Uterine aspiration (first trimester)

Uterine aspiration (first trimester)

Uterine aspiration, also called "suction" aspiration, is often referred to as surgical abortion, though it is not really surgery. It can be performed as a one-day procedure if fewer than 14 weeks have passed since the first day of your last menstrual period.

Uterine aspiration can be done in the clinic using local anesthesia and oral medications for pain relief and relaxation. It can also be performed in an operating room using IV sedation or anesthesia.

If you are interested in having the procedure with IV sedation in the operating room, please let us know. We will discuss the differences compared with having the procedure in our clinic, including scheduling and the need to avoid eating overnight.

You will need to arrange for someone to drive you home after the procedure.

Clinic visits

For clinic procedures, you will be in a private room during your health education session, exam, procedure and recovery. The entire visit will take around three hours if you are fewer than 12 weeks pregnant. If you are 12 to 14 weeks pregnant, your visit will be longer or may be split into two visits.

Preparation

When you check in for your appointment, we will verify your insurance information, collect your copayment if needed and ask you to complete some forms, including a medical history.

The UCSF Center for Pregnancy Options is part of the general Women's Health Center practice. Patients are not identified in the reception area as needing early pregnancy care, and there are no signs advertising our clinic. This helps protect the privacy and safety of our patients and staff.

Shortly after you arrive, one of our health educators will bring you to a private room. You will discuss and learn about the procedure and pain control options. This part of the visit takes around 20 to 40 minutes, and you may remain fully dressed during this time.

The health educator will take your blood pressure, pulse and weight. If you brought a support person with you, they may stay with you during the health education session.

UCSF Medical Center is a teaching hospital, so we may ask your permission to have a clinician in training observe the health education session.

Meeting your clinician

After your conversation with the health educator, you will meet your clinician. Most of our clinicians are obstetrician-gynecologists with specialized training and interest in abortion, miscarriage and family planning, although we are expanding our team to include specially trained midwives and advanced practice nurses.

The clinician will review your medical history, perform an ultrasound exam if one has not already been done and give you medications.

For clinic procedures, you will receive oral pain medications. We generally recommend ibuprofen and acetaminophen for everyone. Most people also choose to take a relaxing medication called lorazepam. Some people also take oxycodone.

If you are 10 or more weeks pregnant, you will also receive misoprostol. This medication softens your cervix to make dilation easier.

This part of the visit takes about 20 minutes.

Waiting for medications to work

The oral medications start to work quickly but need about 45 minutes to be most effective. You will be awake but may feel very relaxed.

You can wait in your room or in the reception area. You may want to bring something to read during this time. If you took misoprostol, it might need more time to work.

Procedure

When you are ready, you’ll be asked to undress from the waist down and put on a patient gown. Your support person can be right next to you for the whole procedure.

During the procedure, the clinician will:

• Use a speculum to see inside your vagina
• Wipe your cervix with gauze soaked in a solution to prevent infection
• Apply numbing medication to your cervix and uterus and check that it is working well
• Dilate your cervix, the tight opening to your uterus, with thin metal rods
• Insert a narrow, flexible tube into your uterus
• Apply gentle suction to the other end of the tube to remove the pregnancy tissue

We do not expect you to "tough it out" during the procedure. If you feel pain, we will pause and make adjustments.

Toward the end of the procedure, you may feel cramping as the uterus shrinks back to its usual size. This cramping pain is harder for us to treat quickly, but it is usually not strong.

The entire procedure typically lasts 15 to 20 minutes, most of which is spent preparing your body. The suction portion only takes one to five minutes.

Recovery

After the procedure, you should rest for a few minutes. You will probably have some cramping and light bleeding. We will give you a heating pack, a menstrual pad and some juice and crackers. When you feel able, you may get dressed.

Your health educator will review instructions on caring for yourself at home. You will already have arranged for someone to drive you. You should go directly home to rest and let the medications wear off.

You should be able to return to normal activities, such as work and school, the next day. If you feel you need more time off, please let your clinician know.

Follow-up visits

You do not need to return for a physical checkup unless you have concerns related to the procedure. If you do have concerns, please contact us so we can arrange a timely visit in our clinic. We can also discuss future fertility or contraception visits.