Clinic 554
Medication vs Surgical Abortions
If you are less than 9 weeks pregnant, you may have the option of a surgical abortion or a medication abortion. The following chart provides some differences between a medication and surgical abortion? Please note that This information is meant to help guide your decisions about abortion, however it is not medical advice and you should always consult with a medical practioner.
| Medication Abortion | Surgical Abortion |
|---|---|
| Process: You swallow a pill that blocks the hormones which support the pregnancy. 24-48 hours later, you place other pills in your cheek or vagina/front hole. These pills cause the uterus to contract and push out the pregnancy tissue. This causes cramping and bleeding that is usually heavy. On average, the abortion is completed 3 days after the first pill, but it may take several weeks. There’s a chance that you made need a surgical abortion if the pills fail. | Process: Before the procedure, you take antibiotics to prevent infection and medications for pain, and to relax. The doctor freezes your cervix, then opens your cervix using an instrument called a dilator. The doctor places a tube into your uterus and uses a gentle suction to remove the pregnancy tissue. On average, the abortion is completed within 5 to 15 minutes. Certainty of completion is the same day |
| Safety: Very safe. Less than 1% of people experience problems like getting an infection or heavy bleeding that requires treatment such as a blood transfusion. The risk of death is extremely small (less than 1 in 100,000). Surgical abortion is required in some cases of heavy bleeding | Safety: Very safe, less than 1% of people experience problems like an infection or heavy bleeding that requires treatment like a blood transfusion. The risk of death is extremely small (less than 1 in 100,000) |
| Appointments: You may need 2-4 appointments and sometimes more. Before getting the medications you get assessed by a practitioner and get blood work done. After you take the medications, you get blood work done again to ensure the abortion was complete and have a follow up with a practitioner or nurse. Community health centres and hospitals often provide blood work and visits with a practitioner in one appointment. If the medication didn’t completely work, you will require more appointments. | Appointments: 1 day appointment that typically takes 2-3 hours. |
| Bleeding: Expect heavy bleeding and cramping for a few hours. A prescription for medication to manage pain may be provided. Expect 1-2 days of heavy bleeding and strong cramps that can range from worse than a normal period to pain that may feel like labour. You may see an identifiable fetus if the pregnancy is over 7 weeks. You may have some period-like cramps for a few days afterwards. Light bleeding usually continues for 2 weeks, but may last longer. |
Bleeding: Expect light bleeding. Moderate to strong cramping happens briefly during the procedure and usually improves within 20 minutes. Conscious sedation (a gas that helps you tolerate the cramping) is provided during the procedure. You will not see an identifiable fetus. You may have some period-like cramps for a few days afterwards. Light bleeding usually lasts for up to 2 weeks but may last longer. |
| Location: You can have the abortion at home or in any location that feels safe and comfortable | Location: Abortions are performed in a clinic or hospital with a specially trained doctor and nurse |
| Efficacy: 93-96% effective if the pregnancy is less than 9 weeks. Medications become less effective the longer the gestational age. Between 9-10 weeks the medications are 93% effective. 5 in 100 people may require a surgical abortion to complete the abortion | Efficacy: >99% effective. A second procedure is rarely required. |
| Side Effects: Side effects from the pain or medications include diarrhea, fever/chills, nausea, vomiting, dizziness and headache. These side effects usually happen over a few hours when the pregnancy is expelling from the uterus. These side effects can be treated with other medications There is no effect on fertility or your ability to get pregnant in the future |
Side Effects: Depending on the medication given, side effects from the medications could include drowsiness, nausea, mild abdominal pain, diarrhea and headache. There is no effect on fertility or your ability to get pregnant in the future |
| Support person: Medication abortion can be completed alone or with a support present. | Support person: You won’t be allowed to drive after a surgical abortion. Some people want to have a support person to take them home, however depending on the facility’s policies, you can take a bus, taxi, or walk home on your own. |
| Gestational Age: Can be done if you are less than 9 weeks from the first day of your last period. Some providers will go up to 10 weeks. | Gestational Age: You need to be at least 6 weeks from the first day of your last period. If you are beyond 16 weeks gestational age, you will need to access care outside of New Brunswick. |
| Coverage/Cost: Mifegymiso, blood work and doctor visits are covered under NB Medicare | Coverage/Cost: Only covered by NB Medicare if completed at Moncton City, George Dumont or Chaleur hospitals. Clinic 554 charges $700 and can arrange subsidies for those who cannot access care at a hospital and cannot afford fees. |