Medical Abortion (Pill) VS Surgical Abortion

A:
Medical Abortion (Pill):

  • Up to 7 weeks LMP (49 days). Some doctors use this method until 9 weeks (63 days). Success rate of 92-97%, may decrease as length of pregnancy increases.

Surigical Abortion:

  • Dilation and Curettage (D & C) Abortion: This abortion procedure is performed on patients from 5-12 weeks into their pregnancy.
  • Dilation and Evacuation (D & E) Abortion: This abortion procedure is performed on patients from 13 – 24 weeks into their pregnancy.

A:
Medical Abortion (Pill):

  • Usually 1-2 visits + required follow-up visit
  • Day 1 for Mifepristone, Day 2 or 3 for misoprostol.
  • Unpredictable when pregnancy will pass
  • Bleeding after misoprostol lasts 4-8 hours for most; days for some to complete
  • Ultrasound at follow-up 7-14 days after Mifepristone will make sure abortion is complete.

Surigical Abortion:

  • 1 visit + follow-up exam
  • Actual abortion less than 5 minutes
  • Follow-up in 2-3 weeks at abortion facility or other doctor or clinic of your choice.

A:
Medical Abortion (Pill):

  • Heavy bleeding & clots are common during the abortion process for 4-8 hours.
  • Afterwards, bleeding like a period is common for an average of 13 to 16 days.

Surigical Abortion:

  • Not much bleeding immediately after procedure.
  • Like a period, up to 14 days, usually about 9 days

A:
Medical Abortion (Pill):

  • Success rate varies from 92-97% by Day 15. Surgical abortion is necessary if it fails.
  • Vaginal misoprostol improves effectiveness.

Surigical Abortion:

  • Over 99% successful. If it fails suctioning will need to be repeated.
  • Early surgical abortion may be slightly less effective (98%).

A:
Regardless of method, abortion is 20 times safer than childbirth. Infections are the greatest threat to fertility, not abortion. Childbearing is not affected, barring rare, serious complications.

A:
Medical Abortion (Pill):

  • Both Mifepristone and misoprostol have been formally studied and used safely.
  • Mifepristone will not end ectopic or tubal pregnancies which, if undetected, can be dangerous or fatal.
  • Need for transfusion (rare).
  • Some women may be allergic to medications.

Surigical Abortion:

  • Surgical abortion has been formally studied for over 25 years.
  • Injury to the uterus is rare in the first trimester. Excessive bleeding is rare. Infection and retained tissue, which would require antibiotics or a re-suctioning, are less than 1%.
  • Vacuum aspiration will not end ectopic or tubal pregnancies which, if undetected, can be dangerous or fatal.

A:
Medical Abortion (Pill):

  • Nausea, vomiting, diarrhea, cramping, bleeding, headache, dizziness, fever or chills, anemia (rare). Possible need for surgical abortion.

Surigical Abortion:

  • Cramping, bleeding
  • For some, light-headedness, nausea.

A:
Medical Abortion (Pill):

  • 100% coverage with valid Ontario Health Insurance Plan (OHIP).
  • Therapeutic abortion services at a reasonable fee for Out-of-Province patients. Fees may be reimbursable in part or in full by the patient’s provincial health insurance plan. Out-of-Country patients may also be reimbursed by their own private health insurance. Patients covered by University Health Insurance Plan (UHIP), Interim Federal Health Plan (IFHP) or private insurance may have the fees reimbursed in part or in full by their relevant Plans. (Please check with your insurance provider).
  • Sometimes higher than surgical. Prices vary. Check what is included.

Surigical Abortion:

  • 100% coverage with valid Ontario Health Insurance Plan (OHIP).
  • Therapeutic abortion services at a reasonable fee for Out-of-Province patients. Fees may be reimbursable in part or in full by the patient’s provincial health insurance plan. Out-of-Country patients may also be reimbursed by their own private health insurance. Patients covered by University Health Insurance Plan (UHIP), Interim Federal Health Plan (IFHP) or private insurance may have the fees reimbursed in part or in full by their relevant Plans. (Please check with your insurance provider).
  • May be less than medical abortion. Prices vary. Check what is included

A:
Medical Abortion (Pill):

  • Mifepristone induces a miscarriage-like process.
  • If available, highly effective and safe for very early pregnancy
  • Avoids shots, anesthesia, instruments, or vacuum aspiration, unless it fails. (Blood work required. Injection needed if your blood type is Rh-. Vaginal ultrasound usually required.)
  • Being at home instead of a clinic may seem more comforting and private.
  • Any support person can be there with you during the abortion process.
  • It is finished quicker than the Methotrexate method.
  • The timing is more predictable than for Methotrexate.

Surigical Abortion:

  • It’s quick, predictable, and over in a few minutes.
  • It’s highly successful.
  • If available, highly effective and safe for very early pregnancy.
  • There’s less bleeding for less time than with other methods.
  • Less time cramping than with other methods.
  • Performed by a doctor with support of medical or counseling staff, which may seem more comfortable and private.
  • Some involvement of support person may be possible.
  • If you are trying to conceal abortion, it may be better.
  • Avoids medication, except for pain relievers and sedatives.
  • It can be done later in the pregnancy than other methods

A:
Medical Abortion (Pill):

  • If you are more than 7 weeks pregnant.
  • Medical conditions: allergy to medications; blood clotting problems or on blood thinners;
    chronic adrenal failure; chronic systemic corticosteroid use
  • If an IUD is in place it must be removed
  • inherited porphyrias
  • severe anemia
  • possible ectopic pregnancy
  • uncontrolled seizures

Surigical Abortion:

  • Some medical conditions or allergies to anesthesia may require a surgical abortion in a hospital setting

A:
Medical Abortion (Pill):

  • It takes several days to end a pregnancy.
  • It is not completely predictable. There is some uncertainty about when you will bleed and pass the pregnancy.
  • Bleeding can be very heavy and lasts longer than with surgical abortion.
  • There may be restrictions if you live more than an hour away from the clinic or a hospital, in case of very heavy bleeding, depends on dr.
  • Cramping can be severe and lasts longer than with surgical abortion.
  • 2-3 visits are required.
  • It fails more often than surgical abortion but is more successful than Methotrexate
  • It cannot end an ectopic pregnancy.
  • For patients without Ontario Health Insurance Plan (OHIP) or other health insurance cost may be a factor.
  • It may cost more than other two options.
  • Not good method if you are trying to conceal abortion.
  • Advisable to have support.

Surigical Abortion:

  • A doctor must insert instruments inside the uterus.
  • Anesthetics and drugs to manage pain during the procedure may cause side effects. (Serious problems are rare.)
  • There are possible complications, although they occur in less than 1% of cases
  • You may have less control over the abortion process and who is able to be with you during some parts of the process.
  • The vacuum aspirator makes a noise. If available, a manual aspirator is silent
  • It may not be done as early in the pregnancy as with the other methods depending on doctor.
  • It cannot end a ectopic pregnancy.

A:
Medical Abortion (Pill):

  • Some women are anxious waiting for the abortion process to complete.
  • Viewing the pregnancy tissue may be difficult.

Surigical Abortion:

  • Some women are anxious in a medical setting or with the idea of surgery.

No matter which method you choose, it’s important to be sure of your decision. No one should be forcing you or pressuring you into any decision about pregnancy. If you have strong doubts about what is right for you, take the time to consider your choices, even if that means you will not be eligible for a medical abortion. Counseling or further thinking may help. The great majority of women do not regret their decision or have serious depression after an abortion. Of course, you may have a variety of feelings.