Providing high quality, comprehensive reproductive health services for women

 

University of Miami Reproductive Health Services

Procedures

Types of Sedation used:

Mild

Conscious 

Medical Abortion

Who should get it?

Women who are less than nine weeks pregnant. This procedure does not require instruments inside the body.

How does it work?

This is a multi-step process. First, at our office, you will take a pill to prevent your pregnancy from continuing to develop. One to three days later, at home, you will take a different medication that will cause your uterus to contract and expel the pregnancy.

You will probably experience strong cramps and may have some nausea. We will provide you with pain-relief medication. You must have a support person at home with you while you are passing the pregnancy. Women usually have heavy bleeding for several hours after this medication and then experience light to moderate bleeding for about two weeks.

Your first appointment may take between one and two hours and you will need a shorter second appointment one or two weeks later to confirm that the pregnancy has passed.

How effective is it?

This procedure is 95 to 98 percent effective in successfully terminating a pregnancy.

Manual Vacuum Aspiration

Who should get it?

Women who are between three and seven weeks pregnant.

How does it work?

Manual vacuum aspiration usually takes between five and 15 minutes. It can be done using local anesthetic and a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen. The doctor will insert a speculum into the vagina and apply a numbing medication to the vagina and cervix. Then, the doctor will pass a thin tube through the cervix and into the uterus. A handheld syringe is attached and used to suction the tissue out of the uterus. As the uterine tissue is removed, the uterus will contract; most women feel cramping during the procedure. The cramps will lessen once the tube is removed. Some women also have nausea, sweating, or feel faint. You should rest after the procedure and resume regular activities the next day.

After the procedure you will experience irregular bleeding or spotting for the first two weeks. You may also have cramps similar to menstrual cramps, which may be present for several hours and possibly for a few days, as the uterus shrinks back to its normal size.

How effective is it?

First-trimester surgical abortions are safe and effective and have few complications. Infection is less likely to develop after an aspiration procedure than any other type of surgical abortion. An aspiration procedure is 97% effective in terminating pregnancy.

Dilation and Suction Curettage (D&C)

Who should get it?

Women who are five to 14 weeks pregnant qualify for this procedure. Some women who are otherwise eligible for medication abortion may prefer dilation and curettage because a D&C is slightly less likely to require a repeat procedure or intervention. It also requires less time and does not generally cause heavy bleeding at home. Finally, it usually requires only one visit to the clinic.

How does it work?

The doctor uses suction to empty the uterus. You will be given medication to help relax you and control your discomfort before the procedure. The doctor will numb and gradually widen the opening to your uterus (the cervix), and then place a narrow plastic tube into your uterus. Suction from a hand-held device or an electric machine is applied to the other end of the tube to empty your uterus.

You may experience cramping during and after this short procedure. You may have light to moderate bleeding for about one to two weeks afterwards. Your visit will last about two hours but more time may be required depending on the gestational size of your pregnancy. You must have someone available to take you home after the procedure. A follow-up visit is usually not required.

How effective is it?

D&C is 98 percent effective in successfully terminating pregnancy.

Dilation and Evacuation (D&E)

Who should get it?

Women who are 14 to 23 weeks pregnant.

How does it work?

The doctor will use suction and instruments to empty your uterus. During the first visit, which will take one to two hours, the doctor will insert laminaria (thin sticks made from seaweed) into the opening, or cervix, of your uterus. The laminaria gradually widen as they absorb moisture from your body, causing the cervix to widen. You may experience cramping overnight and should go home and rest after the procedure.

The next day, you will be given anesthesia and the doctor will use suction and instruments to empty your uterus. You may have some cramping after the procedure and light to moderate bleeding for about two weeks. Although the procedure only takes about 30 minutes, your entire second visit will last about five hours. You must have someone available to take you home after the D&E. A follow-up visit after the procedure is usually not required.

How effective is it?

D&E is the most common and safest procedure used (95% of the time) for an abortion in the second trimester.