First trimester uterine aspiration — sometimes called vacuum or suction aspiration — is performed as an elective abortion, as treatment after a miscarriage and for pregnancy termination due to fetal anomalies. This procedure can be performed in a one-day office visit if the pregnancy is less than 14 weeks. It involves gentle suction to remove pregnancy tissue.
The procedure is generally performed in a doctor’s office with local anesthesia and pain-relieving medications. Patients may take oral anti-anxiety medications to help relax but these medications should not be taken until a doctor instructs you to do so. Intravenous (IV) sedation or general anesthesia is usually not offered for this procedure.
You should not eat or drink for two hours before your appointment. The entire visit should take about three hours if you’re less than 12 weeks pregnant. If you’re 12 to 14 weeks pregnant, your visit will be five to six hours because of the additional time required to soften or dilate your cervix.
Someone must be available to take you home after the procedure since you shouldn’t drive a car or ride a taxi or public transit alone after taking pain and anti-anxiety medications.
Before the procedure, you’ll learn about uterine aspiration, undergo an exam and receive oral medications, which may include pain relief and anti-anxiety medications. If you’re 12 to 14 weeks pregnant, you may receive a medication called misoprostol to soften your cervix for dilation. Misoprostol takes two to three hours to take effect. It is recommended that you bring reading material for this waiting period.
During uterine aspiration, you’ll be awake, but relaxed. If you wish, someone may accompany you during the entire procedure, which takes about 15 minutes. During the procedure, your doctor will:
- Place a speculum to view inside your vagina
- Clean the cervix with gauze soaked in soap
- Apply local anesthesia to numb the cervix
- Dilate your cervix, the opening to the uterus, with tapered rods
- Insert a straw-like flexible tube or cannula through the cervix into the uterus
- Apply gentle suction, using either a hand-held or electric device, to the other end of the tube to aspirate or remove pregnancy tissue
At the end of the procedure, you may feel a cramp similar to a menstrual cramp in your uterus as it shrinks to its normal size.
After the procedure, you’ll rest for a few minutes. You may experience some cramping and spotting. When you feel able, you may get dressed. A health educator will review instructions for care after the procedure and possible complications. You’ll be given antibiotics to prevent infection.
You can expect to return to normal activities, such as work and school, the next day.
Unless you experience complications or have concerns, there’s no need to return for follow up appointments.
Uterine aspiration is one of the safest medical procedures. Although rare, possible complications include:
- A blood clot in the uterus that can cause pain or require a repeat aspiration
- Infection, which is generally easily identified and treated
- A tear in the cervix that can be easily repaired with suture
- Perforation
- Retained pregnancy tissue requiring repeat aspiration
- Excessive bleeding requiring a transfusion
Complications are less frequent and less serious than those associated with giving birth.