Medication & Surgical abortion, and the differences between the methods
We offer two options for abortion at Allegheny Reproductive Health Center: Medication Abortion (the Abortion Pill) and Surgical Abortion. The information on this page will help you decide which option is right for you.
If you choose Surgical Abortion, you can also choose a form of Pain Management for the procedure. Pain Management options are detailed further down on this page.
Option 1: Medication Abortion, a.k.a. the Abortion Pill
If you are 11 weeks or less pregnant, you may be eligible to use the Abortion Pill. The Abortion Pill is a combination of two different medicines, Mifepristone and Misoprostol.
How Medication Abortion Works
Our physician will give you the first pill, Mifepristone, at the clinic. A pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone.
You will use the second medication, Misoprostol, at home 6-48 hours later. This medicine causes cramping, bleeding, and flu-like symptoms to empty the uterus and feels like a really heavy and crampy period. It is like an early-pregnancy miscarriage. The timing and way you take this medication will depend on how many weeks you are in the pregnancy.
You are required to have follow up within 1-2 weeks of using the Abortion Pill. This may be an ultrasound in the office, a phone call and a urine pregnancy test, or blood work.
Option 2: Surgical Abortion
You can get a Surgical Abortion between 5 and 23.6 weeks in a pregnancy (if you are past 11 weeks, you are required to get a Surgical Abortion).
Surgical Abortions in the First Trimester (5-14 weeks)
The procedure typically takes 5-8 minutes depending on how far along you are. It can be performed while awake, with Valium, or under conscious or IV sedation. It is an outpatient procedure called a Suction D&C.
How it Works
The physician will insert a speculum to hold open the walls of your vagina and then numb your cervix with a local anesthetic given by injection. If you’re awake, this typically feels like a pinch.
Next, the physician will gently stretch open your cervix using instruments called dilators. A dilator is a thin metal rod with a rounded end. The stretching takes about a minute and you may feel strong menstrual-like cramps during this part of the procedure.
After your cervix is dilated, a small sterile plastic tube is inserted into your uterus. The pregnancy is then removed with suction. This is done with a hand held suction device or an electric suction machine. During this part of the procedure you may experience stronger cramping. Some women also describe feeling pressure or a tugging sensation.
If you are between 12 and 14 weeks pregnant and have not had a vaginal delivery, you may be given medication 2-4 hours before the procedure to help prepare your cervix for dilation.
Surgical Abortions in the Second Trimester (14.1-23.6 weeks)
On the day of your procedure, you will have an early morning appointment. If you are 14.1 weeks and above, medicine or osmotic dilators may be inserted into your cervix before you have the abortion. You will be awake for this part of the procedure.
The physician will insert a speculum to hold open the walls of your vagina and numb your cervix before inserting these dilators. The osmotic dilators work by absorbing your natural bodily fluids and expanding slowly. This helps to open your cervix slowly and gently. You may have cramping, bleeding, or leaking of fluid with the dilators.
After insertion of the medicine or dilators, you can sit in our Observation Room or waiting room for a few hours.
If you are between 18 and 23.6 weeks in pregnancy, the procedure may require 2-3 visits to the clinic. On the first visit you will have an ultrasound, counseling, and lab work. If you are over 18 weeks pregnant, during the second visit the osmotic dilators will be inserted. You will go home overnight and return the next morning to complete the abortion procedure.
After a surgical abortion, you will rest in our Observation Room for 30-90 minutes. The length of time depends on how far you were in the pregnancy and your choice of pain management. During that time, staff will monitor your vital signs and give you something to eat and drink. We can also provide ibuprofen and a hot water bottle if you’re experiencing cramping. Prior to discharge, you’ll receive both verbal and written instructions for post-abortion care. It is important to keep this information with you so that you may refer to it later.
When you obtain a Surgical Abortion, you can choose a type of pain management for the procedure. Here are the options we offer at Allegheny Reproductive Health Center:
With IV Sedation, you will receive medication through an intravenous (IV) to keep you comfortable, relaxed, and pain-free during the procedure. You will also have little or no memory of the abortion. IV sedation takes effect within minutes and wears off within minutes. When the procedure is over, you will be discharged to our Observation Room. IV sedation is given and monitored throughout the procedure by a CRNA (certified, registered nurse anesthetist).
This sedation option costs between $175 – $500 depending on how far along in the pregnancy you are and is not covered by insurance. You will need to pay a $50 non-refundable deposit at the time you make the appointment that will be deducted from your total cost on the day of your procedure. You are required to bring someone that is able to stay with you for the entire 4-6 hour length of the appointment that will accompany you home, but they will not be able to accompany you into the procedure room. You will not be able to eat, drink, chew gum, or smoke after midnight the day before your appointment.
You will receive medication through an IV to help you relax and to reduce pain.
You will remain awake during the procedure and will be able to respond to the staff in the room. You will be monitored by our nurses and physicians. Because you will be awake, you will most likely feel some cramping.
This sedation option costs $75 and is not covered by insurance. You are required to bring someone that is able to stay with you for the entire 4-6 hour length of the appointment that will accompany you home. There are no eating or drinking restrictions with conscious sedation.
If you plan to be awake but anticipate feeling nervous and anxious, Valium is an anti-anxiety medication that can be given shortly before the start of the procedure. Valium is not a pain medication but may help you relax your body, making the procedure more tolerable.
This sedation option costs $20. You are required to bring someone that is able to stay with you for the entire 4-6 hour length of the appointment that will accompany you home. There are no eating or drinking restrictions with Valium.
You will not receive any additional medication besides the local numbing medication in your cervix. You will remain awake during the procedure and will be able to respond to the staff in the room. Because you will be awake, you will most likely feel strong cramping and pressure. You are not required to bring a guest to this type of appointment. There are no eating or drinking restrictions.