In-clinic abortions are medical procedures used to end a pregnancy or to manage a miscarriage. They are sometimes called surgical abortion or procedural abortion, and may also be referred to by the specific method used, such as aspiration abortion. There are different types of in-clinic abortion methods, depending on how far along the pregnancy is. This page explains each type of procedure and what to expect.
ALL YOU NEED TO KNOW
An in-clinic abortion is a medical procedure that uses instruments or suction to end a pregnancy or manage a miscarriage. It is performed by trained healthcare providers in a clinic or hospital setting.
An in-clinic abortion is a medical procedure performed by trained healthcare providers in a clinic or hospital setting. These procedures are generally safe and around 99% effective, though safety and experience can vary depending on the specific method used and how far along the pregnancy is.
In-clinic methods work by using medications or medical techniques to gradually open the cervix (called dilation). Once the cervix is open, the pregnancy is removed from the uterus using suction, surgical instruments, or by inducing contractions to complete the expulsion.
Some procedures are quick and done on an outpatient basis, while others may require the person to stay in the clinic or hospital for monitoring and recovery, especially in later stages of pregnancy.
There are several safe methods of in-clinic abortion that you can choose from, and it mostly depends on the gestational age of your pregnancy. Because there is some overlap in the gestational ages for different methods of abortion, the decision may also be based on geographic location, availability of equipment, and provider and personal preference.
• Manual Vacuum Aspiration (MVA) is a form of uterine aspiration, and is typically used up to 14 weeks gestation
• Electric Vacuum Aspiration (EVA) is a form of uterine aspiration, and is often used up to 16 weeks gestation
• Dilation and evacuation (D&E) methods are commonly used beyond 14 weeks gestation
• Induction abortion, when used, is typically done for pregnancies beyond 16 weeks gestation
• Dilation and Curettage (D&C) is an outdated method of abortion and has largely been replaced by methods of uterine vacuum aspiration and dilation and evacuation (D&E).
View and Download our infographic on abortion methods for each gestational age.
SAFE AND EFFECTIVE
In-clinic abortion are safe procedures when performed by trained healthcare providers.
Clinics offering suction or surgical abortion methods should follow medical standards based on national regulations and international guidelines, such as the WHO Abortion Care Guidelines and Ipas Clinical Updates.
These guidelines help ensure safety and quality of care by addressing:
People seeking an in-clinic abortion should choose a clinic that uses safe, approved methods and follows up-to-date medical guidance to protect their health and well-being.
RISKS AND WARNING SIGNS
When performed by trained health professionals in an approved facility and access to right equipment, in-clinic abortions are very safe and have low risk of complications. For example, Vacuum aspiration is effective and safe, with success rates over 98%-99% and major complication rates under 1%.
However, there are still some risks to the different procedures, as in any medical practice. These include heavy bleeding, infection, injury to the uterus and surrounding structures, incomplete abortion or retained product of conception, continued pregnancy, and death.
Most complications are not life-threatening and can be treated. This is why monitoring warning signs after an abortion is important.
If you experience any of the following signs or symptoms, you should seek medical attention immediately:
heavy bleeding (completely soaking two pads, per hour, for two hours in a row or more);
a fever (of more than 38°C or 100.4F) for more than 24 hours after the procedure;
severe, worsening pelvic pain; and
continued signs of pregnancy (increasing nausea, breast tenderness, etc).
COMMON SIDE EFFECTS
Most people feel strong cramping and experience bleeding during an in-clinic abortion, especially while the cervix is being opened (dilated) and during the procedure itself. This cramping usually gets better soon after the abortion is done, but it’s also normal to have some cramping and bleeding for a few days or even weeks. If misoprostol is used to help open the cervix, it may cause side effects like nausea, vomiting, diarrhea, fever, or chills.
Local anesthesia is often used to numb the area around the cervix. This helps make the procedure more comfortable and ease some of the pain.
It’s also completely normal to feel a range of emotions afterward. Some people feel relief, others may feel sadness, or a mix of both. If you need support or someone to talk to, it’s always okay to reach out for help.
PAIN MANAGEMENT OPTIONS
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Most people feel some pain and cramping during vacuum or surgical abortion procedures. The most common type of pain is strong cramping during the procedure. For many, the cramping gets better quickly afterward, but some people may have cramps on and off for a few days or even weeks. This pain usually happens because the cervix (the opening to the uterus) is being opened and the uterus is contracting.
How much pain someone feels can depend on how far along the pregnancy is, their personal pain tolerance, whether they’ve given birth before, if they usually have painful periods, and how anxious they feel. Everyone experiences pain differently.
Pain management options should always be offered. You can get medicine before or during the procedure, and take it home to use later if needed.
There are different types of anesthesia that may be used for in-clinic abortion, and which method is used will often depend on the gestational age of the pregnancy, as well as the availability of anesthetic agents in the clinic.
Possible anesthesia methods include:
Local anesthetic:
This is the most common type of anesthetic used for in-clinic abortion. It is a numbing medicine injected next to the cervix to help ease discomfort during the procedure. The person remains awake and fully alert.
Moderate/Conscious sedation:
This is an anesthetic administered directly into a vein, and it slightly decreases the consciousness level of the person. They will respond to verbal commands.
Deep sedation:
This is an anesthetic administered directly into a vein, and it significantly decreases the consciousness level of the person. They will respond only to repeated verbal commands or tactile stimulation.
General anesthesia:
This may use a combination of inhaled or injected anesthetic agents, and it renders the person unconscious. They will not respond to any commands.
POSTABORTION CARE
After an in-clinic abortion, it's often offered a follow-up visit, and while this is not required, each person should listen to the recommendation of their health-care provider.
There is no medically proven amount of time that a person 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 person should: avoid introducing objects into the vagina including tampons and menstrual cups, and avoid intense physical activity. Each person can return to their normal activities as tolerated, and each person will be different.
Prior to leaving the clinic, you should be offered information about methods of contraception. Most forms of contraception can be started immediately, however, a discussion should take place regarding each person and their choice of method. Clinics should provide people with contact information, in case they have questions or concerns after the abortion.
To find the appropriate contraceptive methods of your choice, visit findmymethod.org
Download resources:
FREE AND SAFE ABORTION COUNSELING
We offer evidence-based information on safe abortion. Our free counseling service is safe, confidential, convenient, and free of judgement. We are waiting for your message!
By the safe2choose team and supporting experts at carafem, based on the 2022 Abortion Care Guideline by the WHO, the 2023 Clinical Updates in Reproductive Health by Ipas, and the 2024 Clinical Policy Guidelines for Abortion Care by NAF.
safe2choose is supported by a Medical Advisory Board formed by leading experts in the field of sexual and reproductive health and rights (SRHR).
carafem provides convenient and professional abortion care and family planning so people can control the number and spacing of their children.
Ipas is an international organization focused on expanding access to safe abortion and contraceptive care.
WHO – the World Health Organization – is a specialized United Nations agency responsible for international public health.
NAF – the National Abortion Federation – is a professional association in the USA supporting safe, evidence-based abortion care and reproductive rights.
[1] "Abortion care guideline." World Health Organization, 2022, Retrieved from: srhr.org/abortioncare/.
[2] Jackson, E. "Clinical Updates in Reproductive Health." Ipas, 2023, www.ipas.org/wp-content/uploads/2023/09/Ipas-Clinical-Updates-in-Reproductive-Health-CURHE23b.pdf Accessed November 2024. Accessed November 2024.
[3] "Clinical Policy Guidelines." National Abortion Federation, 2024, Retrieved from: prochoice.org/providers/quality-standards/.
[4] "Clinical practice handbook for quality abortion care". Geneva: World Health
Organization; 2023. Licence: CC BY-NC-SA 3.0 IGO. Retrieved from: https://iris.who.int/bitstream/handle/10665/369488/9789240075207-eng.pdf?sequence=1
[5] Weitz, T. A., Taylor, D., Desai, S., Upadhyay, U. D., Waldman, J., Battistelli, M. F., & Drey, E. A. (2013). Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver. American Journal of Public Health, 103(3), 454-461. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673521/
