Overview of Your Abortion Options

Update

On June 24, 2022, the Supreme Court overturned Roe v. Wade—ending the constitutional right to abortion. Each state now has the power to regulate or prohibit the procedure. President Joe Biden has since taken some actions, including signing an Executive Order, to help protect some abortion access in the country.

Abortion is a procedure that ends a pregnancy. There are different abortion options available depending on how far along you are in your pregnancy. These options include both medical and surgical abortion methods.

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Overview of Abortion Options

If you are trying to decide if abortion is the right option for you, understanding your abortion options may help you in making your decision. Most abortions take place during the first 12 weeks of pregnancy, but the procedure can be performed later in a pregnancy. Which abortion option you choose will most likely be based on how long you have been pregnant.

  • You have three early abortion options that can effectively and safely terminate a pregnancy. These abortion methods can be performed during the first trimester of pregnancy (1-12 weeks).
  • Surgical abortion options are typically used during the second trimester of pregnancy—about 10% of abortions take place in the second trimester.

In general, second-trimester abortions tend to carry more risks than first-trimester abortions. Don't be mislead by rumors that abortion can cause breast cancer or mental health issues.

Medical Abortion

The availability of mifepristone in the United States has been the subject of recent legal challenges. In April 2023, a federal judge in Texas issued a ruling to suspend mifepristone's FDA approval. Shortly after, the Supreme Court ruled to allow mifepristone to remain available and returned the case to the Fifth Circuit Court of Appeals. In August 2023, that court ruled to maintain mifepristone's approval, but with restrictions on when it can be taken and where it can be made available.

The Supreme Court is expected to hear the case again, and until then, mifepristone remains available without the recent court-ordered restrictions.

When seeking an abortion, one option is having a medical abortion. This abortion method is considered to be an early abortion option. During a medical abortion, you are given specific medications to end the pregnancy. Medical abortion is also known as using the abortion pill mifepristone/RU486. In combination with misoprostol, it is FDA-approved to terminate a pregnancy in women up to 10 weeks pregnant (70 days or less since the first day of the last menstrual period).

Once your pregnancy has been confirmed with a pregnancy test, you can use medical abortion options. RU486/mifepristone (brand name Mifeprex) has been widely used safely and effectively for many years. A certified practitioner or a certified pharmacy with a prescription from a certified practitioner will give you the abortion pill either in person or via mail order.

Then, usually 24-48 hours later, you will need to take a second medicine called misoprostol. Sometimes, only misoprostol is used, but alone it is slightly less effective than when used in combination. When both medications are taken, a medical abortion can effectively terminate a pregnancy 92-98% of the time without the need for any surgery.

Manual Aspiration Abortion

Manual aspiration is an early abortion option. You can have this procedure anytime between 5 to 12 weeks since your last menstrual period. During a manual aspiration abortion, your healthcare provider will use a hand-held syringe to generate suction. This abortion option only takes a few minutes (5 to 15 minutes), has a minimal risk of causing scar tissue, and has a quick recovery. The manual aspiration abortion method also has a very high success rate—it is 98-99% effective).

Machine Vacuum Aspiration Abortion

Machine vacuum aspiration is another early abortion method. You can have this abortion option performed from 5 to 12 weeks after your last period. During a machine vacuum aspiration abortion, your healthcare provider will most likely need to dilate (or open) your cervix. Then, a tube, attached to a bottle and a pump will be inserted through your cervix. The pump is turned on and creates a gentle vacuum that will suction the tissue out of the uterus. The machine aspiration abortion method is done quickly, safely, and effectively in your healthcare provider's office or clinic.

Dilation and Curettage Abortion

Dilation and curettage (also known as a D&C) is a surgical abortion option that can be used up until your 16th week of pregnancy. It used to be a popular early abortion option, but because there are more non-invasive abortion options now available, D&C use has been declining. Dilation means to open up the cervix. Curettage means to remove the contents of the uterus. A dilation and curettage procedure may be necessary if your vacuum aspiration abortion is not successful. During a D&C, a curette (a spoon-shaped instrument) is used to scrape the uterine walls. A dilation and curettage abortion may take place in a hospital using general anesthesia, or in your healthcare provider's office using a local anesthetic.

Dilation and Evacuation Abortion

Dilation and Evacuation (also known as a D&E) is another surgical abortion option. A D&E is usually performed during the second trimester of pregnancy (typically 13 to 24 weeks). Around 24 hours before having a dilation and evacuation abortion, a device called an osmotic (cervical) dilator is usually inserted in the cervix to slowly open up the cervix. This abortion method takes about 30 minutes. It usually includes a combination of vacuum aspiration, dilation and curettage, and the use of surgical instruments (such as forceps). A D&E abortion will typically take place in a hospital or clinic. This abortion method is nearly 100% effective — this is because your healthcare provider will examine the removed uterine tissue to make sure the abortion is complete.

Induction Abortion

An induction abortion is a procedure that is performed to end a second or third-trimester pregnancy. This abortion option is usually only used if there is a medical problem in the fetus or the pregnant woman. An induction abortion minimizes risk to your health and may allow healthcare providers to perform a more accurate autopsy on the fetus (to determine exactly what was wrong). Less than 1% of all abortions in the United States are induction abortions. During an induction abortion, you will be given medications that trigger the start of contractions. Then, you will undergo all the steps of delivery and childbirth.

Intact Dilation and Extraction

Intact Dilation and Extraction (also known as D&X and partial-birth abortion) is a late-term abortion option. An intact dilation and extraction abortion are performed after 21 weeks of pregnancy. This late-term abortion method results in the extraction of an intact fetus—so it is the most controversial of all abortion options. The Partial Birth Abortion Ban Act only allows for the use of intact D&X if it is necessary to save a mother's life. This abortion option may or may not be legal in your state—this is because, in certain states, court cases have struck down this law.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Mayo Clinic Staff. Medical abortionMayoclinic. June 2018. 

  2. Food and Drug Administration. Questions and answers on mifepristone for medical termination of pregnancy through ten weeks gestation.

  3. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology, Society of Family Planning. Medication Abortion Up to 70 Days of Gestation: ACOG Practice Bulletin, Number 225Obstet Gynecol. 2020;136(4):e31-e47. doi:10.1097/AOG.0000000000004082

  4. Food and Drug Administration. Questions and Answers on Mifeprex.

  5. CS Mott's Children's Hospital. Vacuum Aspiration for Abortion.

  6. The Mayo Clinic. Dilation and Curettage Abortion.

  7. CS Mott Children's Hospital. Dilation and Evacuation.

Additional Reading
  • Jensen JT, Mishell Jr. DR. Family planning: contraception, sterilization, and pregnancy termination. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012: chap 13.

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.