What is vacuum aspiration?

Vacuum aspiration uses gentle suction to empty the uterus after a miscarriage. Many miscarriages pass on their own, but some don't. With an incomplete miscarriage, some of the pregnancy tissue stays in the uterus. With a missed miscarriage, all of the tissue stays in the uterus.

You may have manual or electric vacuum aspiration. With manual vacuum, the doctor uses a specially designed syringe to apply suction. With electric vacuum, a thin tube is attached to a pump that provides suction.

After the procedure, you may have bleeding and spotting. These symptoms usually don't last more than a few days. You also may have cramps that feel like menstrual cramps. Cramping may last up to a few weeks.

It's common to have many different emotions after a miscarriage. It's also common to want to know why a miscarriage has happened. Hormonal changes during pregnancy can make emotions stronger than usual. These feelings can last awhile.

In vacuum aspiration, a doctor uses gentle suction to remove the contents of the uterus. There are two methods of vacuum (or suction) aspiration.

• Manual vacuum aspiration involves the use of a specially designed syringe to apply suction. A thin tube is passed into the uterus. Then a valve is released that creates suction to remove the tissue.
• Electric vacuum aspiration involves the use of a thin tube that is attached to a pump. The tube is passed into the uterus. Then suction is used to remove the tissue.

• Rest as much as you can. Getting enough rest will help you recover.
• Ask your doctor when you can return to normal activities and strenuous exercise. Most people can return to normal activities 1 to 2 days after the procedure.
• Be safe with medicines. Take medicines exactly as directed
• Use sanitary pads until you stop bleeding. Using pads makes it easier to monitor your bleeding.
• Do not rinse inside your vagina with fluid (douche). This could increase your risk of infections that can lead to pelvic inflammatory disease.
• Ask your doctor when it is okay to have vaginal sex. You can get pregnant in the weeks after a vacuum aspiration. If you don't want to get pregnant, talk to your doctor about birth control options.
• If you need help coping with your feelings, consider meeting with a support group. You also may want to read about the experiences of others or talk to a friend, family member, or counselor. If you feel sad, depressed, or anxious for longer than a couple of weeks, talk to your doctor or a counselor.

Vacuum aspiration is a common type of in-clinic abortion. It is usually effective. In rare cases, the procedure doesn't end a pregnancy. This is more likely to happen during the earliest weeks of pregnancy.

Vacuum aspiration rarely causes any problems. Possible problems include:

• Tissue remaining in the uterus.
• Failure to end the pregnancy (when it's used for abortion).
• Injury to the cervix.
• A hole in the wall of the uterus (uterine perforation).
• Heavy vaginal bleeding.
• Infection.

Vacuum aspiration is a minor medical procedure. A normal recovery includes:

• Irregular bleeding or spotting for the first 2 weeks. Use sanitary pads until you stop bleeding. Using pads makes it easier to monitor your bleeding.
• Cramps similar to menstrual cramps. They help to shrink the uterus back to its nonpregnant size. You may have cramping for up to a few weeks.

After the procedure:

• If your doctor prescribed medicines, take them exactly as directed.
• Rest as much as you can. You can do normal activities the next day, based on how you feel.
• Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Advil). Do not take aspirin unless your doctor prescribed it. Be safe with medicines. Read and follow all instructions on the label.
• Ask your doctor when it is okay for you to have vaginal sex.

  You can get pregnant in the weeks after an abortion. If you don't want to get pregnant, talk to your doctor about birth control options.

Vacuum aspiration can be done in the first trimester to end a pregnancy. It may also be done to empty the uterus after:

• A failed or incomplete pill abortion.
• Death of the embryo or fetus (miscarriage).

Just before a vacuum aspiration procedure, antibiotics are given to prevent infection. A medicine called misoprostol may be given to soften the cervix before the procedure.

Vacuum aspiration usually takes 10 to 15 minutes. It can be done safely in a clinic or medical office under local anesthetic. For this procedure, the health professional will:

• Position you on the exam table. You'll be in the same position used for a pelvic exam, with your feet on stirrups while lying on your back.
• Insert a speculum into the vagina.
• Clean the vagina and cervix with an antiseptic solution.
• Inject a numbing medicine (local anesthetic) in the cervix. Medicine for pain or sedation, along with the local anesthetic, may be given by mouth or through a vein (intravenously). Vasopressin, or a similar medicine that slows uterine bleeding, may be mixed with the local anesthetic to reduce blood loss.
• Grasp the cervix with a tool to hold the uterus in place.
• Open (dilate) the cervical canal with a small tool. Dilation reduces the risk of any injury to the cervix during the procedure.
• Pass a thin tube (cannula) into the cervical canal, and apply suction to gently remove all tissue from the uterus. As the uterine tissue is removed, the uterus will contract. Most women feel cramping during the procedure. The cramps will decrease after the tube is removed. Some women also may have nausea or sweating or feel faint.

The tissue removed from the uterus during the procedure is examined to make sure that all of the tissue has been removed and the abortion is complete.