Surgical Abortion: What to Expect

surgical abortion: what to expect

If you find yourself unexpectedly pregnant, you may experience a lot of different emotions. You may also be wondering what you should do and if abortion is something you want to go through with. You may be asking, “what's a surgical abortion? What should I expect?”

You may also be hearing a lot of different opinions and advice from others on what you should do. But the only person who can make those decisions is you. In addition to the physical effects of the abortion, there are also emotional effects to consider as well.

Where do I start?

Start with getting accurate medical information. Just like any other medical procedure, you shouldn’t rush into abortion without knowing the facts. The following will give you some of the information you need to know to make the best choices for your health.

It is also important to talk to someone supportive before making a decision. Doing so will allow you to work through your thoughts and feelings and clear your head before moving forward.

What should I know before I get an abortion?

  • How many weeks pregnant am I?
    • It is important to have accurate dates for your pregnancy. This will determine the type of abortion you are able to get[1].
    • After 10 weeks of pregnancy, the abortion pill is no longer an option[2][3].
    • Pregnancy weeks are calculated from the first day of your last menstrual period (LMP). If you are unsure when your last period was or have irregular periods, that calculation can be inaccurate.
  • Is the pregnancy in my uterus?
    • Sometimes a pregnancy can implant outside the uterus. This is a rare condition called an ectopic pregnancy and occurs in about 1-2 pregnancies out of 100. This is a medical emergency that needs immediate treatment[4].
    • Abortion will not treat an ectopic pregnancy[5].

The best way to answer the first two questions accurately is with an ultrasound[4]. Only an ultrasound can accurately date your pregnancy and determine that it is an intrauterine pregnancy.

We offer free pregnancy testing and ultrasounds to confirm pregnancy through referral relationship with onsite Care Clinic. 

  • What is my blood type?
    • If you have a certain RH type, you will need to get a shot of a medication after the abortion that will help prevent potential problems in future pregnancies, such as miscarriage. Make sure to ask if the doctor or clinic runs labs to check this[6][8].

Surgical abortions: what to expect

First trimester abortion

Vacuum aspiration abortion is the most common procedure in the first trimester, up to about 14 weeks. These usually take place in one visit.

Before the procedure is started, you may be given pain medication and/or antibiotics. After being positioned on the exam table with a speculum inserted, a local anesthetic will be used to numb the cervix.

The cervix is then dilated (stretched open) with metal rods. A suction tube is inserted through the cervix to suction out the embryo and other pregnancy related tissue.

Sometimes a curette, a surgical tool with a metal or hard plastic loop on the end, will be used to scrape out the inside of the uterus. This would be called a dilation and curettage (D&C) and is used more frequently the further along you are[6][7].

Second trimester abortion

After 14 weeks, dilation and evacuation (D&E) is the most common type of abortion. Due to the increased size of the fetus, the cervix must be opened farther. This procedure may require two visits.

At an appointment the day before your procedure, you may receive pain medications and will be positioned on the exam table with a speculum inserted. A local anesthetic will be used to numb the cervix, then special absorbent sticks (called laminaria) will be inserted into your cervix.

Over the next day they will swell up, slowly dilating your cervix. On the day of your procedure, you will be given sedation and pain medication (or anesthesia if at a hospital). The cervix will again be numbed, and the sticks used for dilation removed.

A suction tube will be inserted through the cervix to break the water. Surgical tools will then be used to remove the baby. Due to the size, it may not be removed all in one piece. Any pregnancy related tissue that is left behind will then be cleared out using suction[8].

What to expect after a surgical abortion

You will have a recovery period of an hour or two after the procedure where you will be observed for any immediate complications. You will need to have someone available to drive you home as you will not be allowed to drive due to the medications you were given.

Side effects to expect at home

  • Bleeding like a period lasting for 2-4 weeks. You may also pass clots or tissue.
  • Cramping lasting for a few days up to two weeks.
  • Breast tenderness can occur even in the first trimester due to hormone changes.
  • Engorgement occurs more often if you were in the second trimester, as your body was already preparing to make breastmilk. It typically starts 2-3 days after the abortion and lasts 1-2 weeks. You may note leaking as well[11][12].
  • Conflicting emotions are common following an abortion. While some people report feelings of relief, others also report feelings of sadness, grief, or loss. You may feel both at the same time, and you may find different emotions come up over weeks, months, or even years.
  • Depression and anxiety can develop post abortion. If you were unsure of your decision, felt pressured into it, or have a history of mental health struggles, you are at higher risk[8][10].

How to take care of yourself

  • Do not use tampons for the first two weeks. Doing so can increase the risk of infection. Avoid swimming and baths. Showering is ok. Do not douche or have sex.
  • Avoid strenuous activity or heavy lifting for the first few days. Heat packs and over-the-counter medications can help[6][8][9].
  • Wear a well-fitting bra, like a sports bra and use cold packs and over-the-counter medications as needed. Cold green cabbage leaves placed in the bra can also help[13].
  • Find a supportive person you can talk to and process your emotions with immediately after your abortion and over time as needed. You deserve to find the support you need.

Risks of surgical abortion

While major complications are rare, occurring in about 1 out of 100 patients (1%), there are risks you should know before you decide to get a surgical abortion.

These can include:

  • Excessive bleeding (hemorrhage)
  • Infection
  • Incomplete abortion
    • When fetal parts or tissue are left behind, requiring a second procedure
  • Injury to the uterus or cervix that may result in scarring
  • Perforation of the uterus with surgical tools
    • This can also result in damage to the bladder or bowel, and may require a second surgery to repair
  • Adverse or allergic reactions to medications or anesthesia
  • A blood clot developing in your leg or other part of your body[6]

Warning signs

If you experience any of these symptoms, contact your provider immediately or proceed to the nearest emergency room, as they require immediate medical attention.

  • Heavy bleeding
    • soaking 2 full size sanitary pads per hour for two hours in a row, or if you are concerned about prolonged heavy bleeding.
  • Shaking, chills, or fever of 100.4 or higher
  • Foul smelling vaginal discharge
  • Severe abdominal or pelvic pain
  • Feel lightheaded or dizzy
  • Chest pain or shortness of breath
  • Pain or swelling in one leg
  • Pain or pregnancy symptoms continuing beyond 2 weeks[8][9]

Care Pregnancy Resource Center is here for you

If you think you might be pregnant and you need support, we offer free and confidential medical grade pregnancy test verifications and limited obstetric ultrasounds.

During these appointments, you’ll have the opportunity to speak one-on-one with Care Clinic’s registered nurse, ask her all the questions you might have, and talk with someone through all your options.

If you've experienced a past abortion and need to talk with someone, you can reach out to us no matter how much time has passed. 

Seek professional help if you experience symptoms of depression, feel hopeless, or lose interest in activities you used to enjoy[8].

If you feel you are in crisis, call or text 988.

*Care Pregnancy Resource Center does not perform or refer out for abortionsAll medical services are provided through referral relationship with onsite Care Clinic. Care Clinic is staffed by licensed medical professionals.


  1. Center for Drug Evaluation and Research. Information about Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. U.S. Food and Drug Administration. (2021, December 16). 
  2. Center for Drug Evaluation and Research. Information about Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. U.S. Food and Drug Administration. (2021, December 16).
  3. Medication Guide, Mifeprex. U.S. Food & Drug Administration.
  4. Stanford Medicine. Ultrasound in Pregnancy. Children’s Health. 
  5. Medical Abortion. Mayo Clinic. (2022, July 29).
  6. MedlinePlus, Abortion - surgical. (2022, November 10).
  7. ScienceDirect, Vacuum Aspiration.
  8. UC San Diego Health, Understanding Dilation and Evacuation (D&E). (2022, November 1).,S,60065
  9. MedlinePlus, Abortion - surgical - aftercare. (2023, January 1).
  10. National Library of Medicine, The abortion and mental health controversy. (2018) October 29).
  11. ScienceDirect, The Experience of Breast Symptoms after Second-Trimester Abortion or Loss. (2023, May).
  12. Obstetrics & Gynecology, Breast Symptoms After Pregnancy Loss and Abortion: An Observational Study. (2020, April 25).
  13. Healthline, 7 Methods to Dry Up Breast Milk (and Methods to Avoid). (2023, February 8).