What’s the difference between an in-clinic abortion and a medical abortion? What are the risks of both types of abortion?

There are two types of abortions: in-clinic or surgical abortion and pill abortion, also known as a medical abortion. In-clinic abortions are the most common in the U.S. and use a procedure that removes the contents of the uterus. The process starts with a pelvic examination. Next, a shot of anesthesia, or pain killer, is applied to the cervix. Some clinics provide general anesthesia, which basically means being put to sleep during the abortion.

Once the anesthesia is applied, a tube is inserted into the cervix. The tube is used to remove the contents of the uterus with suction. The procedure takes 5 to 15 minutes. The cost ranges between $350 and $700, depending on where you go and how long you have been pregnant. Sometimes, for surgical abortions, a procedure called dilation and curettage (D&C) is also used. Later in pregnancy, another type of procedure called dilation and evacuation (D&E) is used. Both D&C and D&E procedures remove what is inside of the uterus.

Medical abortions, also called medication abortion or abortion by pill, are abortions performed with medicine. No medical procedure is required. An abortion by pill usually requires two appointments with a clinician and they can only be performed earlier in your pregnancy—within the first eleven weeks after your most recent period.

On the first visit, the clinician will give you mifepristone. It works by preventing your body from producing progesterone, a hormone that is necessary for a pregnancy to continue. The clinician will instruct you when to take the second medication—misoprostol. This causes the uterus to contract, which leads to a heavy period and a termination of the pregnancy. After taking both medications, it’s important to return to the clinic to make sure the abortion is complete and there are no complications. Medical abortions are 95 percent effective and cost between $350 and $650, depending on where you live.

Medical abortion is safe. It has been used in the U.S. for more than 20 years and is widely recommended by doctors. But there are risks with any medical procedure, including medical abortion.

There are few harmful effects from abortions, as long as they are performed by (or medication is provided by) trained clinicians. Early abortions do not increase the possibility of future miscarriages, ectopic pregnancies, birth defects or low infant birth weight. Even if a person has more than one early abortion, getting pregnant again and having children in the future is possible—abortion has no effect on a person’s future ability to conceive.

• Risks associated with abortion include the following:
• allergic reaction to the medication
• infection
• very heavy bleeding
• incomplete abortion
• undetected ectopic pregnancy (a pregnancy in which the fertilized egg implants outside the uterus)
• in extremely rare cases, death from very serious complications is possible

Serious risks are not common, though. It is medically safer to have an early surgical abortion within the first three months of pregnancy in the U.S. than to have your tonsils removed.