 2-3 days following the procedure, as well as bleeding for up to 2 weeks.
True complications occur in approximately 1-2% of vacuum aspirations.
Allergic reactions to anesthesia or other medications given can occur. It is vitally
important that you report any over-the-counter or prescription medications as well
as illegal drugs so that the anesthetics can be adjusted accordingly.
Bacterial infection can occur during the procedure when surgical tools enter the
uterus, while symptoms won't occur for 2 to 3 days after the procedure. This happens
most frequently when there is an underlying STD that is not diagnosed at the time
of the abortion. Therefore, it is vitally important that you be tested for STDs
prior to the abortion. Infection is the most common post-abortion complication.
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
Heavy bleeding can occur if the uterus fails to contract and may lead to a uterine
blood clot, as mentioned above. Heavy bleeding may require medication, a repeat
abortion, surgery, and/or transfusion.
A cut or torn cervix can occur when the doctor dilates the cervix, grabs the cervix
with the tenaculum, or inserts the cannula into the uterus. This may lead to a weakened
cervix - making carrying a future child to term difficult.
The uterus may be perforated (punctured) during the abortion when the doctor rubs
the cannula against the walls of the uterus, causing heavy abdominal bleeding and/or
infection. You may require surgery to repair the puncture, and rarely you may need
a hysterectomy (removal of the uterus) to stop the bleeding.
Scarring of the uterus may occur, resulting in "Asherman's Syndrome." This scarring
can occur as the doctor rubs the cannula against the walls of the uterus and can
cause future fertility problems.
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, especially
those done before 6 weeks, 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).
Vacuum Aspiration Abortion
Once your cervix is open, the doctor will insert cervical dilators into the opening
of your cervix. These dilators are pictured at right. This process takes 5-10 minutes
and consists of the doctor inserting the smallest rod and progressively inserting
larger rods until reaching the largest, which is about the width of a dime. You
will most likely experience mild to strong cramping throughout dilation. The doctor
will then insert a plastic tube with a pointed tip, called a cannula, all the way
into your uterus, the other end of which is plugged into a suction machine (one type
is pictured at right). With the tube still inside your uterus, the doctor will turn
the suction machine on and begin to rub the tip of the cannula along the surface
of your uterus to dislodge the placenta and the sac that contains the baby. The
lining of your uterus, the placenta, and the developing human will be pulled apart
and suctioned into the tube and collected in a glass bottle attached to the machine.
The process takes approximately 5-10 minutes once the machine is turned on, and you
can expect moderate to strong cramping throughout the procedure and a strong tugging
sensation as the machine pulls on the uterus.