Manual and Vacuum Aspiration for Abortion

There are two methods of vacuum aspiration (also called suction aspiration):

• Manual vacuum. This procedure can be used around 5 to 12 weeks after the last menstrual period (early Reference first trimester Opens New Window). It involves the use of a specially designed syringe to apply suction. This method is not available everywhere. But it may be more available than machine aspiration in some geographic areas.
• Machine vacuum. This procedure is a common method used in the first 5 to 12 weeks (first trimester) of pregnancy. Machine vacuum aspiration involves the use of a hollow tube (cannula) that is attached by tubing to a bottle and a pump, which provides a gentle vacuum. The cannula is passed into the uterus, the pump is turned on, and the tissue is gently removed from the uterus.

Manual vacuum aspiration procedure

Manual vacuum aspiration usually takes between 5 and 15 minutes. It can be done safely in a clinic or medical office using Reference local anesthetic Opens New Window and a Reference nonsteroidal anti-inflammatory drug (NSAID) Opens New Window, such as ibuprofen. For this procedure, the health professional will:

• Position you on the exam table in the same position used for a Reference pelvic exam Opens New Window, with your feet on stirrups while you are lying on your back.
• Insert a Reference speculum Opens New Window into the vagina.
• Clean the vagina and cervix with an antiseptic solution.
• Inject a numbing medicine (local anesthetic) in the cervix.
• Insert a small instrument into the cervix to slightly open (dilate) it, if needed. In most cases, though, dilation isn't needed.
• Pass a thin tube through the cervix and into the uterus. A handheld syringe is attached and used to suction the tissue out of the uterus. As the uterine tissue is removed, the uterus will contract. Most women feel cramping during the procedure. The cramps will decrease after the tube is removed. Some women also have nausea, sweating, or feel faint. But typically symptoms are less severe than with machine vacuum aspiration.

Machine vacuum aspiration procedure

Hours before or the day before a machine vacuum aspiration procedure, a Reference cervical (osmotic) dilator Opens New Window may be placed in the cervix to slowly open (dilate) it. Just before, antibiotics are given to prevent infection. A medicine called misoprostol may be given to soften the cervix before the procedure.

Machine vacuum aspiration usually takes between 10 and 15 minutes. It can be done safely in a clinic or medical office under local anesthetic. For this procedure, the health professional will:

• Position you on the exam table in the same position used for a pelvic exam, with your feet on stirrups while lying on your back.
• Insert a speculum into the vagina.
• Clean the vagina and cervix with an antiseptic solution.
• Inject a numbing medicine (local anesthetic) in the cervix. Medicine for pain or sedation, in addition to the local anesthetic, may be given by mouth or through a vein (Reference intravenously Opens New Window). Vasopressin, or a similar medicine that slows uterine bleeding, may be mixed with the local anesthetic to reduce blood loss.
• Grasp the cervix with an instrument to hold the uterus in place.
• Open (dilate) the cervical canal with a small instrument. Dilation reduces the risk of any injury to the cervix during the procedure.
• Pass a thin, hollow tube (cannula) into the cervical canal and attaching a gentle vacuum that will draw the tissue out of the uterus. As the uterine tissue is removed, the uterus will contract. Most women feel cramping during the procedure. The cramps will decrease after the tube is removed. Some women also may have nausea or sweating or feel faint.

The tissue removed from the uterus during a vacuum aspiration procedure is examined to make sure that all of the tissue has been removed and the abortion is complete.

Sometimes a Reference dilation and curettage (D&C) Opens New Window procedure is needed after a vacuum aspiration if all of the tissue has not been removed. D&C uses a sharp surgical instrument to clear tissue from the uterus.

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