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© 2004 Choice to Live With

Permission to Reprint & Fair Use Notice

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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 appointments.
  • 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 pregnancy.
  • 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 this occurs.
  • 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. 

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