Austin Women's Health Center Blog&Inspiration

UPDATED: Medication Abortion vs. Surgical Abortion: Which is Best For Me?

March 30, 2022
Medical Vs. Surgical Abortion

Updated: March 30, 2022

Navigating an abortion can be complex, especially if you’ve been shamed or live in a state that doesn’t provide resources. At Austin Women’s Health Center, we understand that the decision to have an abortion can be a complex yet necessary decision — and we want to support your choices. If you’re considering abortion, you deserve accurate, evidence-based information when deciding what type of abortion is right for you. This blog will discuss the differences between medication and surgical abortion, how each option works, and some tips to keep in mind! 

Medication Abortion (Available up to 6 Weeks Into Pregnancy)

Medication abortion is a two-part process that requires taking the first pill, mifepristone, in-office with our doctor at the visit following your initial ultrasound. Mifepristone blocks progesterone and stops the growth of the pregnancy. It’s possible to have side effects, such as nausea, dizziness, cramping, or bleeding from this medication, and it’s possible — but less common — that patients will pass the pregnancy with the first medication. You’ll be given a packet that includes anti-nausea medication, a prescription for pain relief, and misoprostol. 

24 to 48 hours after taking mifepristone with the doctor, the abortion is completed by continuing with the medication given the previous day. Misoprostol expels the pregnancy from the uterus and is accompanied by moderate to heavy bleeding and cramping for up to 12 hours. 

Because misoprostol is also a stomach ulcer medication, it can be harsh on our stomach — which means you might feel a little sick throughout the process. It’s also helpful to avoid spicy, greasy, or fried foods throughout the process. Once the pregnancy passes, you can expect to keep bleeding for up to two weeks afterward — sometimes less, sometimes more— and the level of bleeding can still vary from mild to heavy. You’ll have a follow-up visit to confirm the abortion was complete, and if it isn’t, we will provide you with a surgical abortion at no charge. 

While medication abortion has been approved for use up to 10 weeks of pregnancy by the FDA, additional research shows that medication abortions conducted beyond ten weeks are safe and effective. 

The effectiveness of medication abortion depends on how far along you are:

  • For people who are eight weeks pregnant or less, medication abortion is 94 to 98% effective
  • For people who are 8 to 9 weeks pregnant, medication abortion is 94 to 96% effective
  • For people who are 9 to 10 weeks pregnant, medication abortion is 91 to 93% effective
  • For people 10 to 11 weeks pregnant, medication abortion is 87% effective.

Medication abortions usually work. If the medication abortion doesn’t work, you can take additional medications as prescribed by your provider or have a clinic abortion. 

According to an analysis by the Guttmacher Institute, as of 2020, medication abortions account for the majority (54% of all US abortions. This finding signals that medication abortion has become a more widely accepted form of abortion. 

Research has shown that direct-to-consumer medication abortion accompanied with telemedicine is safe, effective, and works well with patients. But beyond being convenient and safe to use, it also allows people to navigate this daunting time in their own homes. 

Surgical Abortion (Available up to 16-18 weeks Into Pregnancy)

Unlike a medication abortion, a surgical abortion (98% effective) completes the abortion process while you’re at the clinic and accompanied by our doctor, nurses, and other trained clinic staff. In addition, we’re able to provide you with anxiety management and IV sedation that helps with both anxiety and discomfort, but not all patients find it necessary. 

A surgical abortion involves injecting a local anesthetic to numb the cervix before using a dilator for a short amount of time to stretch the cervix gently. Once the cervix is dilated, a cannula is inserted into the uterus, and suction is used to remove the pregnancy. It takes around 5 minutes to complete, and afterward, you’ll spend some time in our recovery room — where we have snacks, heating pads, and comfortable seating — while being monitored by our nurses before going home. For pregnancies requiring a 2-day procedure, the doctor will insert laminaria, or medical-grade dried seaweed — into your cervix on the first day, absorbing moisture and slowly expanding your cervix overnight. The doctor will remove the laminaria when you come back the next day, and the abortion will continue as described before. 

Deciding Which Method Is Best For You 

Thinking about what method is best for you before you arrive at the clinic can help you be prepared and know what to expect. For example, some people prefer a medical abortion because they want to be in the comfort of their own home, work schedules, or parents and don’t have childcare for the necessary three visits. Others prefer a surgical abortion because they feel most comfortable completing the abortion with a doctor in a licensed medical clinic, which is faster to complete, and they don’t have to come back for a follow-up visit. Below are some benefits to each method that may help you decide:

Medication Abortion

  • It can be used early on in pregnancy 
  • It requires no in-clinic procedure or anesthesia
  • The process is non-invasive
  • You’re able to eat before and throughout the process
  • It can be done in the comfort and privacy of home, supported by family or friends
  • Some feel more in control of their bodies
  • It may feel more “natural” for some as it is similar to a heavy period or miscarriage

Surgical Abortion

  • A surgical abortion is quick, effective, and safe
  • The abortion is completed in a licensed medical clinic with a doctor and other trained staff 
  • It can be completed in around 5 minutes
  • IV sedation and anxiety management is an option
  • There is no follow-up visit required 
  • It is available later in pregnancy
  • Less bleeding afterward 
  • Discomfort from cramps post-surgical abortion is often managed with just ibuprofen

If you still can’t decide? That’s okay! You’ll get the opportunity to go over your options again with a doctor at our clinic on your first visit, and when you come back, you’ll meet with a counselor before starting the process for any last questions or concerns.