An in-clinic abortion, also known as “surgical abortion,” is a one-day medical procedure that ends a pregnancy. It’s usually done in a doctor’s office or an abortion clinic. In-clinic abortion is a minor surgical procedure that you can opt for during your first trimester or early second trimester of pregnancy.
Here’s a step-by-step look at what in-clinic abortion procedures are and what you can expect from start to finish during a visit.
How Can You Prepare for an In-Clinic Abortion?
If you’re considering an in-clinic abortion, find out all of the requirements beforehand. In many states you must get pre-abortion counseling before you can have the procedure. In some, you will have to wait 24 hours between counseling and getting the procedure. So it’s best to check with your doctor or the clinic before you show up.
You can check your state’s specific laws on this website: https://reproductiverights.gov/.
Before your appointment, it’s a good idea to prepare certain things. If you have kids, arrange for childcare. Your clinic may not allow you to bring children. You may also want to take off some time from work, if it’s possible.
You might also want to have a few things on hand to keep you comfortable:
- Ibuprofen, if your doctor says it’s OK to take
- Any medications you take, so your doctor can keep track of them
- An extra set of underwear
- Pads in case you have a heavy flow after your operation (Don’t use tampons or a menstrual cup.)
- Contact lens case and glasses. You may have to take out your contacts before treatment.
Once you make an appointment, you’ll need to make arrangements to get to and from the clinic. Most in-clinic abortions procedures will include sedative and pain-relief medications that can make you drowsy. You’ll have to arrange for someone to drive you home afterward.
For the appointment, bring a photo ID, your payment, and a book to read or something to watch during recovery. Some clinics will do the procedure the same day as your first appointment. If you’re over 14 weeks pregnant, you might need two to three additional appointments.
What to Expect When Your Arrive at the Abortion Clinic
Arrival and check-in
When you arrive at the abortion clinic, you may have to walk past anti-abortion protestors to get into the clinic. Usually, you’ll find “clinic escorts” or “patient escorts” standing outside the clinic. They are either volunteers or employees who work with abortion or family planning clinics. Their role is to help you enter or exit the clinic safely from your parking spot or the front of the building. If you’re worried for your safety, call the clinic ahead of time to see if a clinic escort can help you.
Some clinics also allow you to bring a friend or a family member as a support person. But in most cases, they might not be able to come into the room where you’ll have your procedure.
At the reception desk, clinic staff will verify your documents and have you fill out some paperwork. This might include your medical history.
Health education and pre-abortion exams
Once you’re checked in, you’ll be led into a private room. This is where you’ll go through health education assessment, medical exams, and the in-clinic abortion procedure.
Then you’ll meet with a health educator or counselor who will discuss your abortion options, what the procedure will involve, and birth control options. They'll also take your blood pressure, weight, and pulse. During this part of the visit, you don’t have to undress.
Next, you’ll meet with an OB/GYN, a doctor who specializes in women’s reproductive health, including abortion. The doctor will:
- Go over your medical history.
- Do an ultrasound to figure out how far along your pregnancy is.
- Explain the abortion procedure.
- If you’re less than 12 weeks pregnant, they’ll give you oral pain medications such as Vicodin (opioid pain reliever), Valium (for anxiety), and ibuprofen (non-opioid pain reliever). The drugs might take 45 to 60 minutes to work. These drugs help with pain, discomfort, and any anxiety you may feel.
- If you’re 12 to 14 weeks pregnant, you’ll take a medication called misoprostol. This softens your cervix to make dilation easier. It can take about 20 minutes for the drug to work.
- If you’re over 14 weeks pregnant, they’ll soften and dilate your cervix with medication and small dilating sticks called laminaria or Dilapan. The insertion only takes 5 to 10 minutes, but the sticks will need to stay in place overnight.
This portion of the visit may take up to an hour. Depending on the clinic’s policy, your support person might be able to come into the exam room with you.
After you get the medications, you’ll either stay in the room or wait in the reception area. If you’re over 14 weeks pregnant, you might need to make an appointment to come back the next day for the procedure. If you’re under 18 weeks, your doctor might opt to do the procedure the same day. But this varies for each person.
What Does an In-Clinic Abortion Procedure Look Like?
There are a couple of different types of in-clinic abortions. Depending on how far along you are in your pregnancy, your doctor or nurse will know which one is right for you. During this procedure, your doctor will use a gentle suction, medical tools along with local anesthesia, and oral pain relief medications that you take by mouth. The time will vary depending on the type of in-clinic abortion you get.
In-clinic abortions types include:
Suction abortion (also called vacuum aspiration). This is the most common type of in-clinic abortion. Your doctor will suggest this if you’re less than 14 weeks pregnant from the first day of your last period. It’s a short and safe procedure and lasts anywhere from 5 to 10 minutes. Depending on the clinic, you may get mild, moderate, or deep anesthesia to numb any discomfort you may feel.
With mild anesthesia, you’re only slightly sedated, or relaxed. With moderate anesthesia, you’re “consciously sedated,” so you’re more relaxed. Deep anesthesia will make you less likely to respond or wake up during a procedure.
The entire visit can take around 3 hours if you’re less than 12 weeks pregnant. If you are 12 to 16 weeks pregnant, your visit will last around 5 to 6 hours.
Dilation and evacuation (D&E). This procedure is advanced and offered usually later in your pregnancy (after 14 to 16 weeks). During a D&E, your doctor will use medications and tools to dilate your cervix (the canal between your uterus and vagina) and use suction to empty your uterus. It usually takes 15 to 45 minutes.
But because this is an advanced procedure, your doctor will give you medications to help your cervix dilate the night before the actual procedure. This means a D&E might take 2 days from start to finish. The first visit is to prepare for the procedure with cervix dilation. This takes about 3 hours. On the day of the actual procedure, it may take around 4 to 6 hours.
During either procedure, you’ll need to undress from the waist down and wear a medial gown. To numb any pain or discomfort, your doctor will give you local anesthesia an in an injection. For a D&E, you can choose general anesthesia, which will be given through an intravenous (IV) injection in your arm. You'll lose consciousness soon after.
Does an Abortion Procedure Hurt?
If you have a surgical abortion, you might have cramping during or after the procedure. Your cramps may be less or more intense. The symptoms are different for everyone.
Dilation and evacuation abortions might cause pain during the procedure. The discomfort is similar to cramps but a bit stronger. You may have cramps in your uterus after your doctor removes the fetus.
For several hours after your abortion, you’ll probably have more intense cramping.
What Can You Expect After an In-Clinic Abortion?
Right after the procedure, you may have light bleeding and cramping and you’ll need to rest for a few minutes. The clinic staff will give you a sanitary pad and a heating pad. When you’re able to, you can get dressed.
Recovery
After you rest, you might be asked to stay in the same room or a recovery room for a couple of hours so your doctor or nurse can confirm the abortion is complete.
The health educator will then meet with you to give you instructions on how to take care of your body. They’ll also give you prescriptions for pain medication and antibiotics to ward off possible infections. Because the medication you take during the visit can make you drowsy, it’s important to have someone to take you home after the procedure. If you’re unable to, take a taxi or ask the abortion clinic if they have a volunteer to help you get home.
Be sure to rest once you get home. The medication effects usually wear off by the end of the day. In most cases, you can resume your normal activities within 1 to 2 days after the procedure. If you notice side effects, let your doctor know.
Complications you need to watch out for include:
- Fever over 100 F or chills
- Loss of consciousness
- Unbearable belly pain or cramps
- Too much bleeding
- Infection
If it’s an emergency, call 911 or head to the nearest hospital.
Do You Need a Follow-Up Visit?
In most cases, unless you have side effects or complications related to the procedure, you don’t need to come back for a follow-up appointment. If you’re planning to start birth control or get a physical exam soon after, make an appointment with your regular doctor.
