Medical abortion vs surgical abortion: how they differ

Two methods, one aim

There are two broad ways to end a pregnancy: with medication, or with a procedure. The World Health Organization describes both as very safe when the method is one it recommends, is appropriate to the duration of the pregnancy, and is provided by someone with the necessary skills.

Neither is “better” in general. The right method is the one that is clinically appropriate for you and that you feel comfortable with.

How they compare

Medical abortion uses medication. The pregnancy passes over a period of time with cramping and bleeding, in a process similar to a miscarriage. Some people value that it feels less clinical and can be more private. Others find the waiting and the bleeding harder than they expected.

Surgical abortion is a procedure carried out by a trained clinician in a clinical setting. It is over in a single visit, with the clinical team present throughout. Some people prefer that certainty. Others would rather avoid a procedure if they can.

What determines which is appropriate

Several things are weighed together:

• How far along the pregnancy is. This is the most important factor, and it is why assessment comes first.
• Your health. Certain conditions or medicines can make one method unsuitable.
• Practicalities. For example, how easily you can reach a clinic, and whether you would have privacy and support at home.
• Your preference. Where both methods are clinically suitable, the choice is yours.

What both have in common

Whichever method is used, good care looks the same at the start and at the end. It begins with a confidential consultation and assessment, includes a clear explanation of risks and alternatives before you consent, and finishes with aftercare and follow-up.

Questions worth asking

You are entitled to understand your care. It is reasonable to ask:

1. Based on my assessment, which methods are suitable for me, and why?
2. What will I experience, and for how long?
3. What pain relief is available?
4. What should I look out for afterwards, and who do I contact?
5. What follow-up will I have?

The decision is yours

A consultation does not commit you to anything. If you are unsure, say so. A good clinician will give you information and time, not pressure.