Austin Women's Health Center Blog&Inspiration

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

September 23, 2020
medical vs surgical abortion

Navigating information about abortion can be difficult because of the endless anti-choice propaganda available that’s designed to shame us out of our decision. At Austin Women’s Health Center, we understand the decision to have an abortion can be a complex, yet necessary, decision — and we want to support you and offer you choices. If you’re considering abortion, you deserve accurate, evidence-based information when deciding what type of abortion is right for you. In this blog, we’ll discuss the differences between medication and surgical abortion, how each option works, and some tips to keep in mind!  


Medication Abortion (Available up to 10 Weeks Into Pregnancy)


Medication abortion is 98% effective when under 8 weeks, and it’s 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 things like anti-nausea medication, a prescription for pain relief, and misoprostol


24-48 hours after taking mifepristone with the doctor, the abortion is completed by continuing with the medication given the previous day. Misoprostol causes the pregnancy to expel from the uterus, and is accompanied by moderate to heavy bleeding and cramping for, generally, up to 12 hours. Because misoprostol is also a stomach ulcer medication, that means 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 through the process because of this. 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. 


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. We’re able to provide you with anxiety management, as well as 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 gently stretch the cervix. 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 that require a 2-day procedure — the doctor will insert laminaria, or medical-grade dried seaweed — into your cervix on the first day, which will absorb moisture and slowly expand your cervix overnight. When you come back the next day, the doctor will remove the laminaria, 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. Some people prefer a medical abortion because they want to be in the comfort of their own home, because of work schedules, or because they’re 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 own 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 
  • 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 are often managed with just ibuprofen


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