| MIFEPRISTONE/ MISOPROSTOL (MIFEGYMISO) | MANUAL VACUUM ASPIRATION (MVA) | DILATATION & CURETTAGE (D&C) | DILTATION & EVACUATION (D&E) | |
|---|---|---|---|---|
| weeks from last menstrual period | Up to 10 weeks | Up to 8 weeks | Up to 14 weeks and 3 days | 14 weeks 3 days and above |
| Type of procedure | Medical | Surgical | Surgical | Surgical |
| How the procedure works | Mifepristone pill taken orally causing pregnancy to detach from the uterus. 24-48 hours later, you place misoprostol tablets between the cheeks and gums of your mouth, causing the uterus to contract and expel its contents. | A flexible tube attached to a plastic syringe is inserted through the cervix and into the uterus. The syringe creates suction and removes the contents of the uterus. | Gentle suction is applied to an instrument that is passed through the cervix into the uterus, removing its contents. | This procedure is similar to a D&C but will require more appointments. An instrument is inserted through the cervix and into the uterus to remove its contents. Suction is also used to remove the contents of the uterus. |
| and approximate length of appointments | 2-3 appointments -pregnancy assessment and counselling with a physical exam, infection check, blood test, ultrasound (3 hours) -blood test in 1 week (at outside lab) -phone call follow up to review results of blood work | 2-3 appointments -pregnancy assessment & counselling with a physical exam, infection check, blood test and ultrasound (3 hours) -MVA procedure (10min, but 2 hours in hospital) -follow up 3 weeks after procedure (30mins) | 2-3 appointments -pregnancy assessment and counselling with a physical exam, infection check, blood tests and ultrasound (3 hours) -surgery (15min procedure, 5 hours in hospital) -follow up 3 weeks after procedure (30 mins) | 1-3 appointments -you can come to the Bay Centre for an ultrasound and referral or refer yourself directly to a clinic procedure (20min, depends on clinic and gestation, 3-4 hours total) follow up 3 weeks after procedure (30 mins) |
| Risks | -Incomplete abortion, which may need to be followed by surgical abortion(2-5%) -Heavy and prolonged bleeding or cramping(1%) -An ongoing unwanted pregnancy if the procedure doesn’t work(1%) -Infection(0.1%) -Allergic reaction(very rare) -Pain and cramping during expulsion(common) | -pelvic infection(1%) -incomplete abortion(1%) -blood clots in the uterus, heavy bleeding(1%) -cut or torn cervix, or perforation of the wall of the uterus(0.1%) -medication side effects(rare) -discomfort during procedure-depends on sedation available | -pelvic infection(1%) -incomplete abortion(1%) -blood clots in the uterus, heavy bleeding(1%) -cut or torn cervix, or perforation of the wall of the uterus(0.1%) -anesthesia-related complications(rare) | -pelvic infection(1%) -incomplete abortion(1+%) -blood clots in the uterus, heavy bleeding(1+%) -cut or torn cervix, or perforation of the wall of the uterus(0.1+%) -anesthesia-related complications.(rare) |
| Other information | Your valid Ontario Health card (OHIP) must be presented to the pharmacy to have the cost of the drug covered, otherwise there will be a cost associated with the Mifepristone. You have some choice about the timing of your abortion. Bleeding and cramping are worse than surgical options but infection and injury risks are less | You may eat up to 2 hours before your arrival time. Clear fluids (water, apple juice, ginger ale) are ok until the time of your procedure. You cannot drive for 24 hours after your procedure. Tend to have lowest bleeding and surgical complications as typically done earlier in pregnancy | You are not allowed to eat or drink after midnight the night before your surgery. The hospital requires that you have someone to pick you up from the hospital and take you home. | Each clinic has its own instructions. You should call them directly for further information. Clinic contact information is available through Bay Centre. Higher risks of bleeding and surgical complications as gestational age increases |