Comparing Your Options: Medication and Surgical Abortion
Choosing between a medication abortion and a surgical abortion is a personal decision, and there's no single right answer. Both are safe and effective — the best choice depends on your stage of pregnancy, your health, your circumstances, and what feels right to you. This page compares the two methods across the questions we hear most often.
You may see this procedure called either "surgical abortion" or "procedural abortion" — they refer to the same thing. Many clinics and patient resources now use "procedural" because the procedure doesn't involve any cutting, incisions, or stitches. The uterus is gently emptied using suction, which is more accurately described as a procedure than as surgery. The shift in language also helps reduce some of the fear and stigma that the word "surgical" can carry. On this page we use both terms interchangeably.
Will It Hurt?
Medication Abortion
The amount of pain varies. Some people feel little or none, others describe it as period-like, and some find it intense. Pain is usually strongest for 2–4 hours, then subsides like a period. Heating pads, massage, and NSAIDs (such as ibuprofen or naproxen) help most people manage it. We'll also provide a prescription for stronger pain medication in case you need it.
Surgical Abortion
Surgical abortions are done at Victoria General Hospital. Most people feel very little pain during the procedure itself. You may be given medication an hour before surgery to soften your cervix, or have laminaria inserted the day before — these can cause some cramping. Just before the procedure, you'll be given medication to relax you. Your cervix is frozen, and the procedure takes 5–10 minutes. Afterward, you'll spend 30–60 minutes recovering until you're fully alert.
In the 1–2 weeks following the procedure, you may have on-and-off cramping similar to period cramps. A heating pad, hot water bottle, acetaminophen, or ibuprofen usually controls it.
Will this affect future pregnancies?
Surgical Abortion
No. The procedure won't affect future pregnancies, and there are no known issues with having more than one abortion.
Medication Abortion
No. The medications leave your body within days.
How much bleeding will I have?
Surgical Abortion
Bleeding is usually lighter than a period. Around day 3 or 4, you may pass some clots and bleed a bit more heavily for a day or two. Most people bleed for 1–2 weeks; some bleed on and off until their next period.
Medication Abortion
Bleeding is usually heavier than a normal period, often with clots. It starts heavy and gradually lightens, like a period. Once it starts, it can last 1–6 weeks — though it's not heavy the whole time.
What is the failure rate?
Surgical Abortion
Less than 0.5% chance of failure. Less than 1% chance of needing a second procedure if it's incomplete.
Medication Abortion
Less than 1% chance of failure requiring a surgical procedure. 2–5% of patients need additional medication to complete the process.
Is it safe?
Surgical Abortion
There is less than a 1% risk of infection or retained tissue.
Medication Abortion
There is a very small risk of infection or heavy bleeding that requires treatment.
What are the short-term side effects?
Surgical Abortion
No short-term side effects beyond waiting for the sedation to wear off.
Medication Abortion
Side effects don't last long. Some people experience chills, headache, fever, nausea, vomiting, or diarrhea; others have none. If they happen, they usually last a day or so and can be managed with medication.
How many appointments will I need?
Medication Abortion
Usually 3.
First visit (often by phone): you'll talk with the nurse educator about your options and contraception.
Second visit: examination with the doctor, including an internal ultrasound, STI testing, and blood work.
Follow-up 10–14 days later to confirm the abortion is complete. This can sometimes be done by lab work instead of in person.
Surgical Abortion
At least 3.
First visit (often by phone): you'll talk with the nurse educator about your options and contraception.
Second visit at our clinic: examination with the doctor, internal ultrasound, STI testing, and blood work. Your procedure date will be scheduled, usually within a week to 10 days.
The procedure at Victoria General Hospital.
We recommend a follow-up 2 weeks after the procedure to check on your recovery. This can be done with us or with your regular healthcare provider.
If your pregnancy is over 14 weeks, you'll need an additional appointment the day before the procedure for laminaria insertion.
What blood tests will I have?
Surgical Abortion
One blood test for Rh factor.
Medication Abortion
Usually none.
Will I need an injection?
Surgical Abortion
Yes. An IV is started for all procedures, and you'll have an injection to freeze your cervix just before the procedure.
Medication Abortion
Usually not.
How much time will I need off work or school?
Surgical Abortion
At least one day — the day of the procedure. Most people feel well enough to return to work or school the next day, unless their job is physically demanding, in which case you may want an extra day or two off or to request lighter duties. You can't drive for 24 hours after the anesthetic, as the sedation makes you legally impaired.
Medication Abortion
Most people don't need any time off. Some take one day — the day they take the misoprostol and experience the heaviest bleeding.