You’ve been warned. We’re getting into more graphic procedures now, so proceed with caution.
So! We’re going to talk about suction aspiration today! Oh god! I’ve got the jibblies already! The things I do for you people. I’m putting it under the break so the more squeamish of all 6 of my followers can skip it if they want to.
Suction aspiration is a form of surgical abortion that takes place during the first 5-12 weeks gestation, or the second half of the first trimester. It’s also referred to as suction curettage or vacuum aspiration. Obviously, this is performed in-clinic, and is an outpatient procedure, meaning you usually wouldn’t have to stay overnight. It may be used as a method of induced abortion, a therapeutic measure used after an incomplete miscarriage or fetal death, or after a failed medical abortion.
Planned Parenthood puts the cost of first trimester abortions anywhere from $300-$950, depending on your health care provider, your ability to pay, the type of procedure, and how far along the pregnancy is. If you need help paying for an abortion, check to see if your provider will reduce the price. There are also organizations that help fund abortions; you can find the link to a list of them at the bottom of the page.
There are two methods of suction aspiration: manual and machine. Before either procedure, you may be given an osmotic dilator to begin dilating the cervix. This is either laminaria, which is made of seaweed and is inserted into the cervix 8-24 hours beforehand, or Dilapan, which is a sterile sponge. Both absorb moisture from the tissues around the cervix, causing it to expand. Another option is misoprostol, which I discussed earlier, to help soften the cervix.
Manual vacuum aspiration takes between 5 and 15 minutes and is done under local anesthesia and sometimes ibuprofen, which means you are awake during the procedure. You lie down and put your feet in the stirrups, just like you’d do for a pelvic exam. The doctor inserts a speculum into your vagina and cleans you up a bit inside with antiseptic, then numbs the cervix with a local anesthetic. Sometimes they might dilate the cervix a bit, sometimes not. Then, the doctor passes a thin tube through the cervix into the uterus and attaches it to a handheld syringe. This is used to draw tissue out of the uterus.
Machine vacuum aspiration can take a little longer, but still no more than 15 minutes, tops. You’re in the same position as before, with the speculum and the cleaning and the anesthetic and all that jazz. In this case, the doctor may also provide vasopressin or another medicine that slows uterine bleeding, to reduce blood loss.
Next, the doctor will use an instrument to grasp the cervix to keep the uterus in place. The cervix is dilated, and a thin, hollow tube, called a cannula, is passed through into the uterus. This is attached to a gentle vacuum that suctions the tissue out of the uterus.
ETA: I feel like I should emphasize this. The suction in suction aspiration is not “29 times more powerful than a home vacuum cleaner.” That’s….that just doesn’t make sense. That would probably suck your insides out. If anyone wants to do the math, it looks like suction units’ max vacuum…force…thing…is up to 0.09MPa or 680mmHg, but I’m not sure how to translate that to household vacuum. Whatever. There’s no citation or source on that fact, ever.
In both cases, as tissue is suctioned out, the uterus will contract, causing cramping. This decreases after the tube is removed. Some will feel nauseated, sweat, or feel faint (I know I would. Probably pass right the fuck out. That’s how I do). These symptoms are generally less severe with manual vacuum aspiration. Sometimes, if all the tissue hasn’t been removed, the doctor will need to perform a dilation and curettage (D&C), which I’ll talk about in another post.
After the surgery, you’ll go to the recovery room for an hour or more so you can get some rest and nurses can keep an eye on you. After that, you’ll need to have someone drive you home. Resting for the rest of the day is probably a good idea, as well as taking the full course of antibiotics and painkillers like Tylenol or Advil, since you might still be a little achey. Some bleeding is normal, and you should avoid putting stuff in your vagina, like tampons and dicks, for at least a week.
That’s it! All done! That wasn’t so bad, right? Go get yourself a soda. You earned it.