Guide to a Safe Manual Vacuum Aspiration Abortion (MVA)

A manual vacuum aspiration abortion (MVA) is a type of surgical abortion that can be performed up to 14 weeks of pregnancy. This page details information about this in-clinic procedure.

What is an Manual Vacuum Aspiration (MVA) Abortion?

Manual vacuum aspiration (MVA) is a very safe method of abortion for pregnancies in the first trimester, and/or early second trimester all the way up to 14 weeks of gestation [1]. The gestational age limit for MVA often depends on the clinic, as well as the healthcare provider performing the procedure.

MVA is performed by a trained provider in a clinic.

During the procedure the clinician uses instruments, including a silent suction device, to remove the pregnancy from the uterus [2]. Most commonly this procedure is performed using local anesthesia while the woman is awake, and it takes typically between 5 and 10 minutes. The woman is likely to experience cramping during the procedure, and there may be some bleeding on and off for several days or weeks afterward.

MVA is Manual Vacuum Aspiration but it might also be known as surgical abortion, aspiration abortion, suction abortion, or vacuum aspiration. [1]

What happens during a Manual Vacuum Aspiration (MVA) abortion procedure?

1/ Pre-procedure medication

The World Health Organization (WHO) recommends administering antibiotics prior to Manual Vacuum Aspiration (MVA). This helps to reduce the risk of infection. [1]

However, if antibiotics are unavailable, an MVA can still safely be performed. Clinics may also choose to give an oral medication to help with the cramping pain, such as ibuprofen. [2]

2/ In preparation on the Manual Vacuum Aspiration (MVA) Abortion

During a clinic visit for a Manual Vacuum Aspiration (MVA), there are often steps taken in preparation for the procedure including (but not limited to) [2]:

  1. Urine pregnancy testing
  2. Determination of Rh blood type
  3. Ultrasound to estimate gestational age
  4. Pelvic exam
  5. Blood pressure measurement

Some additional tests may be performed based on requirements/laws specific to each geographic location.

3/ During the Manual Vacuum Aspiration (MVA) Abortion

The Manual Vacuum Aspiration (MVA) procedure will begin with a pelvic or speculum exam, and then most commonly local anesthesia is injected next to the cervix. The clinician will then begin to gradually dilate the cervix, and this step is guided by the number of weeks of gestation of the pregnancy.

Once the desired dilation is achieved, the clinician will use a silent, handheld suction device called an Ipas to perform the aspiration and remove the pregnancy.

After removal of the pregnancy, the provider may choose to do an ultrasound, and then the woman is allowed to rest. [2]

4/ After the Manual Vacuum Aspiration (MVA) Abortion

The MVA recovery time is relatively short in the clinic.

– For women who have the procedure with only local anesthetic, the recovery time is typically less than 30 minutes.

– For women who were given a sedation medicine for the procedure, the recovery time may be a bit longer (30-60 minutes) while the sedation effect diminishes.

Once the recovery in the clinic is completed, the woman is sent home. Some clinics may request that she have an escort or someone with her to get home, but this depends on the clinic. [2]

5/ Post-abortion care after the Manual Vacuum Aspiration (MVA) Abortion

After a safe surgical abortion, women are often offered a follow-up visit in the clinic, and while this is not required, each woman should listen to the recommendation of her healthcare provider.

There is no medically proven amount of time that a woman has to wait to do specific activities including: shower/bathing, exercise, sex, or using tampons. Generally it is advised that at least until the bleeding lightens after the procedure, the woman should: avoid introducing objects into the vagina including tampons and menstrual cups, and avoid intense physical activity. Each woman can return to her normal activities as tolerated, and each woman will be different.

Prior to leaving the clinic, women should be offered information about methods of contraception. Most forms of contraception can be started immediately, however, a discussion should take place regarding each woman and her choice of method. Clinics should provide women with contact information, in case they have questions or concerns after the abortion. [2]

To find the appropriate contraceptive methods of your choice, visit www.findmymethod.org

What is the MVA equipment used during the procedure

Manual vacuum aspiration (MVA) involves the use of a convenient, handheld device called an Ipas. The Ipas is a silent, suction device that is used to aspirate the pregnancy. [2] More information about the Ipas device can be found here.

Ipas equipment manual vacuum aspiration abortion mva

Most commons side effects of the MVA

The most common pain associated with MVA is strong cramps experienced by the woman during the procedure. Often this cramping will improve quickly afterward, but some women may experience cramping on and off for a few days or weeks. This side effect is best managed with NSAID medications such as ibuprofen.

Local anesthesia is often used during MVA, and this helps to numb the area around the cervix to ease some of the pain during the procedure. [1]

Most women will experience bleeding and cramping during and after MVA, these symptoms will gradually improve in the following days after the procedure.

It is also common to experience many different emotions after a surgical abortion, all of which are valid, and if the woman feels like she needs additional help, she should seek counseling care. [1]

Risks of complications of the MVA

While MVA is very safe, there are still some risks to the procedure which include: heavy bleeding, infection, injury to the uterus and surrounding structures, incomplete abortion, and death.

These risks are very small when the procedure is performed by a trained clinician, but they are important to know when consenting to a procedure.

A routine MVA procedure without complications does not lead to future infertility. [1]

After an MVA, there are a few signs that women should pay attention to and seek clinical attention in case of [2]:

– Heavy bleeding (completely soaking 2 pads per hour for 2 hours in a row or more)

– Fevers (more than 38C or 100.4F) more than 24 hours after the procedure

– Severe, worsening pelvic pain

– Continued signs of pregnancy (increasing nausea, breast tenderness, etc.)

For more information

Get in touch with our counselors to get more information on the manual vacuum aspiration procedure and receive support on the most appropriate abortion methods depending on your situation. You can also learn more about the other method, an abortion with pills if you are under11 weeks pregnant.

Authors:

by the safe2choose team and supporting experts at carafem, based on the 2019 recommendations by Ipas, and the 2012 recommendations by the WHO.

carafem provides convenient and professional abortion care and family planning so people can control the number and spacing of their children.

Ipas is the only international organization solely focused on expanding access to safe abortion and contraceptive care.

WHO is a specialized agency of the United Nations responsible for international public health.


Sources

[1] World Health Organization (WHO). Safe abortion: technical and policy guidance for health systems, second edition. 2012. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/70914/9789241548434_eng.pdf;jsessionid=F77B761669FC579124C1E9CA2CC3CFDB?sequence=1

[2] Ipas. Clinical Updates in Reproductive Health. 2019. Retrieved from: https://ipas.azureedge.net/files/CURHE19-april-ClinicalUpdatesInReproductiveHealth.pdf

Last updated on 05/08/2020

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We advise our readers to:

  1. Read our latest blog post on abortion and COVID-19
  2. Follow WHO safety guidelines on COVID-19
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