Types of abortion, by stage of pregnancy
Which method is used depends mostly on how far along the pregnancy is. Weeks are counted from the first day of your last period, which is about two weeks before conception.
| Method | Usually used | What happens, briefly |
|---|---|---|
| Medication abortion (abortion pill) | Up to 10 weeks (FDA-approved) | Two medicines: one stops the pregnancy developing, the second causes the uterus to cramp and empty, usually at home. |
| Vacuum aspiration | First trimester, usually up to about 13 to 14 weeks | In a clinic, the cervix is gently opened and the pregnancy is removed with suction. The procedure itself takes about 5 to 10 minutes. |
| Dilation and evacuation (D&E) | Second trimester, from about 13 to 15 weeks | The cervix is opened more widely, often starting a day before. The fetus and placenta are removed with suction and surgical instruments. |
| Induction abortion | Later second trimester and beyond (uncommon) | Medicines make the uterus contract and pass the pregnancy, like labor. Usually takes 12 to 24 hours. |
Medication abortion
Mifepristone blocks progesterone, the hormone that sustains a pregnancy, so the embryo or fetus stops developing. Misoprostol, taken 24 to 48 hours later, makes the uterus contract and push out the pregnancy, much like a miscarriage. Expect strong cramps and heavy bleeding for several hours. Read the full step-by-step guide.
Vacuum aspiration (first trimester)
This is the most common procedure in the first trimester and is usually offered up to about 13 weeks (some doctors use a hand-held version up to about 16). You lie on an exam table as for a pelvic exam. The doctor numbs the cervix, and some clinics offer sedation. The cervix is opened with thin rods (dilators), sometimes after medicine to soften it. A thin tube is passed into the uterus and suction, from a hand-held syringe or a machine, removes the embryo or fetus, the pregnancy sac and the lining of the uterus. Cramping during and after is common, and most people go home the same day.
Dilation and evacuation, or D&E (second trimester)
D&E is the method most often used after about 13 to 15 weeks. By then the fetus is larger, so suction alone isn't enough. The cervix has to open wider, which can take several hours or a day or more using dilators that slowly absorb fluid and swell, medicine, or both. During the procedure, usually with sedation or anesthesia, the doctor uses suction and forceps to remove the fetus and placenta. ACOG notes this can mean the fetus is removed in parts.
Before some procedures later in pregnancy, the doctor first injects a medicine (digoxin, potassium chloride or lidocaine) into the fetus or the fluid around it to stop the fetal heart. The Society of Family Planning recommends this near and after viability but not routinely before it.
Induction abortion (later in pregnancy)
Medicines, given by mouth, in the vagina, by IV or by injection into the uterus, make the uterus contract and pass the pregnancy, much like labor. ACOG says this usually takes 12 to 24 hours, and pain medicine is usually given. It is used mainly in the second trimester; most second-trimester abortions are D&E instead. Later in pregnancy, an injection to stop the fetal heart is usually given first, as described above.
Partial-birth abortion
This refers to a procedure called intact dilation and extraction (D&X). It was banned nationwide by the Partial-Birth Abortion Ban Act of 2003, which the U.S. Supreme Court upheld in 2007 in Gonzales v. Carhart.
How common each method is
The CDC's most recent report, for 2022, counts abortions in the states that report to it (not a full national count). In those states:
- About 79% happened at or before 9 weeks, and about 93% at or before 13 weeks.
- About 6% happened between 14 and 20 weeks, and about 1% at 21 weeks or later.
- Medication abortion made up more than half, about 58%.
Things worth knowing first
- An ultrasound tells you how far along you are, which decides which methods are possible. Many pregnancy centers offer one free.
- An ultrasound also rules out an ectopic pregnancy, which none of these methods treats.
- See what has developed at your stage of pregnancy.
Sources
- ACOG. Induced abortion (patient FAQ) and Abortion language guide.
- MedlinePlus. Abortion: surgical.
- StatPearls (NIH Bookshelf). Abortion.
- Society of Family Planning. Induction of fetal asystole before abortion (2024).
- CDC. Abortion Surveillance, United States, 2022.
- Gonzales v. Carhart, 550 U.S. 124 (2007).