Abortion in Clinic: What to Expect

According to the best medical evidence available, abortion is safer than getting a dental procedure or cosmetic surgery [6], and much safer than childbirth. According to that evidence, in the United States, a woman is about 15 to 25 times more likely to die in childbirth than she is during an abortion [7-10].

Most people seeking an abortion are early in the pregnancy. 2/3 of women are 8 weeks pregnant or less [3]. Under 10 to 11 weeks, a person has choice of either a medication abortion at home or a short, in-clinic procedure called a uterine aspiration. They are different, but both are very effective, and which one you choose is really a very personal choice.

In a medication abortion, a person takes two sets of pills. The first pill is called mifepristone. This pill blocks the hormones that allow the pregnancy to develop. Either a few hours or 1-2 days later, they take a second set of pills called misoprostol. These pills cause the uterus to contract to expel the pregnancy. The experience most people have is like having a miscarriage or a very heavy period.

Some people prefer medication abortion because it is private, they can be at home, and they don’t have to have a procedure. The abortion pills work to end the pregnancy over 98% of the time. Around 2% of people will still need a uterine aspiration after using the pills if their pregnancy doesn’t end or if they have heavy bleeding.

A uterine aspiration is done in a clinic or office. In a uterine aspiration, the patient gets undressed from the waist down. The provider places a speculum, like when you get a pap smear done, and then gives some numbing medicine around the cervix. The cervix is opened gently to allow a small plastic straw, or cannula, to pass into the uterus. Suction, either a handheld one like the one in the picture or an electric suction, is used to remove the pregnancy. The entire procedure lasts about 5 to 10 minutes. There are no cuts or incisions—it’s not a big surgery. 

Anesthesia depends on where a person has a procedure and their own preference. Some patients have moderate sedation through an intravenous line. In moderate sedation, the person is responsive but sleepy and has good pain control. However, many patients take just an ibuprofen by mouth before the procedure and have numbing medicine in the cervix and they do just fine. Some patients prefer oral medication only because they may need to drive home or are more worried about sedation than the procedure. The choice of sedation is made between you and the clinic staff.

A few patients have deep sedation or general anesthesia where they are completely asleep. Deep sedation or general anesthesia are not needed in most abortion cases but may be offered for patient comfort or if a person has medical reasons where they need to be asleep. 

Most people who get moderate sedation or sedation by mouth will feel some cramping or strong contractions as the cervix is dilated and the aspiration happens. However, the procedure is very fast, lasting about five to ten minutes, and the medications help to ease discomfort. By the time people leave the clinic, they should be feeling much better. Most people can go back to their regular activities the next day. 

It’s really up to each person. Some prefer a medication abortion because they can take the pills in the privacy of their own home, with their own support people around them. They don’t have to get undressed in the doctor’s office or have the aspiration done. To some people, medication abortion feels more natural, like a miscarriage. They are OK with having bleeding and cramping and are able to follow-up if there is a concern. Other people would rather have the uterine aspiration because it’s quick and once it’s over, they know they are done and not pregnant—it’s a big relief to walk out of the clinic with the abortion complete. Every person is different, and the choice is theirs to make!

Less than 10% of abortion care is provided after 14 weeks in the U.S. and in Canada [11]. This abortion procedure is done slightly differently. Peole may take medications or have overnight dilators placed to open the cervix. The procedure is completed using either suction or suction combined with instruments. Although the entire process takes a bit longer, still the abortion procedure itself is short, takes about 10 minutes, and there is no incision or cutting. Later procedures can take place safely in a clinic or office—they do not need to be in a hospital or operating room [12]. Some of these later abortions are done using medications only, although this is rare in the U.S. and Canada.

Tell the clinic staff about yourself. Tell them the name you want to be called, what pronouns you use, and important things to know about you. Tell them if you have had a previous experience with abortion—good or bad! Tell them if you want a friend, family member, or partner with you. Tell them if you want to be told everything that they are doing, or if you would rather listen to music or chat about movies. Tell them how you want to be treated.

Let go of shame, guilt, or fear. Know that you are making the best decision for you and your life. You are not alone – many people just like you have walked this path. Sometimes reading or hearing about other people’s experience with abortion can be helpful. A great website for abortion stories is wetestify.org.

People decide to have an abortion after concluding that it is the right choice for themselves and their lives. According to the best evidence, if you ask people who had an abortion five years later whether abortion was the right choice, over 99% of them will say that it was [13]. The story that women regret their abortions is one that is mostly made up by people who are against abortion. 

Abortion is safer than having a child, so having more than one abortion is definitely safer than having more than one child. There is no “maximum” number of times that a person can have an abortion in her lifetime.