Surgical abortion or pharmacological abortion? Understanding your options

24 Jul 2020

diferencias aborto quirúrgico y aborto farmacológico

Making the decision to abort can be challenging, and choosing which type of abortion procedure is best for your circumstances can add to the confusion. In this article, we discuss the differences between surgical abortion and medical abortion, to help you better understand your options.

Surgical abortion

Surgical abortion is one of the safest and most frequently performed procedures, with the largest number of women undergoing the procedure each year. Although surgical abortion can be performed up to the second trimester (up to 22 weeks in Spain), this implies a more complex surgical procedure.

A surgical abortion in the first trimester is performed with both local anesthesia and sedation. Once the anesthetic has taken effect, the doctor inserts a small tube into the uterus and, applying gentle suction, removes the contents and lining of the uterus.

The procedure itself lasts around 10 minutes; however, from the time of arrival at the clinic, to preparation for surgery and recovery after anesthesia, having a surgical abortion can take between 4 to 5 hours. After the anesthetic is gone and the nurses have given you aftercare advice, you can go home.

The details of surgical abortion

Surgical abortion is one of the safest operations; However, all surgery carries some risks. Although complications can occur in an estimated 3% of cases, major complications are rare.

Why choose surgical abortion?

In general, surgical abortion is a very safe and highly successful option for terminating pregnancy in the first trimester. The advantages of choosing a surgical abortion are:

  • It can be performed in later stages of pregnancy than pharmacological abortion
  • The procedure itself only takes a few minutes;
  • Normally it is a single visit to the clinic;
  • There is usually less bleeding and cramping than with a pill abortion;
  • Medical personnel are present throughout the procedure;
  • It can be performed under sedation, which reduces consciousness and discomfort;
  • It has a very low complication rate and a high success rate;
  • You can continue breastfeeding, while with medical abortion you should stop breastfeeding

Drug abortion

Drug abortion has been more widely available in the past, and is a non-surgical abortion option, available to most women up to 9 weeks gestation. Choosing between a pharmacological or surgical abortion largely depends on your circumstances and personal preferences.
For many women, the availability of medical abortion has meant greater privacy and a less invasive method of accessing an abortion. Medical abortion is possible once a pregnancy is detected by ultrasound (generally around 5 weeks) until 9 weeks (63 days) of gestation. Abortion is accomplished using a combination of two medications that work together to end a pregnancy.

The doctor administers the first drug. This medication is an anti-hormone, which works by blocking the effects of progesterone, the hormone necessary for pregnancy to continue.48 hours after taking the first drug, the second one is taken vaginally. The second medicine opens the cervix and helps the uterus to expel the pregnancy. This should occur within 30 minutes to 24 hours after taking the second pills, but most women already experience some vaginal bleeding, cramping, and some tissue ejection within the next 4 hours.

Before receiving the first pill to perform a medical abortion, an ultrasound scan is necessary to determine that you are no more than 9 weeks (63 days) pregnant and to exclude ectopic pregnancy (a tubal pregnancy).

Almost all women are eligible for a medical abortion, although there are some medical conditions that may mean that you are not suitable. If you have a bleeding disorder or are taking blood thinning medications, have adrenal gland problems, or are taking corticosteroid medications such as prednisone, a medical abortion would not be appropriate. It is important that it is carried out under the supervision of a doctor and at the same time have access to emergency medical attention during the process.

Medical abortion is a safe and effective method to interrupt a pregnancy until 9 weeks of gestation;

Why choose a medical abortion?

If your pregnancy is less than 9 weeks gestation and you prefer not to have surgery, then a pharmacological abortion is a good option. Other reasons why women choose abortion with pills instead of surgical abortion include:

  • Does not require anesthesia;
  • The procedure is not invasive;
  • There is more privacy than with a surgical abortion;
  • As a non-surgical procedure, there are no surgical risks associated with medical abortion;
  • You are at home and you can have the support of friends and / or family if you wish;
  • It can feel “more natural”, since it is similar to having an intense period or a miscarriage.

What is the best for you?

Above all, the decision to undergo a surgical or medical abortion is up to you and you must take into account your particular circumstances, your medical history and your personal preferences. If you are not sure which option is right for you, it is always best to talk to your doctor.