Abortion methods being used in 2023 and their potential risks

Abortion is a situation that women may face during pregnancy, either due to circumstances that prevent them from having a child or because the embryo is not developing healthily.

This article shares the insights of obstetrician and gynecologist Dr. Hong Zhichen about the methods of abortion and their potential risks.

I want to have an abortion, what should I do?

Abortion should be performed under the guidance and supervision of a doctor, and it must be done at a legal obstetrics and gynecology clinic or hospital. RU486 medication for abortion should only be used with the approval and supervision of healthcare professionals. It is not recommended to self-purchase unverified medications from pharmacies.

4 common abortion methods

There are two main types of abortion: medical abortion and surgical abortion. Surgical abortion can be further divided into vacuum aspiration, dilation and curettage, and induction of labor. Doctors typically base their decision on the patient's condition and pregnancy duration to determine the most appropriate method:

1. Medical abortion: Abortion with medication
2. Surgical abortion: Vacuum aspiration
3. Surgical abortion: Dilation and curettage (D&C)
4. Surgical abortion: Induction of labor (labor induction)

In principle, for pregnancies between 1-7 weeks, most obstetricians and gynecologists recommend using medication for abortion. For pregnancies that are slightly longer (7-14 weeks) or if the mother prefers not to use medication due to side effects, surgical abortion is usually advised.

Comparison of abortion methods
	Phá thai bằng thuốc	Hút thai chân không	Nong và nạo hút thai	Khởi phát chuyển dạ
Suitable Pregnancy Age	1-6 weeks	7-10 weeks	11-14 weeks	Over 14 weeks
Safety	Safest method	Slightly risky	Slightly risky	Most dangerous among 4 methods
Impact on health	Relatively low impact	Relatively low impact	May cause uterine damage	Can cause significant uterine damage, high risk
Average cost	2.500.000-3.000.000 VND	2.500.000- 4.000.000 VND	5.000.000-6.000.000 VND	Varies by healthcare facility/hospital

 

Medication Abortion is typically used within the first 6 weeks of pregnancy

Medication abortion is the simplest method of abortion, with a high safety rate and minimal damage to the uterine lining. It is the only abortion method that does not require surgery. The procedure involves the use of commonly known medications such as RU486, prostaglandins, and uterine contraction drugs. For this reason, doctors typically recommend medication abortion in the early stages of pregnancy (within 1-6 weeks).

However, not everyone’s body is suitable for medication abortion. The medication can stimulate vasodilation, so if the mother has abnormal blood clotting or cardiovascular issues, careful consideration and evaluation are needed before using this method.

The cost of a medication abortion is approximately 2,500,000 – 3,000,000 VND (this can vary depending on the clinic and location).

Question: How does the medication abortion process work?

Simply put, the steps are as follows:

1. Visit a reputable clinic or hospital. If you meet the doctor's requirements, you can take the first dose of medication under the supervision of the doctor.
2. The doctor will usually ask you to return to the clinic to take the second dose, but some may prescribe the second dose to take at home.
3. About 3 hours after taking the second dose, noticeable bleeding will occur. If you feel uncomfortable, you can take pain relievers or anti-nausea medication to alleviate the discomfort.
4. Follow up with your doctor as instructed to confirm that the embryo has been expelled.

Question: Is fasting required for a medication abortion?

Most doctors do not require fasting for the first dose, but some clinics may recommend fasting to enhance the effectiveness of the medication.

For the second dose, most doctors recommend fasting for at least two hours or taking the medication immediately upon waking in the morning.

Question: What should I do if the embryo is not fully expelled after the medication abortion?

If the medication abortion is unsuccessful, surgical abortion methods may need to be used. Visit a clinic or healthcare facility immediately so the doctors can provide timely consultation and treatment to prevent any dangerous complications for your health.

Question: How long does it take for the pain to subside after taking RU486?

The experience varies for each individual. Both the second and third doses of the medication will stimulate strong uterine contractions, which may cause more discomfort. For those who are more prone to menstrual cramps, the pain may feel more intense at this stage. Even if pain relievers are taken as prescribed by the doctor, the discomfort may still persist. Therefore, if you have a low pain tolerance and are not averse to surgery, you may consider opting for a surgical abortion method.

Question: What should be noted when taking the second dose of RU486?

After a medication abortion, the discharge (lochia) will primarily consist of blood with clots and some tissue, similar to normal menstrual blood. The amount of bleeding will increase over time. More importantly, there is a risk of infection if the tissue is not fully expelled.

Therefore, if symptoms such as persistent fever, infection, rapid heartbeat, or low blood pressure occur, it is crucial to return to the clinic immediately for consultation and prompt medical attention.

Surgical Abortion (Vacuum Aspiration & Dilation and Curettage): Typically used for pregnancies between 7-14 weeks

Vacuum Aspiration: Typically used for pregnancies between 7-10 weeks

Vacuum aspiration is suitable for pregnancies around 7-10 weeks, where the fetus has grown larger. At this stage, simply using uterine contractions will not completely terminate the pregnancy, so vacuum aspiration is a safer and more effective method compared to medication abortion.

The vacuum aspiration procedure usually takes 10-20 minutes. First, the doctor will administer anesthesia, and then, under ultrasound guidance, a thin, 0.5mm tube is inserted into the uterus to gradually suction out the tissue, completing the abortion. Because the suction force of the tube is not too strong, it causes minimal damage to the uterine lining and poses no significant harm to the body.

Dilation and Curettage (D&C): Typically used for pregnancies between 10-14 weeks

As mentioned above, the suction power of the vacuum tube is limited, so for pregnancies longer than 10 weeks (10-14 weeks), abortion cannot be completed solely with vacuum aspiration and needs to be combined with dilation and curettage.

The principle of D&C is similar to vacuum aspiration. It requires a cervical dilation instrument to help open the cervix, followed by a curette (a small spoon-like instrument) about 1cm in size, which is inserted into the uterus to break apart most of the tissue into small pieces. Finally, a vacuum aspiration tube is used to complete the abortion procedure.

Question: What is the cost of surgical abortion (vacuum aspiration/dilation and curettage)?

The cost of surgical abortion is approximately 2,500,000 VND – 6,000,000 VND (this can vary depending on the clinic and location).

Question: What preparations are needed for a surgical abortion?

To ensure the procedure is safe and effective, you should fast for 8 hours before the surgery, avoid wearing makeup (no metal jewelry, makeup, nail polish, or contact lenses), and try to bring a family member or friend with you. Do not drive yourself to avoid any risks.

Question: Will there be any long-term consequences after a dilation and curettage (D&C) procedure?

If you take good care of yourself and follow the recommended health guidelines after the procedure, the risk of complications will be significantly reduced. The care and follow-up guidelines can be found in the instructions provided below the article.

Induction of Labor (Premature Birth): Applied for pregnancies from 14 weeks onward

"Induction of labor" is suitable for cases where the pregnancy has reached 14 weeks or more and is the last resort when necessary. The reason for using this method is that induction of labor is riskier compared to the previous three methods, primarily because, in the later stages of pregnancy, the mother's health may be compromised, or the fetus may not be developing as expected, leading to the decision to proceed with labor induction.

The process of induction of labor is similar to normal childbirth, but since the pregnancy is premature, labor signs do not occur naturally. Instead, medication is used to stimulate contractions, and the mother will experience labor pains and uterine contractions, after which the baby will be born naturally. This method does not have a specific week limit, except in cases of ectopic pregnancy, where a cesarean section is required, and induction of labor cannot be performed.

Question: What is the cost of abortion through labor induction (premature birth)?

The cost of abortion through labor induction depends on many factors:

• General check-up fees
• Surgical procedure fees
• Post-surgery care fees
• Additional incidental costs

Additionally, the cost will depend on the quality of the healthcare facility and the condition of the mother and fetus. Therefore, the costs can vary depending on the individual case.

Question: What is an amniotic sac (water bag) for induction of labor?

In the process of labor induction, a special "catheter" is used to insert into the cervix, and water is injected to form a distended water bag. This gradually helps to dilate the cervix, facilitating the process of expelling the fetus.

Should a medication abortion or surgical abortion be chosen for a pregnancy at an early stage?

 Dr. Hong Zhichen shares that, typically, after a comprehensive evaluation, the doctor will provide the most appropriate recommendation. For example, if the pregnancy is between 6 to 7 weeks, a medication abortion is theoretically an option. However, in practice, there may be cases where the abortion is not fully completed, and in such situations, vacuum aspiration may be considered. This method is the least risky and most favorable for the woman.

Regardless of the gestational age, miscarriage or abortion at any stage requires proper health care and follow-up.

Miscarriage and abortion at any gestational age require health care

Things to avoid and important considerations after miscarriage or abortion
Pay attention to the amount, color, and consistency of the discharge. If there are any abnormalities, seek medical attention promptly.	Ensure regular meals to support recovery. Eat protein-rich foods to help repair tissues and boost overall health.		Using herbs or Traditional Chinese Medicine may speed up recovery, but always consult with your doctor before using any treatments.
Rest for at least two days to help your body recover. Avoid any strenuous activities.		It is recommended to wait for at least two weeks or until bleeding stops before engaging in sexual activity to prevent complications.

 

Post-miscarriage and abortion care is a critical time for the mother to recover her health, similar to the postpartum period after childbirth. This is the time to heal wounds, so it's important to pay more attention to diet, lifestyle, and proper rest to help the body recover as quickly as possible. Compared to nutritional supplements, Ai-Xiao-Yue contains real medicinal herbs that help replenish energy and vital essence after a miscarriage or abortion, while enhancing the woman's ability to regulate her body.

The most important thing is that before making a decision, you must first understand your own physical condition, the characteristics of the abortion methods, and find the method that suits you best. That is the best choice!

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Author Information
Dr. Hong Zhichen (杜丞蕓) – Licensed Traditional Chinese Medicine Physician (USA)
Master’s degree holder from National Taiwan University/USA.

 is the author of several health-focused books, including For Women Only, Timeless Beauty, and Nutrition for Rejuvenation. She specializes in gynecology, internal medicine, and pediatrics. With expertise in natural medicine and holistic therapies from various countries, she offers modern interpretations of traditional Chinese medicine, medicinal diets, dietary therapies, meridians, and yoga.

Her approach emphasizes the safest and most non-toxic methods to enhance beauty and youthfulness.