How Is Abortıon Performed?
How abortion is performed is a question frequently asked by people who are considering termination of pregnancy or who want to obtain medical information on this subject. Abortion is the termination of pregnancy by medical methods and must always be performed under appropriate healthcare conditions, by a specialist physician, and within legal limits [1][2][5].
Today, one of the most commonly used surgical methods in early weeks of pregnancy is vacuum aspiration. The World Health Organization recommends vacuum aspiration for surgical pregnancy terminations under 14 weeks and does not recommend the routine use of sharp curettage [1][4]. In Turkey, according to Law No. 2827 on Population Planning, uterine evacuation may be performed upon request until the completion of the tenth week of pregnancy, provided there is no medical contraindication for the mother’s health [5].
The abortion procedure may be planned under local anesthesia, sedation, or general anesthesia depending on the individual. Before the procedure, gestational age, intrauterine location, general health status, bleeding risk, medications used, and legal eligibility are evaluated [2][3]. Therefore, abortion should not be regarded as a “simple and risk-free” procedure; it should be considered a short intervention that nevertheless requires medical evaluation and sterile conditions.
Abortion Methods
Abortion methods are determined according to gestational age, the person’s health condition, legal limits, the facilities of the center where the procedure will be performed, and the physician’s evaluation. In early pregnancies, vacuum aspiration is the most commonly used surgical method [1][2]. Medical methods may also be used in some countries; however, applicability, legal regulations, and medical suitability may differ from country to country [1][2].
1. Vacuum Abortion — Vacuum Aspiration
Vacuum abortion is the process of emptying the uterine contents with the help of thin plastic cannulas and an aspiration system. The WHO recommends vacuum aspiration for surgical pregnancy terminations under 14 weeks [1][4]. The NHS also states that surgical termination in early pregnancy can be performed with vacuum aspiration [2].
Before the procedure, the gestational age is evaluated by ultrasound. The cervix is prepared appropriately, the anesthesia method is determined, and the pregnancy tissue is aspirated by placing a thin cannula into the uterus under sterile conditions. The procedure usually takes a short time; however, the total duration may vary from person to person, including preparation and observation stages [2][3].
2. Surgical Abortion — Dilation and Evacuation / Curettage
In later weeks of pregnancy or in cases where vacuum aspiration is not sufficient, different surgical methods may be required. The WHO recommends dilation and evacuation for surgical pregnancy terminations at 14 weeks and above [4].
The sharp curettage method, which was used more frequently in the past, is not recommended as a routine first-line option in modern guidelines. The WHO recommends preferring vacuum aspiration for surgical pregnancy termination under 14 weeks and not using dilation and sharp curettage [1][4]. Therefore, in the current approach, the aim is to empty the intrauterine tissue as safely and controllably as possible while reducing the risk of complications.
Comparison of Abortion Methods
| Method | Advantages | Points to Consider |
|---|---|---|
| Vacuum aspiration | It is a commonly used, short-lasting surgical method in early pregnancies and is recommended in modern guidelines [1][2][4]. | Gestational age, intrauterine location, bleeding risk, and legal eligibility should be evaluated before the procedure. |
| Dilation and evacuation | It is one of the methods used when surgical termination is required in later weeks of pregnancy [4]. | As gestational age advances, the procedure requires more expertise, preparation, and follow-up. |
| Sharp curettage | Today, it may be used in some special medical situations. | The WHO does not recommend routine sharp curettage in early surgical pregnancy termination [1][4]. |
When choosing an abortion method, not only the duration of the procedure but also gestational age, the person’s health status, uterine structure, bleeding risk, suitability for anesthesia, and post-procedure follow-up conditions should be evaluated together [2][3].
Abortion Prices
Abortion prices may vary depending on the healthcare institution where the procedure will be performed, the physician’s experience, gestational age, type of anesthesia, pre-procedure tests, ultrasound evaluation, and the post-procedure follow-up plan.
However, when evaluating price, not only the fee but also whether the procedure is performed within legal limits, sterile conditions, anesthesia safety, emergency intervention facilities, and the post-procedure follow-up process should be taken into account. Pregnancy terminations performed under unsafe conditions may lead to serious bleeding, infection, uterine injury, and complications that may affect fertility [1][2][3].
In Turkey, the legal limit for elective pregnancy termination is evaluated under Law No. 2827. It is not correct to provide a definite price before gestational age and medical eligibility are clarified [5].
What Is Abortion and How Does It Happen?
Abortion is the process of emptying pregnancy tissue inside the uterus using medical methods. In early weeks of pregnancy, the vacuum aspiration method is most commonly used [1][2]. Before the procedure, it is necessary to confirm that the pregnancy is located inside the uterus, determine the gestational age, and evaluate the person’s general health condition [2][3].
Ultrasound is usually performed before abortion. Rh incompatibility, bleeding risk, medications used, allergies, and previous surgeries are questioned. The anesthesia plan is determined according to the person’s condition and the scope of the procedure [2][3].
During the procedure, the cervix is prepared as needed and the uterine contents are aspirated with the help of a thin cannula. After the procedure, the person is kept under observation for a while. Bleeding, pain, blood pressure, general condition, and, if necessary, ultrasound findings are evaluated [2].
After the procedure, mild cramp-like pain and vaginal bleeding may occur. The NHS states that pain and bleeding may occur for a few days after surgical pregnancy termination [2]. However, a doctor should be consulted in cases such as heavy bleeding, foul-smelling discharge, fever, or severe abdominal pain [2][3].
Is Abortion Harmful?
It is not correct to describe abortion as having “no harm at all” or being “completely risk-free.” When performed under safe healthcare conditions, at an appropriate gestational age, and by a specialist physician, the risk of serious complications is low; however, like every medical intervention, abortion also has some risks [1][2][3].
Possible risks that may be seen after abortion include:
- Bleeding
- Infection
- Retained tissue inside the uterus
- Injury to the cervix or uterine wall
- Side effects related to anesthesia
- Pain and cramping
- Very rarely, uterine perforation
- Psychological difficulty or emotional fluctuations after the procedure
The WHO emphasizes the importance of providing safe and evidence-based pregnancy termination services within the healthcare system [1]. Following post-procedure recommendations, monitoring signs of infection, and not missing the follow-up appointment are important for early recognition of complications [2][3].
How Is Painless Abortion Performed?
What is commonly referred to as painless abortion usually means that the procedure is performed with appropriate anesthesia or sedation support. During abortion, local anesthesia, sedation, or general anesthesia options may be evaluated. Which method will be used is determined according to the person’s health condition, gestational week, anxiety level, and the evaluation of the anesthesiologist/physician [2][3].
Thanks to anesthesia, the sensation of pain during the procedure can be significantly reduced. However, after the procedure, cramps similar to menstrual pain and mild bleeding may occur due to uterine contractions [2]. Therefore, the expression “painless” does not mean that there will be no pain at all after the procedure.
If general anesthesia or sedation is planned, fasting for a certain period before the procedure may be required. This duration is determined according to the type of anesthesia and the protocol of the healthcare institution. Medications used, allergies, and chronic diseases must be reported to the physician before the procedure [2][3].
How Is Abortion Performed? How Long Does It Take?
The duration of the abortion procedure may vary depending on gestational age, the method used, uterine structure, type of anesthesia, and the person’s medical condition. Vacuum aspiration often takes a short time; however, the time spent in the clinic may be longer when preparation, anesthesia, and post-procedure observation are included [2].
The general stages of abortion are as follows:
- Preliminary evaluation: Gestational age, intrauterine location, general health status, and legal eligibility are evaluated [2][5].
- Ultrasound: The week of pregnancy and its location inside the uterus are checked.
- Anesthesia plan: Local anesthesia, sedation, or general anesthesia options are evaluated.
- Cervical preparation: When necessary, the cervix is prepared for the procedure.
- Vacuum aspiration: The uterine contents are emptied in a controlled manner with the help of a thin cannula [1][2].
- Control: Bleeding, pain, and general condition are evaluated.
- Discharge and recommendations: Medications, follow-up appointment, and warning signs to watch for are explained.
Mild bleeding and cramping may be expected after the procedure. Re-evaluation is required in cases of excessive bleeding, foul-smelling discharge, fever, severe pain, feeling faint, or continued pregnancy symptoms [2][3].
Things to Consider After Abortion
Post-abortion care is important for reducing the risk of infection and ensuring a safe recovery process. After the procedure, medications recommended by the doctor should be used regularly, and the follow-up appointment should not be missed [2][3].
Things to consider after abortion include:
- It should be known that mild cramping and bleeding may occur in the first days.
- If the doctor has recommended painkillers or antibiotics, they should be used regularly.
- Intense exercise and heavy lifting should be postponed for a short time.
- The period recommended by the doctor should be awaited before returning to sexual intercourse.
- Practices that may increase the risk of infection, such as tampon use, vaginal douching, or swimming pools, should be avoided.
- A doctor should be consulted in cases of fever, foul-smelling discharge, severe pain, or heavy bleeding.
- An appropriate birth control method should be planned to prevent a new pregnancy [1][2].
Fertility may return within a short time. Therefore, it is important to consult a physician about contraception after abortion to prevent an unintended pregnancy [1][2].
Frequently Asked Questions About Abortion
In early pregnancies, abortion is most often performed with the vacuum aspiration method. The uterine contents are emptied in a controlled manner with the help of a thin cannula [1][2].
The vacuum aspiration procedure often takes a short time; however, the total time spent in the clinic may be longer when preparation, anesthesia, and post-procedure observation are included [2].
Pain during the procedure can be reduced with anesthesia or sedation. After the procedure, cramps similar to menstrual pain and mild bleeding may occur [2].
No. Under safe conditions, the risk is low; however, bleeding, infection, uterine injury, retained tissue, and anesthesia-related risks may occur [1][2][3].
According to Law No. 2827 on Population Planning, uterine evacuation may be performed upon request until the completion of the tenth week of pregnancy, provided there is no medical contraindication for the mother’s health [5].
Mild or moderate bleeding may last for a few days. A doctor should be consulted if there is heavy bleeding, large clots, foul-smelling discharge, or fever [2][3].
The time to resume sexual intercourse varies depending on the person’s recovery and the physician’s recommendation. To reduce the risk of infection, the period specified by the doctor should be awaited [2][3].
Yes. Fertility may return within a short time. If a new pregnancy is not desired, an appropriate birth control method should be planned after the procedure [1][2].
A doctor should be consulted in cases of fever, foul-smelling discharge, severe abdominal pain, heavy bleeding, feeling faint, or continued pregnancy symptoms [2][3].
The price may vary according to gestational age, type of anesthesia, healthcare institution, tests, and follow-up process. An examination and gestational age evaluation are required for an exact fee.
References
- World Health Organization (WHO). Abortion care guideline, 2022. (https://www.who.int)
- NHS. Abortion. (https://www.nhs.uk)
- American College of Obstetricians and Gynecologists (ACOG). Induced Abortion. (https://www.acog.org)
- NCBI Bookshelf / WHO. Abortion care guideline, second edition. Surgical abortion recommendations. (https://www.ncbi.nlm.nih.gov)
- Law No. 2827 on Population Planning. Article 5. (https://www.lexpera.com.tr)