Comparing medical and surgical abortion

There are two types of abortions. One type is done with medicines (medical abortion). The other is a procedure (surgical abortion). The best type for you may depend on things such as your past health, where you live, and how many weeks pregnant you are.

In a medical abortion, you take medicines to end the pregnancy. This may be done at home. Your doctor will explain how to take the pills. They can be taken as soon as you know that you are pregnant. These medicines usually cause bleeding and strong cramps for 3 to 5 hours. You may need to take pain medicine. After 3 to 5 hours, the cramps and bleeding usually lessen. Then for about 1 to 2 weeks, you will probably bleed like you do when you have your period.

You will have an ultrasound or a lab test to make sure the abortion worked. You will be told when to do this. In a few cases, the medicine doesn't work. If that happens, you may need to take a second dose of medicine or have a surgical abortion.

In a surgical abortion, a doctor gently widens the opening of your cervix and puts a tube in your uterus. The tube uses suction to remove the contents of the uterus. This procedure takes less than an hour. Before the procedure, you may get medicine to relieve pain and help you relax. After, you may have strong cramps and light bleeding. They don't usually last more than a few days. But cramping may last for up to a few weeks.

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Your doctor will give you information about what to expect after an abortion. Normal symptoms that most often occur include:

• Irregular bleeding or spotting for as long as the first few weeks.
• Cramping for up to a few weeks.
• Nausea and vomiting for 4 to 6 hours after using abortion pills.
• Fever for up to 4 hours after using abortion pills.

Follow your doctor's instructions on what to do at home.

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You have severe vaginal bleeding along with light-headedness or nausea.
• You have chest pain, are short of breath, or cough up blood.
• You feel you cannot stop from hurting yourself or someone else.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away.

• Call or text Canada's suicide and crisis hotline at 988.
• Call Talk Suicide Canada: 1-833-456-4566 or text 45645 (4 p.m. to midnight ET).
• Go to the Talk Suicide Canada website at https://talksuicide.ca for more information.

Consider saving these numbers in your phone.

Call your doctor now if you have any of these symptoms after an abortion:

• Severe bleeding. Any abortion usually causes bleeding that is different from a normal menstrual period. Severe bleeding can mean:
  • Passing clots that are bigger than a golf ball, lasting 2 or more hours.
  • Soaking more than 2 large pads in an hour, for 2 hours in a row.
  • Bleeding heavily for 12 hours in a row.
• Signs of infection in your whole body, such as headache, muscle aches, dizziness, or a general feeling of illness. Severe infection is possible without fever.
• Severe pain in the belly that isn't relieved by pain medicine, rest, or heat
• Hot flushes or a fever that lasts longer than 4 hours
• Vomiting lasting more than 4 to 6 hours
• Sudden belly swelling or fast heart rate
• Vaginal discharge that has increased in amount or smells bad

Call your doctor for an appointment if you have any of these symptoms after a recent abortion:

• Bleeding (not spotting) for longer than 2 weeks
• No menstrual period within 6 weeks after the procedure
• Still feeling pregnant or having pregnancy symptoms
• Signs of depression. Hormonal changes after a pregnancy can cause depression that requires treatment.
• You are not getting better as expected.