How painful is abortion?

If you’re having an abortion procedure, you may have the option to have IV sedation during your procedure. If you have “conscious sedation” administered this way, you’ll be awake but very relaxed, and the procedure should be virtually pain-free. If you have general anesthesia, which is a type of IV sedation that puts you to sleep completely, you won’t feel or experience anything during the procedure—you’ll simply wake up and it will be over. Sedation generally costs extra.

During the abortion, you’ll be undressed from the waist down with a sheet over your lap. If you prefer, you can wear a long, flowy skirt or dress, and then you can just remove your underwear and pull the skirt up. (Just keep in mind that if you wear a jumpsuit or romper, you will have to take the whole thing off.) You’ll lie back on an exam table with your feet in stirrups—just like when you go to a gynecologist or other provider to get a Pap smear or a swab for a yeast infection. The health care provider will use a speculum to separate the walls of your vagina in order to get a good view of the cervix, and they will then inject numbing medication into your cervix. For abortions early in pregnancy, the provider will then dilate (open) your cervix. Soon after, the abortion provider will use a gentle suction to empty your uterus. The procedure itself typically takes only a few minutes to complete. If your pregnancy is more than 16 weeks along, you may need an extra step to dilate your cervix more before the procedure to make it easier to complete the abortion. You’ll either take a medication to dilate your cervix, or a health care provider will insert a special dilator called laminaria into your cervix. The laminaria will slowly expand and open your cervix gradually. This kind of abortion is called a D&E—dilation and evacuation. The dilators—whether it’s medication or laminaria—may take a few hours or overnight to work. After your cervix is properly dilated, the abortion provider will use suction and some tools to gently empty your uterus.

After an abortion procedure, you’ll spend a little time in a recovery room before heading home. If you’ve been given sedatives, you’ll need someone to help you get home, like a partner, friend, or family member, even if you’re taking public transportation or taking a cab or rideshare service. If you have an abortion procedure, you may have some cramping and bleeding in the days after your abortion, but it should taper off over the next week or so. Some people have almost no bleeding, and others have spotting that lasts a few weeks. It varies from person to person, but generally the earlier in pregnancy you have the abortion, the less cramping and bleeding you can expect afterwards. You can go back to regular activities the very next day, and you can have sex again as soon as you feel ready. If you have a medication abortion, once you’ve passed the pregnancy tissue, bleeding should decrease over a few days after the pregnancy tissue passes, but you may bleed like you’re having a period for a week or two after, and you could continue bleeding for up to 6 weeks. The bleeding should get lighter over time, but it’s normal for it to stop and start. Just like with the abortion procedure, if you have a medication abortion, you can go back to work, school, taking care of your kids, or your other normal activities the next day, but if you’ve had a misoprostol-only medication abortion, you should avoid hard physical labor and heavy exercise for a few days. You can have sex again as soon as you feel ready after medication abortion. Some health care providers will recommend a follow-up appointment a few weeks after your medication abortion to make sure the pregnancy is over. Some health care providers prescribe preventive antibiotics for all people having an abortion. You should get your period within 8 weeks of having an abortion. But you can get pregnant again before then if you aren’t using birth control and you’re having penis-in-vagina sex. If it’s been 8 weeks or more since your abortion, and you haven’t had a period, contact a healthcare provider.