Types of Abortions

Medically Reviewed by Shruthi N, MD on November 03, 2024
Written by Sylvia Davis
14 min read

An abortion is a medical intervention to end a pregnancy growing in the womb (uterus). It's sometimes called an induced abortion.

An estimated 1 in 4 women in the U.S. will have an abortion during their lifetime. In 2023, there were about 1 million abortions in the U.S., up 20% from 2020.

There are two main types of abortions: medical and surgical. For a medical abortion, you take prescription drugs to end a pregnancy. With a surgical abortion, a doctor does a procedure in a medical office, clinic, or hospital. Almost all abortions are outpatient, which means you won't have to stay overnight in a medical facility.

The type of abortion you get will depend on several things, including your health and how far along you are in your pregnancy. In the U.S., your choices also vary depending on where you live. Since the Supreme Court overturned the Roe v. Wade decision that legalized abortion nationwide, many states have banned or limited abortion. State abortion laws may change often due to court challenges and legislative initiatives.

 

What happens before an abortion depends in part on what type you're having and what's legal in the state where you live.

Before you have a surgical abortion, or a medical abortion through a clinic or other health care facility, you'll need to meet with a health care provider. This may involve:

  • Providing information about your health and medical history
  • Testing to confirm pregnancy
  • A physical exam
  • Other lab tests to check your blood type and whether you're anemic
  • An ultrasound to find out how far the pregnancy has progressed (some states require this step)
  • A discussion about your options and what to expect
  • Signing a consent form for the abortion

All of this information, which your doctor will discuss with you during a short counseling session, will help them determine which procedure is right for you.

If you choose medical abortion, you may be able to do the provider visit via telehealth and have any tests you need done at a local lab. But you may be required to get counseling in person or to have a doctor with you when you take the first dose of medication.

Also, many states require you to wait a certain amount of time after the counseling session until you get an abortion, although there's no medical reason for this. Depending on the state, this waiting period could be from 18 to 72 hours. If you're having a medical emergency or your life or health is in danger, states waive the waiting period requirements.

If you schedule a surgical abortion, the health care provider will probably give you some instructions ahead of time. Because in-clinic abortions are considered surgeries, you may have to fast starting around midnight the night before your procedure.

For a medical abortion, the provider will give you instructions on how to take the medication, as well as a number to call in case you have questions or issues. You may be able to have the drugs sent to your home.

A medical abortion can end an early pregnancy with prescription medicine — usually mifepristone (RU-486) followed by misoprostol. You can usually only get a medical abortion during the first three months (first trimester) of pregnancy.

You need a prescription for these medications. In some states, a doctor must prescribe them, while in others, you can get a prescription from a physician's assistant or nurse.

Some states require you to take your first dose with a doctor present, but in others, you can take both doses at home. Some, but not all, states allow you to have the drugs mailed to you. These drugs aren't legal in states with abortion bans.

Before you have a medical abortion, make sure your health care provider is aware of your health history. Medical abortions may not be safe for those who:

  • Have an intrauterine device in place (you can get it removed before the abortion)
  • Have anemia, a blood clot disorder, or chronic adrenal failure
  • Take corticosteroid drugs for a long time
  • Have an ectopic pregnancy (when the fetus is growing outside your womb)
  • Don't have access to medical care in case you need it
  • Are allergic to the medical abortion drugs

What to expect in a medical abortion

There are usually two steps to a medical abortion:

  • First, you take mifepristone, which causes the lining of your uterus to shed like it would during your period.
  • After 6-22 hours, you take misoprostol. This drug makes your uterus contract, causing bleeding and cramping.

You can take both types of pills either by mouth or by inserting them into your vagina. These medications may cause:

  • Heavy vaginal bleeding
  • Strong cramps
  • Nausea and vomiting
  • Fever and chills

You can use nonprescription pain relievers to ease discomfort, or your doctor can give you a prescription for pain medication. A medical abortion is usually complete about two to six hours after you take the second pill, though it can sometimes take longer. Rest as comfortably as you can during this process.

After a day or two, your bleeding should lessen. You may have light bleeding for several weeks. To prevent infection, don't have sex or use tampons for at least two weeks.

You'll need to follow up with your health care provider to make sure the abortion was completed. You may do this in person or via telehealth. A pee test you take at home can't show right away whether the abortion was successful because pregnancy hormones remain high for up to a month. But a blood test or an ultrasound can confirm it about a week after you take the drugs. If your abortion isn't complete, you may need more medication or a surgical abortion.

Self-managed abortion

Some people choose to order abortion pills and take them on their own without consulting a health care provider. They may do this because they don't have access to, or can't afford, abortion care. The World Health Organization says this option is safe if you have good-quality medications, accurate information about the process, and access to health care if needed. If you do this in a state where abortion is banned, you may risk criminal charges.

You might get a surgical abortion instead of a medical one if:

  • You're more than three months pregnant
  • You have a health condition or take medication that makes a medical abortion less safe
  • You want a procedure that takes less time and requires fewer appointments
  • You want to have medical professionals on hand during your abortion

Here are details on how abortions are performed at various stages of pregnancy:

First trimester abortion: Vacuum aspiration (suction abortion)

Most abortions done in the U.S. take place in the first 12-13 weeks of pregnancy. If you opt for an in-clinic abortion in your first trimester, you'll have a vacuum aspiration, also called a "suction abortion."

Your cervix may not need to be opened (dilated) for this procedure. But if you're more than about 10-12 weeks pregnant, your health care provider may take steps to open your cervix a bit so the medical tools can access your uterus. To do this, they'll likely insert little sticks made of sterilized seaweed that absorb moisture and expand, called laminaria. These usually stay in place overnight.

Once you're ready for the procedure, your health care provider will have you lie on an exam table with your feet in stirrups, like you're having a pelvic exam.

When you're comfortable and sedated, if you so choose, your health care provider will insert a medical tool called a speculum into your vagina to keep it open and swab your vagina and cervix with an antiseptic solution called Betadine. They'll inject an anesthetic into the cervix to numb it, holding your cervix in place with a grasping instrument.

They'll then insert a small tube attached to either a handheld syringe or a suction machine into your uterus and clear out its contents. From start to finish, the procedure takes several minutes.

Afterward, your doctor will check to make sure that the procedure was successful, and then let you rest for about 30 minutes under observation.

Second trimester abortion: Dilation and evacuation (D&E)

If you're more than 12 weeks pregnant, your provider will use an ultrasound to date your pregnancy. The farther along you are, the more prep work you may need to prepare your body for the procedure.

While doctors can do vacuum aspirations until about 14 weeks, the most common type of second-trimester abortion is called D&E. (They sometimes use this method for first-trimester abortions, too.)

Your cervix will need to be dilated with medication, laminaria, or rods for this procedure. Your doctor may start this process the day before your operation.

To manage pain, you'll get sedation or an epidural block before the procedure starts. As with a vacuum aspiration procedure, you'll lie on an exam table with your feet in stirrups, and your doctor will swab your vagina and cervix with Betadine.

The main difference is that in addition to using a vacuum suction in your uterus, they'll also use forceps and other medical tools, including one called a curette to scrape the inside of your uterus. Your doctor may use an ultrasound to guide them and will likely use a suction or vacuum to make sure everything is cleared out. Some providers may use a medication, which you get as a shot into your abdomen, to stop the fetal heartbeat before the procedure. Afterward, the doctor may give you a medication to contract your uterus and reduce bleeding.

This procedure takes 10-20 minutes. You'll rest for 30 minutes to an hour while your health care providers make sure you're well.

Late-term abortion: Dilation and extraction (D&X)

If you need an abortion further along in your pregnancy, a specialized doctor can do a D&X. Doctors usually only do this procedure when you have medical complications or if there's a serious problem with the fetus.

The steps leading up to the procedure and steps afterward are the same as for a D&E, including the ultrasound to date your pregnancy and prep work to soften and dilate your cervix. For sedation, you might be offered a general IV anesthesia, especially if the procedure is done in a hospital.

There are a few other options, like labor induction, hysterotomy, and hysterectomy. But because they're riskier, doctors only do them if medically necessary.

Your doctor will talk to you about types of pain management available to you during your abortion. What type you use depends in part on what type of procedure you're having.

For a medication abortion, nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen may be enough.

For a vacuum aspiration, you'll probably get local anesthesia, meaning that your cervix will be numbed but you'll be awake. While 600-800 milligrams of ibuprofen usually provides enough pain relief, your doctor might also offer you an oral medication to calm you down or mildly sedate you so you're awake but relaxed.

If you prefer heavy sedation, meaning you're in a light sleep throughout the procedure, you can ask if a sedative medication can be given to you through an IV.

For an abortion after the first trimester, you may have IV sedation or an epidural, which blocks pain from your waist down.

Once your procedure is done, you'll rest at the clinic under supervision for about 30 minutes. You can then continue to relax in a recovery area until you're ready to head home. If you've had any sedation, you'll need someone to drive you. You may get a prescription for an antibiotic, too.

You'll probably have some cramping for a few days and light bleeding for up to two weeks. Most pain and cramping can be effectively treated with an over-the-counter or prescription painkiller like acetaminophen, ibuprofen, or codeine.

Plan to rest on the day of your procedure. You may need a few more days of rest if you had a D&E or D&X. You shouldn't lift anything heavy for a few days. Ask your doctor when it will be OK to have sex or use a tampon again — it may be up to a month before you can have anything in your vagina.

If you have intense pain, a fever over 100°F, or soak through more than two pads per hour, call your provider or the emergency contact they gave you right away.

Most providers will have you come back for a follow-up appointment in one to four weeks to make sure that you've recovered and are no longer pregnant.

In general, abortion is very safe. In fact, it's safe than giving birth. It comes with small risks, like any medical procedure does, though it's very rare for abortion to result in serious complications.

Possible complications include:

  • An incomplete abortion. This is more likely with a medication abortion. You'll need more medication or a procedure.
  • Infection. Your doctor can prescribe antibiotics to clear it up.
  • Heavy bleeding. Call your doctor if your vaginal bleeding is very heavy after an abortion.
  • Injury to your uterus, bowel, or cervix. You may require further surgery for this very rare complication.

For a surgical abortion, go to a doctor or a nurse with special training in a clinic or hospital. It can be very dangerous to try to end a pregnancy on your own.

If you want to have a medication abortion at home, it's important to have access to accurate information, reliable abortion medications, and safe, nonjudgmental, and supportive medical care in case you need it.

The cost for an abortion varies a lot depending on how many weeks pregnant you are, whether you get anesthesia or sedation for pain or discomfort, your financial situation, and where you get the procedure.

Some insurance plans cover abortion care. And many clinics offer free or sliding-scale payment options based on how much money you make. To explore these options, look into your local Planned Parenthood or other women's health clinics.

According to the Kaiser Family Foundation, costs in the U.S. for people paying out of pocket in 2021 (the latest year for which national figures were available) averaged:

  • $568 for a medical abortion
  • $625 for a first-trimester surgical abortion
  • $775 for a second-trimester abortion

Federal Medicaid funds can be used for abortions only if you get pregnant because of rape or incest or if the pregnancy threatens your life. But some states ban abortion even in cases of rape or incest. Other states use their own Medicaid funds to help with the costs of abortions in a broader range of circumstances.

If you have health insurance, abortion might be covered, depending on the rules of the state you're insured in. In about half of the states, health insurance plans you buy on Marketplace aren't allowed to cover abortion. But other states require Marketplace plans to cover it.

If your insurance covers your abortion, it may be free. In some situations, you may have a copay, just like with other medical procedures.

If you need a low-cost or free abortion, there are organizations that can help. You can find more information at:

Neither medical nor surgical abortion is likely to harm your fertility or affect future pregnancies in any way.

In rare cases, scar tissue can form in your uterus after you have a D&E or D&X. This is called Asherman syndrome, and it could make it harder to get pregnant. But you can have surgery to repair it.

Talk to your doctor if you're concerned about your ability to get pregnant later on.

Spontaneous aborton is a medical term for miscarriage. It's not a procedure like a surgical or a medical abortion.

Doctors also use a term called "missed abortion" to mean that there's a fetus in the womb but it no longer has a heartbeat.

People get abortions because they don't want to continue with their pregnancies. There are many possible reasons for this. You might:

  • Be unable to properly care for a dependent or an additional dependent
  • Lack financial or emotional resources
  • Have relationship problems
  • Not have the right support
  • Have health conditions that make pregnancy unsafe or more complicated

It mainly depends on where you live. Restrictions on surgical and medication abortions vary by state. Doctors who provide abortions are required to follow the laws of the states where they're licensed to practice medicine. If they don't, they could risk losing their license or facing criminal or civil penalties.

The restrictions on abortions on various states include:

  • Total abortion ban. Some states ban abortion is in nearly all circumstances.
  • Timing ban. Some ban abortion after a certain stage of pregnancy, sometimes as early as six weeks.
  • Method ban. Some states don't allow D&E abortions or permit them only in limited circumstances.
  • Parental consent. In some states, parents must give permission for someone under 18 to get an abortion.
  • Waiting period. You might have to have an ultrasound and/or get counseling, then wait a day or more before you can get an abortion.

In other states, abortion remains legal. Some states have added extra protections to keep it that way. If you live in a state where abortion is banned, it's not illegal to travel to another state to get one.

Keep in mind that state laws on abortion can change quickly because of court challenges and legislative action. If you're not sure what your state's abortion laws are, consider using the state-by-state guide on AbortionFinder.org

An abortion is a medical intervention to end a pregnancy. The two main types of abortion are medical, in which drugs are used to stop the pregnancy, and surgical, in which a doctor does a procedure. Abortions are considered medically safe. But they're illegal or tightly restricted in several U.S. states.

What are the types of abortions?

The two main types of abortion are:

  • Medical, in which you use prescription drugs to stop the pregnancy
  • Surgical, in which a health care provider does a procedure to end a pregnancy

How to deal with ending a pregnancy?

It's normal to feel sad, depressed, or relieved — or a combination of all these things — after having an abortion. If your bad feelings last a long time or interfere with your life, talk to your doctor or see a mental health provider. You can also seek support from friends or family members.

What are the solutions to unwanted pregnancy?

There are three basic solutions to an unwanted pregnancy:

  • Parenting — giving birth to the child and raising it
  • Adoption — giving birth to the child and placing it with another family to raise
  • Abortion — ending the pregnancy

This is a very personal decision that involves your life goals, the support and resources you have, and your personal and spiritual beliefs. A doctor or counselor can help you make an informed decision and point you to places to get help.

Is abortion legal in the U.S.?

As of October 2024, there was no national legal right to abortion. It's legal in some states, others have near-total bans, and others have various kinds of restrictions.

At what age is abortion legal?

While there's no age limit for an abortion, many states require anyone under 18 to notify or get permission from at least one parent first. Some allow other adult relatives, such as grandparents, to give consent instead. There are exceptions for medical emergencies or in case of abuse or neglect. Minors can also get a judge to allow them to get an abortion without their parents' knowledge or consent.

What are the side effects of an MTP kit?

A medical termination of pregnancy (MTP) kit is mifepristone and misoprostol for a medical abortion. Side effects may include:

  • Heavy vaginal bleeding
  • Cramps
  • Fever and chills
  • Nausea and vomiting
  • Diarrhea
  • Tiredness
  • Dizziness

See your doctor if you have:

  • Signs of an infection, such as a long-lasting fever or bad-smelling discharge
  • Bleeding so heavy that you soak through two thick pads in an hour
  • Serious back or belly pain
  • No bleeding 24 hours after you take the second drug
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