This page Includes: Your Pregnancy Situation—Surgical Abortion Summary—Surgical Abortion Procedures—Risks—Complications—Considerations—Questions—Abortion Clinic Research—Next Steps—Get Help—Glossary—Citations.

You are probably on this page because you are considering an abortion, due to an unexpected or unplanned pregnancy. You may be feeling emotional and unsure what to do next. You may have many questions. Your feelings and your concerns are important.

Women may have different and sometimes unexpected experiences during and after an abortion – physically, emotionally, and mentally. American Psychological Association (APA) research indicates it is important that women’s varied experiences of abortion be recognized, validated, and understood.1

Options Women’s Center is here for you. We can help you understand some possible abortion experiences you may have. We carefully listen and then walk through the surgical abortion details with you to help answer your abortion questions and provide information and resources as you consider your pregnancy options. We respect your right to choose and are sensitive to your need for support and help. All our services and information are FREE.

A surgical abortion is completed by surgically removing the contents of the uterus to end a pregnancy. The abortion surgery takes place in a clinic setting by licensed medical personnel.

There are currently two legal surgical abortion procedure methods in California. ^2,5  The difference is when and how each abortion procedure is done.

• Suction / Vacuum Aspiration – between 6 to 16 weeks gestational age.
• Dilation and Evacuation (D&E) – between 16 to 24 weeks gestational age.

Gestational age is the common term used during pregnancy to describe how far along the pregnancy is. It is measured in weeks, from the first day of the woman’s last menstrual cycle to the current date.

Since it is a surgical procedure, surgical abortion poses different risks than medical abortion, though both have some similar risks. With any medical procedure that affects your health, you should be aware of the details since it can affect your short term and long-term future.

The other abortion option is Medical Abortion / the Abortion Pill, which uses medication to end a pregnancy.

Before starting the abortion procedure, you must confirm you are pregnant with a viable pregnancy. This can be done with a pregnancy test and ultrasound. Options can be the first step in this process for you by providing FREE information about pregnancy and abortion options, and a FREE ultrasound.

A surgical abortion takes place in an abortion clinic or similar setting by licensed medical personnel.

Suction / Vacuum Aspiration Abortion ²

This surgical abortion method is sometimes also called a suction abortion, vacuum abortion, or first trimester abortion. This abortion procedure is done at 6 to 16 weeks gestational age. This procedure usually takes 10-15 minutes to complete. Recovery may require you to stay for up to 5 hours.

1. A vaginal speculum is inserted to spread and hold open your vaginal walls.
2. A numbing solution is administered to your cervix.
3. A tenaculum (a surgical instrument that resembles a pair of scissors with sharp pointed hooks at the end) is used to hold the cervix open so that it can be stretched wide enough by cone shaped rods to insert a cannula (a long plastic tube connected to a suction device).
4. The cannula will then suction out the contents of the uterus.
5. If complications or issues exist, then additional medical care by the abortion provider and/or other medical professionals may be required, such as a Dilation and Curettage (D&C) procedure. ^3,4

Dilation and Evacuation (D&E) Abortion ⁵

This surgical abortion method is sometimes also called an evacuation abortion or second trimester abortion. This abortion procedure is done at 16 to 24 weeks gestational age. This surgical abortion procedure normally takes about 30 minutes, with extended recovery time.

1. Usually 24 hours before a D&E abortion, the abortion provider will insert laminaria or a synthetic dilator inside the cervix.
2. At the time of the abortion procedure, sedation may be used. Some women may need deeper sedation.
3. Cone-shaped rods of increasing size are used to stretch your cervix to prepare you for the cannula. Depending on the gestational age, some providers may deliver a shot with a long needle through your abdomen to cause fetal demise before the procedure begins.
4. The cannula is inserted to begin removing the fetus. The lining is scraped with a curette (a surgical instrument designed for scraping biological tissue or debris) to remove any residual fetal parts. If the fetus is larger, forceps may be used to remove larger parts. Some providers prefer to crush the skull for easier extraction.
5. After the procedure, the woman needs to demonstrate stable vital signs, good pain control, and minimal vaginal bleeding before being released. A health-care professional trained in management of recovery care who can provide basic cardiopulmonary resuscitation and related emergency care must monitor the woman during this time.

If complications or issues exist, then additional medical care by the abortion provider and/or other medical professionals may be required, such as a Dilation and Curettage (D&C) procedure. ^3,4

A Surgical Abortion is a major decision since it is a medical procedure, with possible physical, mental, and emotional impact on your health. Therefore, it is important that you understand the step-by-step abortion process, legal issues, risks, side effects, possible complications, and alternatives.¹

It is wise to review the process ahead of time with a licensed medical professional, so you understand everything completely. Options can help inform you also.

Surgical abortion risks can include the following: ^{2, 6, 7, 10, 11}

• Sedation – some women may need deeper sedation
• Heavy vaginal bleeding
• Infection of the uterus
• Infection of the fallopian tubes (which can cause scarring and cause infertility)
• Puncture (perforation) of the uterus
• Scarring of the uterine lining (suction tubing, curettes and other abortion instruments may cause permanent scarring of the uterine lining)
• Damage to the cervix (creating complications with future pregnancies)
• Side effects and complications – see sections below.
• Death, in rare circumstances

Side effects may include physical and mental issues, and emotional feelings a person may have during or after an abortion.

Possible surgical abortion side effects can include: ^{1, 5, 7, 8, 9, 10, 11}

• Pelvic / abdominal pain – requiring pain management methods
• Intense cramping of the uterus – possibly for a few weeks
• Vaginal bleeding – excessive bleeding may require surgery to stop it
• Breast engorgement / lactation
• Emotional / psychological impact / distress

Complications are a secondary condition a person may have during or after an abortion.

Possible surgical abortion complications can include: ^{1, 5, 7, 8, 9, 10, 11}

• Hemorrhaging – excessive bleeding may require surgery to stop it
• Infection – indicated by fever, pain, foul smelling discharge
• Emotional / psychological impact / distress – may require medical or psychological assistance

We can discuss these and other topics with you during your visit to Options.

Miscarriage. This is a spontaneous loss of a pregnancy, so you may not need to take any abortion action if this occurs. About 10% to 20% of known pregnancies end in miscarriage, but the actual number is likely higher. ¹²

Your Rights. If you are unsure about what to do with your pregnancy, do not take the abortion pill or get a surgical abortion impulsively. If you have questions, are unsure, are being pressured or misled into an abortion, or are having second thoughts about abortion, consider speaking with Options. Please note that Options staff do not provide legal advice.

Costs. There are potential costs involved with an abortion, including financial, physical, mental health, social, and others.

STD Test. Before getting an abortion, you should get an STD test to prevent an active STD infection from spreading or having an impact on you long term.

Here are just a few pregnancy and abortion questions you may be asking, or you may have heard from others. Our team can help answer these questions and others you may have, at your Free appointment.

• How do I know for sure if I’m pregnant?
• Are there pros and cons of abortion?
• What are possible risks, side effects, and complications of surgical abortion?
• How much does surgical abortion cost?
• What are the best options for my situation?
• What type of abortion should I get?

Here are a few initial questions to ask an abortion clinic – we can help guide you through these and other issues you should address.

• Is the abortion provider a licensed medical clinic?
• Will a licensed OB/GYN physician perform the abortion procedure?
• Do they clearly and completely explain your legal rights?
• Do they clearly explain all the risks, side effects, and possible complications?
• What type of post abortion care, both physical and emotional, do they provide, if any?
• Do they provide reviews from other patients who have used their abortion services?

Ask to speak with other patients who have used their services to understand their experience – the positives and negatives.

Look at the clinic’s Yelp, Google, and other reviews online.

It is important to take one step at a time, and not get ahead of yourself and do something you may regret later. Sometimes emotions can get ahead of us. Taking one careful step at a time allows your emotions to catch up to the facts and information that you gather.

An ultrasound is the only way to confirm a viable pregnancy, fetal location, and gestational age (how far along you are). This information determines which abortion procedure you would qualify for, to help you make a decision with confidence.

The next best step is to schedule a FREE appointment with Options, so we can provide you with a free pregnancy test and free ultrasound. At this appointment, we also provide you with more details about abortion types, methods, risks, possible side effects and complications, costs, and alternatives. We can also help answer your questions.

After you have your FREE pregnancy test and ultrasound, you will have more information about your choices and can take the next steps. A registered nurse will be to provide you with more information.

Contact us today – 626-671-0581, office@optionslapuente.org, or request an online appointment.

All our services are FREE and confidential!

We are not an abortion provider or abortion referral agency, so we do not benefit financially from your decision.

We are here for you.

Cannula – a tube that can be inserted into the body, often for the delivery or removal of fluid.

Dilation and Curettage (D&C) – a procedure to remove tissue from inside a uterus.

Fetus – an offspring of a human in the early stages of prenatal development.

Uterus – an organ of the female reproductive system, located between the bladder and the rectum. It functions to nourish and house a fertilized egg until the fetus is ready to be delivered.

Vaginal speculum – is a tool that doctors use during pelvic exams. Made of metal or plastic, it’s hinged and shaped like a duck’s bill. Your doctor inserts the speculum into your vagina and gently opens it during your exam.

Content is reviewed for accuracy by licensed Medical Professional(s) and staff editor(s). Our editorial process.

12 Sources / Citations

¹ American Psychological Association (APA), Task Force on Mental Health and Abortion. (2008). Report of the Task Force on Mental Health and Abortion. Washington, DC: Author. Retrieved May 20, 2022 from http://www.apa.org/pi/wpo/mental-health-abortion-report.pdf

² CS Mott Children’s Hospital. (2023). Vacuum Aspiration for Abortion. Retrieved October 20, 2023 from https://www.mottchildren.org/health-library/tw1078

³ Mayo Clinic. (2021). Dilation and curettage (D&C). Retrieved October 20, 2023 from https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910

⁴ Cleveland Clinic. (2021). Dilation and curettage (D&C). Retrieved October 20 from https://my.clevelandclinic.org/health/treatments/4110-dilation-and-curettage-d–c

⁵ IPAS. (2018). Dilation and Evacuation. Retrieved October 20, 2023 from https://www.ipas.org/wp-content/uploads/2020/06/DESTRE18-DilationEvacuationReferenceGuide.pdf

⁶ Mayo Clinic. (2023). Incompetent cervix. Retrieved October 25, 2023 from https://www.mayoclinic.org/diseases-conditions/incompetent-cervix/symptoms-causes/syc-20373836

⁷ American Psychologist. (2009). Abortion and Mental Health – Evaluating the Evidence. Retrieved October 25, 2023 from https://www.apa.org/pubs/journals/features/amp-64-9-863.pdf

⁸ Mayo Clinic. (2022). Could an elective abortion increase the risk of problems in a subsequent pregnancy? Retrieved October 25, 2023 from https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/expert-answers/abortion/faq-20058551#:~:text=While%20many%20studies%20have%20shown,birth%20and%20low%20birth%20weight

⁹ Eastern Journal of Medicine. (2020). Psychological Effects of Abortion. An Updated
Narrative Review. Retrieved October 25, 2023 from https://jag.journalagent.com/ejm/pdfs/EJM_25_3_477_483.pdf

¹⁰ BMC Psychiatry. (2023). Global prevalence of post-abortion depression: Systematic review and Meta-analysis. Retrieved November 7, 2023 from https://pubmed.ncbi.nlm.nih.gov/37884930/ and  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05278-7#Sec27

¹¹ Psychiatry & Clinical Neurosciences. (2013). Abortion and subsequent mental health: Review of the literature. Retrieved November 7, 2023 from https://pubmed.ncbi.nlm.nih.gov/23859662/ and https://onlinelibrary.wiley.com/doi/10.1111/pcn.12067

¹² Mayo Clinic. (2023). Medical Abortion. Retrieved February 14, 2024 from https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/symptoms-causes/syc-20354298