Making the decision to have an abortion 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, in order to help you better understand the choices available to you. Show Surgical abortion is one of the most commonly performed and safest surgical procedures in Australia, with up to 80,000 women undergoing the procedure every year.1 Most commonly performed in the first trimester, up to 14 weeks’ gestation, surgical abortion has a low complication rate when carried out during this time. While surgical abortion can be performed in the second trimester (up to 20 weeks in most states, and up to 24 weeks in Victoria); this does involve a more complex surgical procedure. A surgical abortion in the first trimester is most often carried out under ‘twilight sedation’, although the option of a local anaesthetic is available. Once the anaesthetic has taken effect, the doctor inserts a small tube into the uterus and, applying gentle suction, removes the contents and lining of the uterus. This is why a surgical abortion is often called a ‘suction curette’. The procedure itself takes around 10 minutes; however, from the point of arrival at the clinic, to preparation for the surgery and recovery from the anaesthetic, having a surgical abortion can take 4 – 5 hours. After the anaesthetic has worn off and you have received your aftercare advice, you will need to be driven home. The risks of surgical abortionSurgical abortion is one of the safest operations carried out in Australia; however, all surgery carries some risks. Although complications can occur in an estimated 3% of cases, major complications are rare. Below is a list of the risks associated with surgical abortion:
Women who experience heavy bleeding, fever or severe pain or discomfort following a surgical abortion must consult a doctor as soon as possible. Why choose surgical abortion?Overall, surgical abortion is a very safe and highly successful option for termination of pregnancy in the first trimester. The advantages of choosing a surgical abortion are:
Medical abortionMedical abortion has been more widely available in Australia since 2012, and is a non-surgical abortion option, available to most women up to 63 days gestation. Choosing between a medical or surgical abortion is very much dependent on your circumstances and personal preference. For many women, the availability of medical abortion in Australia has meant greater privacy and less invasiveness in accessing a termination. The more recent introduction of medical abortion via teleconsultation has also made early termination more readily available to women living in rural and regional areas or without access to an abortion clinic. Medical abortion is available once a pregnancy is detected via ultrasound (usually around 5 weeks) up to 9 weeks (63 days) gestation. The abortion is achieved using a combination of two medications which work together to terminate a pregnancy.
The second medication opens the cervix and assists the uterus to expel the pregnancy. This should occur between 30 minutes to 24 hours after taking the second medication, but most women can expect to experience some vaginal bleeding, cramps and to pass some pregnancy tissue within 4 hours. Before being prescribed the medication for medical abortion you must have an ultrasound to determine that you are no more than 9 weeks (63 days) pregnant and to exclude ectopic pregnancy (a pregnancy in the tubes). Almost all women are suitable for a medical abortion, although there are a few medical conditions that may mean you are not suitable. If you have a bleeding disorder or are on blood thinning medications, if you have adrenal gland problems or are taking corticosteroid medications, such as prednisone, a medical abortion is unsuitable for you. Your doctor will take a medical history to make sure that you are eligible for a medical abortion. You will also need to able access emergency medical care during the time you are having the medical abortion. The risks of medical abortionMedical abortion is a safe and effective method of terminating a pregnancy up to 9 weeks’ gestation; however, like surgical abortion, medical abortion carries some risks:
What to expect after taking the second medicationVaginal bleeding and cramping is normal and usually starts within a few hours of taking the second medication (misoprostol). The amount of bleeding and cramping varies from patient to patient.
Contact the MSI Australia aftercare service if:
If bleeding does not occur, some patients may require a repeat dose of misoprostol, or another method of termination may be suggested. You should contact your doctor as soon as possible if this occurs. Why choose a medical abortion?If your pregnancy is under 9 weeks’ gestation and you prefer not to undergo surgery, then a medical abortion is a good option. Other reasons women choose medical abortion over surgical abortion include:
What’s best for you?Above all, the decision to have a surgical or medical abortion is up to you and has to take into account your particular circumstances, medical history and personal preference. If you are unsure about what is the right option for you, it’s always best to talk to your doctor or make an appointment for a telephone consultation with one of our pre-care nurses. If you’d like to talk to an experienced and supportive professional about your decision to have an abortion, we provide free over-the-phone pregnancy options counselling. For more information about surgical or medical abortion, visit our abortion services page. To make an appointment or to discuss your options, contact MSI Australia. |