This leaflet answers common questions about surgical abortion using vacuum aspiration under local anaesthetic. If you would like further information, or have any particular worries, please do not hesitate to ask your nurse or doctor.

In all cases, a doctor will explain the procedure to you and answer any questions you may have.

What is a surgical abortion using vacuum aspiration?

A surgical abortion using vacuum aspiration is a procedure where a thin tube is inserted through the neck of the womb and gentle suction is used to remove a pregnancy. This can be done using local or general anaesthetic. When done using local anaesthetic it is known as manual vacuum aspiration or MVA.

Who is this type of procedure for?

You can have a surgical abortion using vacuum aspiration under local anaesthetic up to 12 weeks of pregnancy. This is a safe option for most women, but for some it might not be recommended, for example if you have large fibroids (harmless growths) in the womb or if you have had previous surgery to the neck of the womb.

What will happen before the procedure?

Before the procedure, the doctor or nurse will carry out a medical assessment where you will be asked questions about this pregnancy, and whether you have any medical problems or take any regular medications. This is to ensure that surgical abortion using vacuum aspiration is a safe and appropriate option for you.

They will also ask about your feelings about this pregnancy and your decision to have an abortion. This is to check that no one is pressuring you into having an abortion, and to support you with your decision if you need it. Whether or not you have an abortion is your choice and you will be treated in a non-judgemental and respectful manner. If you have any worries or concerns, or are unsure about what to do, please discuss it with the doctor or nurse. There is also a counselling service available if you need further support.

You will be advised about the process of having a surgical abortion and the possible complications. You will then be asked to sign a consent form to confirm that you understand the information given to you. This does not mean that you are obliged to proceed with the abortion, you can change your mind at any time. You will also be asked about whether you would like contraception and informed about the different options available.

An ultrasound scan will be carried out to accurately determine how many weeks pregnant you are, as well as a blood test. You will also be offered a self-taken swab test for sexually transmitted infections (STIs).

What are the risks of this type of procedure?

Abortion is a very common and safe procedure and complications are rare, especially earlier in pregnancy. Possible complications include:

  • Infection of the womb – around 1 in 100.
  • Failure of the procedure (where the procedure fails to end the pregnancy) - less than 1 in 100.
  • Retained products of conception (where some of the pregnancy tissue may be left inside the womb) - around 1 in 100.
  • Severe bleeding (very heavy bleeding that may require a blood transfusion) - less than 1 in 1000.
  • Cervical tear (damage or a small tear to the neck of the womb) – less than 1 in 100.
  • Uterine perforation (making a small tear in the womb) – less than 1 in 1000.

If you experience any complications, you may require further procedures such as a repeat vacuum aspiration, laparoscopy (keyhole surgery) or a blood transfusion.

Is there an alternative to a surgical abortion?

Up to ten weeks of pregnancy, it is possible to have a medical abortion where medication is taken to end the pregnancy. Please ask the doctor or nurse if you would like more information on this option.

What to expect on the day of the procedure?

It is recommended that you have something light to eat on the day of the procedure.

When you arrive at the ward you will be given some pain relief medication as well as some a medication called misoprostol. This softens the neck of the womb in preparation for the procedure and takes around one hour to work.

During the procedure, a speculum (plastic tube) will be inserted into the vagina, and anaesthetic medication is injected into the neck of the womb (cervix) to numb the area.

Narrow rods (called dilators) are then used to open the neck of the womb if needed, and a thin suction tube is then inserted through the neck of the womb. A hand-held suction device will then gently empty the womb. You will feel cramps, like period pains, during the procedure. A nurse will stay with you to support you during the whole process.

The procedure usually takes 10 to 20 minutes. You will be able to go home 30-45 minutes afterwards if you feel well enough.

What will happen with the pregnancy tissue?

You will be asked about what you want to happen with the pregnancy tissue that is removed from your womb. Most people opt for the hospital to take care of this, and the pregnancy tissue is disposed of in a sensitive manner. However, you have the option to make alternative arrangements if you wish. The doctor or nurse can discuss this with you.

What to expect after a surgical abortion?

You may experience bleeding like a period, for up to 10 days, which should get lighter with time. Most women feel well enough to return to work and other normal activities within a day or two. You can resume sexual activity whenever you feel comfortable to do so.

Most women feel relieved after an abortion, but it can be normal to go through a range of emotions including sadness and maybe even guilt. If you would like to talk to someone about how you are feeling after the abortion you can be referred to a counselling service, please discuss this with the doctor or nurse.

You do not need to attend the clinic again after a surgical abortion unless there is a problem, or you have any other concerns.

When should I seek help?

You should seek help if you have any of the following:

  • bleeding that is not getting lighter with time, is worsening or very heavy.
  • vaginal discharge that smells unpleasant.
  • constant lower abdominal pain or deep pain during sex.
  • fever or feeling shivery.

You can call the clinic within working hours on 020 7830 2495, or alternatively your GP or 111. In an emergency, please call 999 or attend A&E.

When should I start using contraception again?

If you have been given contraception such as pills or patches these should be started straight away, ideally on the day of the abortion, or as soon as possible afterwards. This is because you are at risk of getting pregnant again very quickly, as early as one week after the abortion.

If you have chosen to have an implant or contraceptive coil, these can be fitted at the same time of the procedure. You can read more about contraceptive coils and the implant on the Sexwise website.