Our unique, individualized approach to abortion care includes ensuring you’re familiar with what to expect from the very beginning. We want to support your experience, especially since patients are required to navigate political obstacles in the form of abortion restrictions that make access more difficult. Not only will you meet with our doctor to discuss any questions and concerns about methods at your first visit, but at your second visit, you’ll also meet with a counselor to thoroughly review consent forms, to become familiar with what to expect during the procedure, and to answer any questions that may have come up since your first visit. A common question patients have is, “How long does a surgical abortion take?” In this blog, we’ll explain how a surgical abortion is performed, the efficacy rate, possible risks and complications, and how long you can expect the procedure to take.
Surgical Abortions Are Extremely Safe
A surgical abortion is 98% effective in terminating a pregnancy, which means a patient will not remain pregnant 98 out of 100 times. According to medical evidence, it’s even safer than a dental or cosmetic procedure. While commonly referred to as a “surgical” abortion, it actually isn’t surgery at all—no incisions are made! Some are even moving away from this language as it can be misleading, more intimidating for patients, and even add to the propaganda perpetuated by anti-choice extremists.
How Is A Surgical Abortion Performed?
A surgical abortion is a quick, non-invasive procedure that takes about 5-10 minutes. At Austin Women’s Health Center, we offer the use of IV sedation or valium, as well as nitrous oxide, to manage discomfort and anxiety you may have before and during the procedure. But some patients find the procedure is manageable with just ibuprofen beforehand, which we’ll administer to you after your counseling session. Before the procedure begins, we’ll make sure any sedation management has taken effect, and we’ll be checking in with you throughout to offer support and monitor your vital signs.
The procedure with the use of a speculum to separate the vaginal walls in order to see and sterilize the cervix. After injecting the cervix with lidocaine to numb and relax it, we’ll dilate your cervix using a dilating rod, and then apply suction by inserting a cannula through the cervix and into the uterus to remove the pregnancy. Both the dilation and suctioning can induce mild to intense cramping, and it’s also normal to feel pressure and a pulling or tugging sensation. However, both dilation and suctioning will only take about 1-3 minutes to complete. So, keep in mind that the procedure will be over quickly! If at any point you’d like to take a break, you can ask our nurses and doctor for one before continuing. It can also be helpful to try counting to 50, as generally the procedure will be over soon and counting can help distract ourselves from how we’re feeling.
If you’d like to use other relaxation techniques, we recommend practicing deep breathing during the procedure or using our headphones (or your own) to listen to music throughout. If you’re using IV sedation, also known as twilight sedation, it includes both medication for pain and anxiety, and it can also create the feeling of being asleep throughout the procedure — even though you’re still conscious! Many patients often don’t remember the procedure due to this. But it’s also normal to still feel aware during a surgical abortion with IV sedation, so if you still experience discomfort, keep in mind that it’s normal. We administer the most sedation that we can safely provide you, but not everyone responds to it the same way.
What is Recovery Like For a Surgical Abortion?
The recovery time for surgical abortion is minimal. Compared to medical abortion, or the pill option, postoperative bleeding is generally less, and there is no follow-up visit required. Expect to spend some time in our recovery room before being discharged, though, so we can assess your level of bleeding before you go home. If you’re using sedation, we also want to make sure you’re able to safely exit the building following IV sedation administration.
Many patients also don’t experience bleeding afterward until days three to seven following the procedure. Bleeding can range from mild to intense and can be accompanied by mild to intense cramping as well. You can expect to bleed for up to a week like normal to a heavy period, and we’ll make sure you have access to pain medication to manage any discomfort later.
What Are The Possible Complications and Risks of a Surgical Abortion?
Serious complications from a surgical abortion are rare. In fact, abortion is 14 times safer than continuing a pregnancy. According to the National Abortion Federation, in less than 1% of cases, perforation, infection, and excessive bleeding has occurred; all of which would require follow-up management. Additionally, since a surgical abortion is only 98% effective, there’s a small chance that the procedure may fail or be incomplete. This can be more of a concern in early pregnancies (less than 7 weeks since last menstrual period, or LMP), but our doctor takes steps to ensure that the procedure is successful. If we have concerns, we’ll speak with you about what we recommend as far as follow-up management. While there’s always a chance the abortion may fail, this doesn’t mean you’ll have to stay pregnant.
The History of Abortion
Prior to the late 1800s, abortion was largely unregulated. In fact, if a pregnant person wanted an abortion in the 17th and 18th centuries, there were no restrictions that could stop them. The first English settlers in America focused on community and families were the Puritans, and with them came their progressive take on abortion laws from England; abortion was seen as normal before “quickening” (typically between four and five months into pregnancy), no matter how many times it was needed. Through the help of each other in their communities, colonial women used herbal methods to induce abortions; surgical abortions at the time were considered rare and dangerous, but this was likely due to one Connecticut woman’s death resulting from complications of a later-term surgical abortion after a failed attempt at self-inducing an herbal abortion.
However, in the 19th century, the acceptance of abortion changed and by 1910 abortion was illegal in every circumstance except to save the pregnant person’s life — a result of several factors including changes in “social, class, and family dynamics.” In the Victorian era, it was thought that abortion was an issue caused by “upper-class white women who were choosing to start their families later and limit their size.” This independence from women was perceived as a threat to the patriarchy. By the mid-1900s, American doctors started battling “irregular” doctors, like midwives, who safely performed abortions in an attempt to assert the “legitimacy of male-dominated scientific medicine”, and illegitimate this form of healthcare entirely; emphasizing these “irregular” doctors were “unscientific.”
There was also systemic racism and xenophobia at play, as “white men were also concerned by shifting ethnic and racial dynamics in the United States, worrying that the low birthrate of the white upper class would lead to racial inferiors and un-American immigrants overrunning the country.” Not long after, a coalition of white, male doctors backed by the American Medical Association and the Catholic Church campaigned for the criminalization of abortion, and they “largely succeeded” in restricting a pregnant person’s access to abortion. One historian said restricting abortion was the only way white male physicians could “assert clear authority” over their female patients, and the Victorian anti-abortion movement demonized women who had abortions as “unnatural, selfish and undermining the expected, patriotic, and godly role of the American woman—that of wife and mother.”
Abortion remained criminalized until 1973 when Roe v. Wade established our protected right to have an abortion as we know it today. Under Roe, abortion is legal until at least 20 weeks except in cases of rape, incest, or if the pregnant person’s life is at risk. Several states have their own gestational limits that permit abortion beyond 20 weeks. Not long after Roe v. Wade legalized abortion, federal funding was banned from going towards most abortions under the Hyde amendment.
At Austin Women’s Health Center, we know all too well that our right to an abortion doesn’t mean much if we can’t access it, and as we’ve discussed before, Texas has the most cities 100 miles or more from an abortion clinic. And since most patients cannot use their public insurance, like Medicaid, to pay for their abortions, the out-of-pocket costs and long distances make accessing an abortion an impossibility for many. We have continued to provide the Austin area with abortion care for decades, including when Texas HB2 closed over half the state’s abortion providers—like our sister clinic Killeen Women’s Health Center—and when Texas Governor Greg Abbott and Attorney General Ken Paxton banned abortions temporarily earlier this year, deeming them non-essential during a global pandemic. And we’ll continue to provide it as the political landscape of abortion rights continues to shift.