Suction and curettage
(Also referred to as mechanical vacuum aspiration)
Performed later in pregnancy—from 6 to 14 weeks since the
start of your last menstrual period—a suction and curettage
abortion is a surgical procedure using a mechanical suction machine
to remove the pregnancy tissue from the uterus. Suction and curettage
(also referred to as mechanical vacuum aspiration) can
be performed under either local or general anesthetic. Local anesthetic
numbs the cervix. General anesthetic, on the other hand, implies
that you will be asleep throughout the procedure.
Hours before or the day before a machine vacuum aspiration, a cervical
dilator is placed in the cervix to slowly dilate it. This device, when
placed in a closed cervix, absorbs moisture from the tissues surrounding
the cervix. This causes the device to swell and to open the cervix slowly,
with little discomfort.
A synthetic dilator may be used instead. This device saves time and can
be used several hours before the procedure. In this instance, the cervical
opening is dilated by inserting and removing a series of narrow, tapered
rods, each wider than the last.
What will happen?
Just before the procedure is set to begin, you will be given
antibiotics to prevent infection. You may also be given misoprostol,
a medication to induce labor. Misoprostol is sometimes given to
soften the cervix.
Usually lasting between 10 and 15 minutes, suction and curettage can be
performed in a doctor's office or clinic under local anesthetic. It can
also be performed in a hospital or clinic under general anesthetic.
The doctor will place you on an exam table in the same position as for a
pelvic exam: you will be lying on your back with your feet in stirrups. He
or she will insert a speculum into your vagina. Once your vagina and cervix
are cleaned with an antiseptic solution, a local anesthetic will be injected
into your cervix. Pain medication and/or sedative, in addition to local
anesthetic, may be administered intravenously. In addition, Vasopressin or
a similar medication may be mixed with the local anesthetic to slow the
uterine bleeding and prevent blood loss.
The doctor will then grasp the cervix with an instrument designed to hold
the uterus in place and will dilate the cervical canal. Dilation reduces the
risk of injury to the cervix. Once the cervix is dilated, the doctor will
then pass a thin, hollow tube called a cannula into the cervical canal.
A gentle vacuum is attached to the cannula and is used to draw the pregnancy
tissue out of the uterus. As this tissue is removed, the uterus will contract,
causing cramping. The cramps will lessen once the cannula is removed. You
may experience nausea or sweating, and/or you may feel faint.
Once the uterus is empty, the suction is stopped and the walls of the
uterus are then felt with a loop-shaped instrument called a curette. This
is done to ensure no pregnancy tissue remains. The tissue removed from your
uterus will then be examined to make sure all pregnancy tissue has been removed
and that the abortion is complete.
What are the advantages of a suction and curettage abortion?
- Mechanical vacuum aspiration is safe and simple.
- This type of abortion can be performed later in the first trimester of
- There is a less than 1 percent chance the abortion will be incomplete.
What are the disadvantages?
- You may experience side effects such as pain, menstrual-like bleeding,
and abdominal cramping for 2 weeks following the procedure.
- You may experience cramps for up to a week afterward.
- Although rare, serious complications such as infection or damage to the
uterus and/or cervix are possible. The risk of complications increases with
more advanced pregnancies.
What can I expect afterward?
Immediately following your surgery, you'll be taken to a recovery area
where nurses will observe you and care for you. You will stay in the recovery
room from 1 to 4 hours. Before you are discharged, your doctor or nurse will
give you special instructions and information to help you in your recovery.
You will likely be given a sheet with these instructions and the names and
numbers of whom to contact if a problem arises.
Once you return home following your abortion, rest quietly. You may feel
tired. You may also experience pain, cramping, and light vaginal bleeding. You
may also experience other side effects such as nausea, diarrhea, headache,
constipation or gas. In order to feel better and recover quickly, it's important
to limit your activity and to increase it slowly. Rest when you need to, and
be sure to get enough sleep.
Walking can help alleviate gas pain. If you have too much pain or feel
too tired, slow down.
Depending how you feel the following day, you should be able to resume
normal activities. You may experience pain: medications such as Ibuprofen
(Advil) or Acetominophen (Tylenol) can help relieve cramping pain.
You'll want to avoid sexual intercourse until you are fully recovered and
the bleeding has stopped-usually 2 to 3 weeks. You can begin
birth control pills
immediately following the procedure, but be sure to use a
condom during the
first weeks of intercourse to prevent infection.
Following surgery, you can expect to have irregular bleeding or spotting
during the first 2 weeks. During the first week, avoid tampons and use only
pads. You'll also want to avoid rinsing your vagina with douche or other
As the uterus shrinks back to its pre-pregnancy state, you'll experience
cramps similar to menstrual cramps. They may be present for several hours
or possibly a few days. Some women experience cramps for up to 6 weeks
after their abortion.
You can also expect emotional reactions for 2 to 3 weeks.
Avoid intense exercise such as sit-ups or heavy lifting for at least 6
It's important after surgery to take all your prescribed antibiotics in
order to prevent infection.
What about my follow-up visit?
A follow-up examination is needed 2 to 3 weeks after a suction and
curettage abortion. During this visit, your doctor will perform a pelvic
exam, conduct a follow-up pregnancy test, check for low blood counts and
discuss any problems or concerns you may have. He or she will also tell
you when you can resume sexual relations and will help you choose an appropriate
method of birth control to
How will I feel?
Some women find it very emotionally difficulty to cope with having had
an abortion. In fact, between 5 and 30 percent report feelings of anxiety,
guilt or mild depression. It's normal to experience a broad range of
emotions after an abortion—from relief and happiness to sadness, shame,
regret, guilt, grief and loss. There are as many reactions as there are women
and each woman is unique.
Most women feel they have made the right decision; it's rare for
them to become clinically depressed following an abortion. However, if your
feelings are overwhelming and persistent, or if you have a previous history of
depression, you should consult a professional
therapist. (Refer to Finding
and Evaluating a Therapist for more information.) Depression is a very
Consider counseling even if you feel "OK"—abortion is a weighty issue
and there is no "right" or "normal" way to feel about it: every woman is
Understanding your emotions and taking care of yourself are important: doing
so can help you let go of pain and start to heal. Talk to your partner, friends,
or family to let them know what you're feeling. You may also want to consider
professional counseling. If you're not sure where to go for counseling, talk
to your abortion provider: most providers can refer you to counseling services to assist
you in dealing with your feelings.