Comparing medical abortion and surgical abortion.

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Medical abortion using Mifepristone and Misoprostol for pregnancy ≤ 12 weeks 2

Surgical abortion using vacuum aspiration  for pregnancy ≤ 12 weeks 2

Can be used from 4 weeks LMP.

May not be available before 7 weeks LMP.

Resembles a natural miscarriage.

It’s a surgical procedure, which involves inserting a narrow tube into the uterus to aspirate the contents, using local or general anesthesia.

Medicines can be used at home and abortion can happen there.

Abortion happens in a health facility and is done by a health professional. (Untrained providers may cause severe complications and risks to the woman).

Abortion process lasts more than one day.

Procedure is completed within 5-15 minutes.

May be painful for 2-3 hours or more after using misoprostol

May be painful during the procedure, if done under local anesthesia, and afterwards when the uterus contracts.

Severe complications are rare.

Severe complications are rare if the health professional is experienced and well-trained.

Longer period of post-abortion bleeding, up to several weeks.

Shorter period of post-abortion bleeding.

Anesthesia is not needed. Pain medication should be available.

Pain medication, light sedation and local anesthesia should be provided.

Efficacy 95-98%.

Efficacy 95-100%. 1

Women may see blood clots and the products of conception.

Women do not see products of conception.

Women can start using pills the day of the first pill, but the IUCD (intrauterine contraceptive device ) or sterilization can be done only after the confirmation that the woman is no longer pregnant.

Women can start using a contraceptive method right away (pills, etc.) The IUCD can be inserted right after  the abortion.

 

IMPORTANT: Sharp curettage (D&C, scraping) is an outdated method of surgical abortion that may be risky.  It should be replaced by vacuum aspiration and/or medical methods.16 Despite compelling evidence against it, unfortunately sharp curettage is still a widely practiced method in Latin America, Africa and Eastern Europe either to manage incomplete, missed or induced abortion.17