What is the Difference between a Medical vs Surgical Abortion?

The information contained on this page is related to Western Australian laws and regulations. If you are located outside WA, contact your state’s Family Planning Association.  

If you are in Western Australia and have decided to terminate your pregnancy, you will need to figure out which abortion procedure is right for you.  Talking to your doctor or calling 1800 4 Choice (1800 424 642) can be useful to discuss what options are available/suitable for you.  

What is a medical abortion? 

A medical abortion involves using medication to end a pregnancy. In Western Australia this option is available up to 9 weeks gestation.  

A medical abortion uses a medication called MS-2 Step. It includes two medicines: mifepristone and misoprostol. Mifepristone stops the hormone (progesterone) that helps a pregnancy grow. Misoprostol makes the uterus (womb) contract, and the cervix (the opening of the womb) relax, helping the body to pass the pregnancy. 

The mifepristone tablet is taken first, then 36-48 hrs later, four misoprostol tablets are taken between the cheek and gum. After this you can expect to experience vaginal bleeding and cramps usually within the first four hours. You may like to talk to your health professional about appropriate pain management for the initial days after taking the medication. Bleeding may be heavy and can last for about 10-16 days. If you have questions relating to the medication you can call 1800 4 Choice to speak to one of the nurses on the phoneline.  

Medical abortions are available through medical centres, sexual health clinics and hospitals. To find locations where to access medical abortions in WA you can use the interactive map or call 1800 4 Choice. 

What is a surgical abortion? 

A surgical abortion is a simple procedure performed under sedation at a dedicated clinic or hospital by a specially trained doctor. Before the procedure, your doctor will explain any risks so you can decide if it is right for you. 

Before 12 Weeks 

If your pregnancy is early, a soft, thin tube is passed through the cervix and into the uterus. The pregnancy tissue is then removed using gentle suction. Most people only have a little bleeding afterward and there is usually no follow up appointment unless there are concerns. 

After 12 weeks

For pregnancies further along than 12 weeks the procedure differs slightly. The opening of the cervix is gently stretched open using rods called dilators. The pregnancy is then removed using gentle suction or forceps (surgical tools). At the end of the procedure, the doctor will check to make sure the procedure is complete. 

As you are under sedation during a surgical abortion, you can also consult your doctor about the possibility of inserting a contraceptive device such as an intrauterine device (IUD) or an implant (Implanon NXT), which offers immediate contraception post-insertion. 

To find locations providing surgical abortions in WA you can use the 1800 4 Choice interactive map at map.4choice.org.au or call 1800 424 642. 

What are the risks involved? 

With medical abortions you can expect to experience side effects such as nausea, vomiting, diarrhoea, dizziness, abdominal pain/discomfort and cramps, as well as fever and chills. These side effects are usually short term and should not last more than 24 hours. 

Surgical abortions are a low risk and safe procedure, particularly if done in early pregnancy (up to 12 weeks). However, there are a small number of possible, but rare, complications involved with the procedure – the clinic or hospital will discuss these with you in more detail. It’s common to experience some bleeding and period-like cramps for a short while afterwards. In some cases, further treatment (a procedure or dose of medication) may be required. There is also a small chance of damage to the uterus or cervix during a surgical abortion. While still very small, this risk is greater if the procedure is performed after 12 weeks of pregnancy. 

Do I need a follow-up examination? 

You should always make sure to see a doctor 1-2 weeks after both a medical and surgical abortion to make sure there are no problems or ongoing pregnancy. Do not rely on a home pregnancy test, as they can stay positive for some time after a pregnancy. Follow up appointments are also a good time to discuss contraception with your doctor, as you can get pregnant soon after having an abortion. 

Post-abortion support 

There is no "right" way to feel after an abortion, and everyone's experience is unique. It can be helpful to talk to someone about your feelings. For those facing an unplanned or unwanted pregnancy, free counselling services are available. There are also counselling services specifically for post-abortion support. 

You can find more information about counselling resources here or call the 1800 4 Choice team to discuss your options.