Surgical Abortion

Safe and gentle Surgical Abortion suction (Dilation & Curettage) services up to 17 weeks

Metropolitan Family Planning Clinic makes surgical abortion services available to women in Rockville, MD, Silver Spring, MD, and the nearby areas. We make sure to provide a caring and sensitive approach for every patient. Our goal is to offer gentle and safe surgical abortion services in a confidential and private setting.

Metropolitan Family Planning Institute has been providing safe elective surgical abortions to the Washington D.C. Metropolitan area for over 30 years. Our safe and gentle surgical procedure is available up to 17 weeks of gestation. Our unique approach to cervical preparation prior to the procedure has given us the ability to minimize painful instrumentation and cervical dilation. It also gives us the ability to provide SAME DAY procedures up to 17 weeks.

By providing our patients with as much information as possible we hope to show that our approach ensures minimal instrumentation, pain and trauma. We also hope this information will make our patients more comfortable and at ease with their decision. We understand that this is not an easy decision so our goal is to make your experience at our clinic a pleasant and comfortable one. Please read the following information about the surgical abortion procedure provided at our clinic.

Please read the following information about the Surgical Abortion procedure provided at our clinic.

• English version PDF [Surgical Abortion]

• Español version PDF [Aborto Quirurgico]

Before Your Visit

• Please be on time for your appointment. If you are running late, please call us to reschedule.
• Eat a light meal (nothing heavy or greasy)
• No children are allowed in our clinics
• One person may accompany you to your appointment, but are not allowed in the examination room
• If you chose to have conscious sedation, you must have a ride home – you cannot drive yourself!
• Your total time in the office can range from 2-4 hours so please plan your day accordingly.

Before Your Procedure

1. After completing a basic history form you will be called for a sonogram to verify the estimated gestational age of your pregnancy.
   • It is very important that you notify our staff of any drug allergies that you have. Drug allergies are the leading cause of major morbidity and mortality associated with this procedure.
2. You will then be called into our laboratory where our friendly and gentle lab staff will check your vital signs and draw blood to check your RH status as well as a current hemoglobin and hematocrit.
   • Approximately 15% of women are RH negative and will require a Rhogam injection after the procedure to protect future pregnancies.
   • There is a small fee for this injection if the need arises.
   • If you have further questions about RH status please ask one of our staff to discuss the information further.
3. During this time, we encourage you to read our office provided information about the surgical abortion procedure. Our staff is available to answer any questions.

Once your decision is made and depending on your estimated gestational age you will be given a medication called Cytotec (Misoprostol) which will help to accomplish natural cervical dilation and aid in the process of making mechanical dilation easier and gentler.

Please see the Frequently Asked Questions below for more information about why we use Cytotec.

Our Process

After about 30-60 minutes, we will call you to the procedure room where you will be asked to undress from the waist down. If you have elected to have Conscious Sedation, it will be administered at this time by one of our physicians. The physician will perform a pelvic and speculum exam. Betadine, an antiseptic, will then be used to cleanse the cervix.

• It is important to let our staff know if you have an allergy to betadine or Iodine or other antiseptic agents.

Next the physician will inject a local paracervical anesthetic block. This is done to help reduce pain during your procedure.

• It is VERY IMPORTANT to inform our staff and physician if you have an allergy to any anesthetic or have had any allergic reaction to anesthesia in the past.
• Most severe and sometimes FATAL complications during the procedure are as a result of allergy to anesthetic medications and NOT the procedure itself.

After a few minutes have passed, we will perform the procedure using only vacuum aspiration and a plastic cannula. The actual procedure time is extremely short, usually no longer then 2-5 minutes. You will experience cramps like those of a normal period, which will subside shortly after the procedure has been completed. This cramping sensation, while uncomfortable, is the body’s natural way of preventing excessive bleeding.

After the procedure you will continue to lie down until one of our medical staff helps you to get dressed. If you are dizzy or light-headed please continue to lie down until it has resolved.

After Your Procedure

• After your surgical abortion procedure is complete you will be led out to our comfortable post procedure area where you will be observed for a short period of time.
• After a brief stay in the recovery room, you will be called for a post procedure sonogram to ensure that the procedure has been completed satisfactorily.
• You will also receive a prescription for antibiotics and pain medication.
• You will receive all post procedure instructions at this time as well.
• If you wish to start contraception, please let our staff know and one of our physicians will have a consultation with you to select what is the best option for you.

  We may have samples of different types of contraception and will dispense them if available.

• We will schedule a follow up appointment to take place 2 weeks after your procedure. During this follow up we will conduct another sonogram and address any issues that you may have. There is no fee for follow up visits and they are a mandatory part of your care.

Post Abortion Instructions

After your procedure is complete and we have examined both the tissue removed, and the images from your post procedure sonogram you will leave the office reassured that you are no longer pregnant.

Here are some basic post abortion care instructions:

• You may resume a normal diet immediately; if you are still experiencing nausea or vomiting, please avoid spicy or greasy foods.
• You should use pads for 2 weeks after the procedure; using tampons increases the risk of infection.
• AVOID vaginal intercourse for 2 weeks after the procedure and when you resume intercourse make certain to use condoms.
• You should rest and undertake light activity on the day of your procedure. You may resume your normal daily activities gradually.
• AVOID strenuous activity, especially bending and lifting for approximately 1 week.
• If you need a work/school note please let our staff know and we will provide one for you. Our notes are very general and do not contain specific information about what was done in the office.
• You May Shower as desired, but AVOID tub baths, swimming, douching for approximately 2 weeks after your procedure.
• If you plan to become pregnant soon we recommend that you wait at least 3 normal menstrual cycles prior to attempting your next pregnancy.
• Symptoms of pregnancy will usually resolve in about 10 days. If you are experiencing signs of pregnancy past this time, please call the office.
• The majority of women will have a period by 4-6 weeks after the procedure has been completed. If it has been more then 6 weeks and you have still not had your period, call our office to schedule an appointment to be seen.

Frequently Asked Questions

Why do you give Cytotec (Misoprostol) before the procedure?

We routinely give our patients Cytotec (Misoprostol), which is a synthetic prostaglandin. This softens the cervix. This has two effects: it significantly reduces the pain associated with dilation; and it also makes the procedure much safer because it lessens the need to dilate the cervix. Dilation of the cervix is not only painful but also carries the risk of more potential for damage. The number of Cytotec tablets depends on many factors including your estimated gestational age, number of previous vaginal deliveries, number of previous C-sections and history of fibroids.

Why do we do a sonogram before an abortion?

We routinely do sonograms on all our patients to determine accurate dating of pregnancy. Other clinics may rely solely on doing a pelvic exam but this carries a higher incidence of error. We NEVER do a procedure without doing a sonogram and knowing your estimated gestational age.

The sonogram also allows us to identify pregnancies that are abnormal. If we are not able to see a pregnancy inside the uterus on either a transabdominal or transvaginal sonogram this may point to a phenomenon called an Ectopic Pregnancy (pregnancy outside the uterus). Ectopic pregnancies are potentially very serious and require further evaluation by blood work to check your HCG level 2 times (48 hours) apart.

What is conscious sedation?

We offer conscious sedation as an additional charge for any patient who is undergoing our surgical abortion. It consists of a two-part process, the first of which consists of a tablet for anxiety. The second part consists of a single intramuscular injection that contains a very strong pain medication as well as a strong sedative.

The combination will allow you to go through the procedure with LESS pain, discomfort, cramps and anxiety. You can only receive conscious sedation if you have someone that can take you home after the procedure. Please ask the front office about this extremely valuable addition to your care.

How far along can I be to have a Surgical Abortion?

In our office we do surgical abortions up to 17 weeks. If you are further along than 17 weeks we can refer to you to a nearby clinic that does abortions for pregnancies that are further along.

How long does the process take?

While the actual abortion procedure takes no more then 5 minutes your total office visit can take up to 2 hours which accounts for time for registration, sonogram, lab draws and pre procedure preparation.

Will Surgical Abortion have any effect on my ability to have children in the future?

Surgical abortion has been formally studied for over 25 years. First trimester abortion has less than 1% complication rate, and is at least 10 times safer than childbirth. Childbearing ability is not affected, barring rare serious complications.

What are the ADVANTAGES of Surgical Abortion?

• The abortion will be completed on the same day as your initial appointment.
• In general it is associated with less bleeding and less cramping then the medical abortion.
• Our medical staff will present throughout the entire process.
• The surgical procedure can be completed up to 17 weeks of pregnancy in our clinic and thus can be further along then the medical abortion

What are the DISADVANTAGES of Surgical Abortion?

• It is more invasive then the medical abortion and necessitates a vaginal exam, speculum exam and use of surgical instruments.
• The surgical procedure cannot be done earlier then 6 weeks of pregnancy.
• There is an inherent risk of causing a uterine perforation; overall the rate is 1-3%
• A support person cannot be with you in the procedure room.

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