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Therapeutic Abortion: Surgical

(Abortion; Vacuum Aspiration; Dilation and Curettage; Dilation and Evacuation)

En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor


Therapeutic abortion is a procedure to end a pregnancy. It is done before the fetus is able to survive on its own. A surgical therapeutic abortion is done using one of three methods:

  • Manual vacuum aspiration (MVA)
  • Dilation and suction curettage ( D&C)
  • Dilation and evacuation (D&E)

Undilated Cervix

female organs cervix
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

A therapeutic abortion may be done to:

  • Preserve the mother’s physical or mental health
  • End a pregnancy that tests have shown would result in a child with severe abnormalities

Possible Complications

These procedures are very safe. But, no procedure is free of risk. Problems resulting from abortion can include:

  • An incomplete procedure
  • Bleeding
  • Infection
  • Injury to the cervix or other organs
  • Reaction to anesthesia

The earlier in a pregnancy the abortion is done, the better the chances of a procedure with no complications.

If you think you might be pregnant, see your doctor. The earlier you find out, the more time you have to make an informed choice about the pregnancy. Early symptoms of pregnancy include:

  • A missed period
  • Tender, swollen breasts
  • Fatigue
  • Nausea or vomiting
  • Increased sensitivity to odors

What to Expect

Your doctor may:

  • Examine you—to determine the stage of your pregnancy by checking the size of the uterus (womb)
  • Do blood and urine tests—to confirm the pregnancy
  • Use ultrasound—to give an accurate assessment of the stage of pregnancy
  • Give you medicine—to help dilate the cervix

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

  • Aspirin or other anti-inflammatory drugs
  • Blood thinners

Local anesthesia with sedation may be used. The local anesthesia will numb the cervix. Sedation will help you relax. In some cases, regional or general anesthesia may be used.

You may be given an antibiotic before the procedure.

The doctor may inject a numbing agent in or near the cervix. Special tools will be used to stretch the cervix opening. A tube will be inserted into the uterus. The tube will then remove the contents.

The steps for an MVA will be followed. The doctor will then use a narrow metal loop to remove the tissue lining the uterine walls.

This procedure is similar to a D&C, except that it is done during the second trimester. It will also require wider dilation of the cervix. The fetus and other products of conception are removed from the uterus with medical instruments and suction. This usually requires regional or general anesthesia.

About 5-20 minutes

Women report cramps similar to menstrual cramps. Talk to your doctor about medicine to help manage discomfort.

Acetaminophen (such as Tylenol) or ibuprofen (such as Advil) can reduce most of these symptoms. Do not take aspirin unless directed to by your doctor.

After a therapeutic abortion:

  • You may have cramps and bleeding.
  • You may also have nausea and diarrhea.
  • You should not use vaginal medicines until your doctor allows it.
  • Do not have sex for at least one week.
  • Baths and showers are okay.
  • You should recover within a couple of days.
  • Make sure you return to see your doctor for follow-up.

Sudden hormone changes may intensify natural feelings of guilt, anger, sadness, and regret. Most doctors can offer or refer you to follow-up counseling, if you choose.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Increasing abdominal pain
  • Heavy vaginal bleeding (soaking more than one pad per hour)
  • Foul-smelling vaginal discharge
  • Pain that is not helped by medicine, heat, and rest
  • Persistent vomiting

In case of an emergency, call for medical help right away.


American Congress of Obstetricians and Gynecologists


Planned Parenthood Federation of America, Inc.



The Society of Obstetricians and Gynaecologists of Canada


Women's Health Matters



Abortion. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com/about/about-us. Updated November 9, 2012. Accessed December 17, 2012.

Abortion. Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/abortion-4260.asp. Accessed on December 17, 2012.

Surgical abortion. The Abortion Clinic Directory website. Available at: http://www.abortionclinic.org/topics/articles/article_99.asp. Accessed December 17, 2012.

The Women’s Health Centre: therapeutic abortion. Regina Qu’Appelle Health Region website. Available at: http://www.rqhealth.ca/programs/in_hospital_care/womens_health/therapeutic.shtml. Access December 17, 2012.

1/11/2010 DynaMed's Systematic Literature Surveillance http://dynamed.ebscohost.com/about/about-us: Robson SC, Kelly T, Deverill M, et al. Randomised preference trial of medical versus surgical termination of pregnancy less than 14 weeks' gestation (TOPS). Health Technol Assess. 2009;13(53):1-124.

Last reviewed September 2013 by Andrea Chisholm, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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