How a Medical and Surgical Abortion Differ

If you’re facing an unplanned pregnancy, you’re not alone: millions of women in the United States deal with unintended pregnancies every year. Although many women decide to carry an unexpected pregnancy to term, an estimated two in five women choose to end their pregnancy with either a medical or surgical abortion. 

If you’re considering having an abortion, it’s important to understand what your options are. Let’s explore the difference between medical abortions and surgical ones, and how timing can have a major influence over which procedure is best. 

Medical abortion basics

Also known as non-surgical abortion, a medical abortion uses two different medications to terminate an early pregnancy. Early pregnancy is defined as being within the first 70 days (10 weeks) of the first trimester, as determined by an ultrasound.  

The first medicine, mifepristone, interferes with your body’s production of progesterone, a hormone that’s required to maintain pregnancy; without progesterone, the pregnancy sac detaches from the uterine wall and stops progressing. 

The second medicine, misoprostol—which is sometimes referred to as the “abortion pill”—facilitates a miscarriage by making your uterus shed the pregnancy. Both of these medications are FDA-approved. 

Mifepristone and misoprostol can only be used to terminate an early, normal pregnancy in the uterus; they’re not effective for ectopic (tubal) pregnancies. 

There is a medical abortion option for ectopic pregnancies, however; known as the “abortion shot,” it combines methotrexate and misoprostol to stop the rapidly dividing cells of ectopic pregnancy and induce a miscarriage.  

The medical abortion success rate

The abortion pill is very effective, particularly in the first 49 days (7 weeks) of pregnancy, which is when it works 98% of the time. Between the 8th and 10th week of gestation, it’s effective 91% to 96% of the time. The abortion shot effectively terminates an early ectopic pregnancy 94% to 95% of the time.

Surgical abortion basics

A surgical abortion, also known as an in-clinic abortion, is a safe and highly effective medical procedure that can be used to end a pregnancy that’s anywhere between the early stages of the first trimester and, in the state of Florida, the 24th week of the second trimester, as determined by an ultrasound.

There are two main types of surgical abortions, both of which use suction to gently remove a pregnancy from your uterus. If your pregnancy is more advanced, the procedure is a bit more involved.  

First-trimester surgical abortion

An early surgical abortion can be performed using menstrual aspiration as soon as one to three weeks after your first missed period, and up to your 7th week of pregnancy as determined by an ultrasound. With this simple method, a thin, ultrasound-guided syringe is used to remove the embryonic tissue from the uterine lining. 

If you’re between your 8th and 12th week of pregnancy, surgical abortion is done via vacuum aspiration or dilation suction. This sterile, gentle procedure uses ultrasound guidance to ensure all embryonic tissue is removed from your uterus. 

Second-trimester surgical abortion

Once you enter your 13th week of pregnancy, you’re in your second trimester. In the state of Florida, second-trimester abortions can be performed up until the 24th week of pregnancy. 

An early second-trimester surgical abortion, performed between weeks 13 and 16, is very similar to a first-trimester vacuum aspiration procedure. Because the pregnancy is more advanced, however, your cervix must be dilated in advance, and because your uterus is softer at this stage, the procedure must be performed slowly.  

Starting at your 17th week, surgical abortion becomes more complicated. A late second-trimester abortion is a two-step process that takes two days. 

First, you’re given medication that dilates your cervix overnight. The abortion is performed the next day, using gentle suction and medical tools to remove the contents of your uterus.   

The surgical abortion success rate

Surgical abortion is more than 99% effective, fewer than 1% of patients require a repeat procedure. Because of its ultra-high success rate, surgical abortion is the go-to solution for incomplete or failed medical abortions.

The bottom line

If your pregnancy is in the early stages of the first trimester, opting to have a medical abortion allows you to experience it in the comfort of your own home, either with the support of a loved one or on your own. Because a medical abortion is similar to a miscarriage, many women feel that it’s more “natural” and less invasive. 

Although a surgical abortion is your only option once you’re past the 10th week of pregnancy, there are still advantages to choosing this method to end an early pregnancy. 

Supported by a fully trained medical staff from start to finish, surgical abortions are much faster than medical abortions. Once you’re fully dilated, it usually takes no longer than 10 minutes. Much like a miscarriage, a medical abortion may take up to 24 hours.

If you’d like to learn more, the experienced team at Eve Medical of Miami can help. Call our Miami office today, or use the easy online tool to schedule an appointment with one of our women’s health experts.