A clinical abortion is a medical procedure done at a clinic or hospital. A doctor uses instruments and suction to empty the uterus. It is also called surgical abortion or in-clinic abortion.

Types of Clinical Abortion

Suction Aspiration (also called vacuum aspiration, D&C, or aspiration abortion): Used up to 14-16 weeks of pregnancy. The most common type of surgical abortion. Uses gentle suction to remove pregnancy tissue. Takes 5-10 minutes.

Dilation and Evacuation (D&E): Used after 14-16 weeks of pregnancy. Uses suction and medical instruments to remove pregnancy tissue. Takes 10-20 minutes May require cervical preparation the day before.

What Happens During The Procedure

You will be at the clinic for 3-5 hours total. The procedure itself is quick. Most of the time is preparation, paperwork, and recovery.

Before the Procedure

• Sign paperwork and consent forms
• Ultrasound to confirm how far along you are
• Blood pressure and vital signs
• Meet with a counselor or health educator
• Talk with the doctor about pain management options
• Get pain medication and antibiotics

Cervical preparation: The doctor may need to open your cervix before the procedure. This can be done with medication or small dilators. For early pregnancies, this is done the same day. For later pregnancies, you may need to come in the day before.

Pain management options:

• Local anesthesia: Numbing medication injected into or near your cervix. You are awake. You feel cramping but less pain. This is the most common option.
• Sedation: Medication to relax you. You are awake but very relaxed and may not remember much. Some cramping.
• General anesthesia: You are completely asleep. No pain or memory of the procedure. Only available at some clinics.

During the Procedure

• You lie on an exam table with your feet in stirrups
• A speculum is inserted to see inside your vagina
• The doctor cleans your vagina and cervix
• Numbing medication is applied to your cervix (if using local anesthesia)
• The cervix is dilated (opened) with thin rods if needed
• A tube is inserted through the cervix into the uterus
• Gentle suction removes the pregnancy tissue
• The doctor may use a small tool called a curette to make sure the uterus is empty
• An ultrasound confirms the procedure is complete

The actual procedure takes 5-20 minutes depending on how far along you are.

What it feels like

If you are awake, you will feel cramping. Like strong period cramps. Some people describe it as very uncomfortable. Some describe it as painful. The cramping is worst during the suction portion. Then it gets better quickly.

If you are sedated or asleep, you will not feel pain during the procedure.

After The Procedure

• In the recovery room: You rest for 30-60 minutes. The staff monitors you. You may have cramping and bleeding. You get pads and a heat pack. When you feel ready, you get up and get dressed. You get written instructions for aftercare.
• Getting home: If you had sedation or general anesthesia, you cannot drive. Arrange for someone to take you home. If you had local anesthesia only, you can usually drive yourself.
• Same day: Rest for the remainder of the day. You may have cramping and bleeding. Take pain medication like ibuprofen. Use a heating pad. Most people feel better by the evening.

Recovery

• How long: Most people return to normal activities in 1-2 days. You can go back to work or school the next day if you feel up to it.
• Cramping: You may have cramps like period cramps for a few days to 2 weeks. Take ibuprofen for pain.
• Bleeding: Light bleeding or spotting for up to 4 weeks is normal. You can use pads, tampons, or a menstrual cup. Your clinic may recommend pads initially so you can track bleeding.

When to Call a Doctor

• Heavy bleeding (soaking through 2 pads per hour for 2 hours)
• Fever above 100.4°F
• Severe pain not helped by ibuprofen
• Foul-smelling vaginal discharge
• No bleeding at all (rare but should be checked)

Sex and tampons: Wait at least a few days before having sex or using tampons. Your clinic will give you specific instructions. Usually 1-2 weeks.

Your period: Your normal period should return in 4-8 weeks. You can get pregnant immediately after an abortion. Use birth control if you do not want to get pregnant.

Birth control: You can start birth control right away. Some clinics can insert an IUD or implant right after your abortion during the same procedure. Ask when you schedule.

Age and Parental Consent

If you are 18 or older: You do not need parental consent to get an abortion anywhere in the US.

If you are under 18: It depends on the state. Idaho has a near-total abortion ban. Parental consent laws are still on the books but are generally not enforced because abortion itself is banned. Each state has its own rules for minors. Some states require parental consent or notification. Some do not.

No parental consent required:

• Alaska
• California
• Colorado
• Connecticut
• District of Columbia
• Hawaii
• Illinois
• Maine
• Montana
• Nevada
• New Jersey
• New Mexico
• New York
• Oregon
• Vermont
• Washington

Parental consent or notification required: Most other states

Judicial bypass: In states that require parental consent, minors can usually petition a judge for permission to have an abortion without telling their parents. This is called judicial bypass. You will need help from a legal organization to do this. It takes time. It may delay your abortion.

Idaho’s trafficking law: Idaho passed a law making it illegal for anyone other than a parent to help a minor travel out of state for abortion without parental consent. This law is being challenged in court. If you are a minor, contact a legal helpline for current information.