There are several types of abortion, and the options depend on the duration of the pregnancy. They include medical abortion, vacuum aspiration, dilation and evacuation, and labor induction.

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Abortion is a medical means of ending a pregnancy. Worldwide, around half of all reported unintended pregnancies end in abortion.

This article discusses the different types of abortion and what they involve. It also looks into their advantages and disadvantages, recovery, and potential risks.

Key facts:

  • A person can have an abortion by taking medication or undergoing surgery.
  • The stage of the pregnancy usually determines the type of abortion.
  • In the United States, different states have different laws on whether or when a person can have an abortion.

On June 24, 2022, the Supreme Court of the United States overturned Roe v. Wade, the landmark 1973 ruling that secured a person’s constitutional right to an abortion.

This means that individual states are now able to decide their own abortion laws. As a result, many states will ban or severely restrict abortion access.

The information in this article was accurate and up to date at the time of publication, but the facts may have changed since. Anyone looking to learn more about their legal rights can message the Repro Legal Helpline via a secure online form or call 844-868-2812.

Where abortion is legal in the U.S., doctors usually perform them in the first trimester or the early part of the second trimester.

The first trimester lasts from conception to week 12 of pregnancy. The second trimester is from week 13 to week 28. Some states may allow abortion in the latter part of the second trimester.

In 2015, two-thirds (65.4%) of reported abortions in the country took place when the pregnancy had lasted fewer than 8 weeks, according to the Centers for Disease Control and Prevention (CDC).

In the same year, almost all reported abortions (91.1%) took place when the pregnancy lasted fewer than 13 weeks.

First trimester termination

In the first trimester, options for abortion commonly include medical abortion or vacuum aspiration.

A person can usually access medical abortion until about 7–9 weeks after their last period. It involves taking two types of medication.

Surgical options, such as vacuum aspiration and dilation and evacuation, are more common between 6 and 14 weeks of pregnancy.

Second and third semester termination

In the second trimester, a pregnant person may undergo dilation and evacuation (D&E). Doctors typically perform this between weeks 12 and 24.

In the third trimester, a pregnant person may undergo labor induction abortion. However, this is very rare. Only 1% of abortions take place in after 21 weeks, according to a 2018 survey of abortions in the U.S. published in 2020.

A medical abortion requires a pregnant person to take pills at separate times.

How it works

This type of abortion involves taking two medications: mifepristone (Korlym, Mifeprex) and misoprostol (Cytotec).

Typically the person will take 200 milligrams (mg) of mifepristone. They should take the second medication, misoprostol, no more than 24–48 hours after taking mifepristone.

A doctor may recommend they take it orally by swallowing, by placing it between the gum and cheek or under the tongue, or vaginally.

Mifepristone stops the pregnancy from developing, while misoprostol triggers the uterus to empty, which will begin 2–24 hours after taking the pill.

A person will experience cramping and bleeding as the uterus empties, which may feel like having an unusually heavy period. Some people feel more severe cramping than others.

Advantages

Some advantages of a medical abortion are:

  • It does not involve surgery.
  • It is available in the first trimester.
  • An anesthetic is not necessary.
  • No further treatments are necessary.

Disadvantages

Some disadvantages of a medical abortion are:

  • It is unavailable in the second trimester.
  • Only part of the treatment takes place in a clinic.
  • It may cause painful cramping.
  • Rarely, it is not effective.

It may be a good idea to have a partner or friend close by for support while the tissue is passing.

Recovery

Recovery from a medical abortion involves some bleeding and spotting that may last for several weeks. People will also need a checkup with the doctor to monitor their recovery.

Risks

Some people experience side effects of the medications. These can include:

Complications

In some cases, a medical abortion can lead to complications. These can include the below:

  • The termination fails.
  • Some of the pregnancy material does not expel, which may lead to heavy bleeding and a need for surgery to clear the uterus.
  • A hemorrhage can occur, involving extreme bleeding that can be life threatening.
  • Infection in the uterus can occur, which requires antibiotics and can be serious if doctors do not identify it quickly.

Vacuum aspiration is a type of surgical abortion that involves using gentle suction to end a pregnancy. Doctors typically recommend this during the first trimester.

How it works

  1. A doctor begins the vacuum aspiration procedure by inserting a speculum into the vagina.
  2. They then apply medication or use an injection to numb the area.
  3. Next, they use thin rods called dilators to open the cervix, then insert a tube into the uterus.
  4. They then use either a manual or mechanical suction device to empty the uterus.

Advantages

The advantages of vacuum aspiration are:

  • It is available in the first 12 weeks of pregnancy.
  • It is quick, with the procedure taking 5–10 minutes.
  • It is relatively pain-free, though some people experience cramping, sweating, nausea, or a combination.
  • It does not require a general anesthetic.

Disadvantages

The main disadvantage of vacuum aspiration is that it is not available in the second trimester.

Recovery

Recovery from vacuum aspiration involves:

  • resting for up to 1 hour after treatment
  • taking antibiotics to prevent infection
  • avoiding sex for 1 week after treatment

Additionally, some people experience cramping for a few days following the procedure. They may also experience irregular bleeding or spotting for several weeks.

Risks

The potential complications of vacuum aspiration include bleeding and infection. However, the risk of these complications is low.

A person should consult their doctor right away if signs of bleeding or new symptoms occur.

A D&E is a type of surgical abortion that doctors commonly use during the second trimester.

How it works

  1. A doctor may give a general anesthetic before performing a dilation and evacuation. This type of anesthetic ensures that a person does not feel anything during the procedure.
  2. The doctor begins by inserting a speculum into the vagina.
  3. They use dilators to open the cervix.
  4. They then remove the pregnancy tissue with small forceps.
  5. Finally, they use suction to remove any remaining tissue.

Advantages

The advantages of D&E are that it is available in the second trimester and is a safe and effective way to end a pregnancy.

Disadvantages

The disadvantage of dilation and evacuation is that it may require a general anesthetic.

Recovery

Recovery from dilation and evacuation involves resting.

Mild pain and cramping can occur for a few days after the procedure, and there may be some bleeding for up to 2 weeks.

Risks

Potential complications of dilation and evacuation include:

  • infection
  • heavy bleeding
  • injury to the uterus

However, the risk of injury to the uterus or other organs during a second-trimester abortion is less than 1 in 1,000, according to The American College of Obstetricians and Gynecologists.

Labor induction abortion is a late-term method of ending a pregnancy in the second or third trimester.

This type of abortion is rare, and a doctor may recommend it if a pregnant person’s life is in danger.

How it works

Labor induction involves using medications to start labor, which causes the uterus to empty over a period of around 12–24 hours. A person can take these medications by mouth. Alternatively, the doctor may place them into the vagina or inject them into the uterus.

Doctors usually also administer pain relief medication or a local anesthetic, as intense cramping occurs during this type of abortion.

Recovery

After an abortion, a person tends to remain in the clinic or the hospital for anywhere from a few hours to 1–2 days, depending on their health and other factors.

The doctor can help determine the length of the stay, and they may be able to estimate it before the abortion.

Risks

The medications that induce labor can cause side effects, such as:

  • nausea and vomiting
  • fever
  • diarrhea

Complications are rare but can include:

  • hemorrhage
  • cervical injury
  • infection
  • rupture of the uterus
  • incomplete release of the pregnancy tissue

Different countries have different rules about whether a person can end a pregnancy and under what conditions. Since the year 2000, at least 38 countries have either legalized or reduced the limits on abortion procedures.

In the United States, since the overturning of Roe v. Wade, the number of states banning abortions could grow. Currently, at least 11 states either ban or significantly limit a person’s ability to terminate their pregnancy. Eleven more states have passed similar laws that have not yet taken effect.

These types of restrictions require some pregnant people to travel to a different state or country to have an abortion. Black pregnant people in particular disproportionally experience negative birth outcomes as a result of restrictions on abortion. This includes things such as preterm birth and low birthweight.

A person can speak with a healthcare professional for advice about access to abortion.

The following are answers to some additional questions about abortions.

What can I expect before having an abortion?

Before a termination procedure, the doctor will want to know as much as possible about the pregnant person’s health, and they will give them a physical exam. They will also carry out an ultrasound to check the stage of pregnancy and then recommend the best procedure for the person. They should outline the potential risks and provide instructions for home recovery.

What should I do if I am in pain after an abortion?

Some pain is typical after pregnancy termination. Generally, over-the-counter pain relievers should help relieve temporary discomfort. These include 800 mg of ibuprofen (Motrin, Advil) every 8 hours, 500 mg of naproxen (Aleve) every 12 hours, and 1,000 mg of acetaminophen (Tylenol) every 4–6 hours. A doctor should advise a person on which option is best for them.

How much does abortion cost?

According to an analysis of more than 2,000 records and 32 studies, the mean total cost per person for an abortion or postabortion care in the U.S. ranges from $23 to $564. Annually, the overall cost can range from $189,000 to $134 million. What a person would actually pay out-of-pocket depends on the type of termination, whether they have medical insurance, and whether their insurance covers abortion. And while some states require insurance companies to cover abortion, others restrict the coverage.

Abortion is a medical means of ending a pregnancy. There are various types of the procedure, including:

  • medical abortion
  • vacuum aspiration
  • dilation and extraction
  • labor induction

A healthcare professional will recommend a type, depending on the stage of a person’s pregnancy.

In many countries, access to abortion is legal, as well as in some U.S. states.