- Virginia Women’s Wellness
Abortion Pill vs. In-Clinic Abortion Procedure: The Pros and Cons of Each
Key Facts
- Abortion pill : Mifepristone, then misoprostol 1–2 days later; you pass the pregnancy at home. It is a miscarriage.
- In-clinic procedure : Aspiration (gentle suction) in the first trimester; induction and evacuation in the second
- How far along : Pills through 14 weeks and 6 days · procedures through 27 weeks and 6 days
- Effectiveness : Pills about 95–98% through 10 weeks, about 90-95% for 11 to 14 weeks · procedure almost 100% (99.9%)
- Time it takes : Pills: cramping and bleeding mostly over several hours to several days, at home · Procedure: about 10 minutes in the procedure room
- Pain control : Pills: Ibuprofen at home · Procedure: your choice of awake, twilight, or fully asleep
- Where : Pills: in person, or by telehealth for women in Virginia · Procedure: at our Virginia Beach office
- Cost : From $295; full price quoted before your visit
What is the difference between the abortion pill and an in-clinic procedure?
The abortion pill (medication abortion)
Uses two medicines. You take mifepristone first, which stops the pregnancy from growing. A day or two later you take misoprostol, which makes the uterus cramp and empty, inducing an early miscarriage. You pass the pregnancy at home, wherever you choose.
An in-clinic procedure
Is done at our office by a clinician. In the first trimester it’s an aspiration: the cervix is gently opened, and the pregnancy is removed with gentle suction, in about 10 minutes. In the second trimester it’s an induction and evacuation, which usually needs the cervix prepared beforehand. You can be awake with local numbing, in twilight sedation, or fully asleep.
Side by side
Abortion pill | In-clinic procedure | |
|---|---|---|
How far along | Through 14 weeks and 6 days | Through 27 weeks and 6 days |
Where it happens | At home (or wherever you choose) | At our Virginia Beach office |
How long | Several hours to days of strong cramping and heavy bleeding, usually within a day of the second medicine; lighter bleeding for 1–2 weeks | About 10 minutes for a first-trimester procedure; longer, with cervical preparation, in the second trimester; light bleeding for a few days |
What you feel | Strong Cramps from period-like to strong; heavy bleeding with clots; often nausea, chills, or diarrhea from misoprostol | Awake: pain and cramping for 5-10 minutes · Twilight: drowsy, little memory · Asleep: nothing |
Effectiveness | About 95–98% through 10 weeks; 90-95% 11-14 weeks. | Almost 100% (99.9%) |
Who is with you | Anyone you choose, at home; our nurses are a call away | Our clinicians, and a friend or family member for much of the visit |
Pain. | Longest Pain. Hours to days. Very strong cramps. | Asleep is effectively painless during the procedure. Twilight patients don’t sense much. Awake patients experience intense pain and cramping, but only for 5-10 minutes. |
Certainty | Not guaranteed to work. Success rates 90-98% depending on gestation. | You leave knowing it’s complete |
Telehealth? | Yes, for women in Virginia | No – in person only |
Who chooses the abortion pill?
- To be at home In their own bed, with a partner or friend, on their own schedule.
- To avoid instruments : Some women find the idea of a procedure harder than a few hours of cramping.
- It feels like a miscarriage : Many women describe it that way because it actually is a real miscarriage. It is just an induced miscarriage.
- No visit at all : if they’re in Virginia and choose telehealth they don’t even have to come into the office at all.
- It is less expensive : Pills are cheaper than procedures.
- To avoid a pelvic examination : This seems most appealing to our teenage patients.
The trade-offs: it takes longer, you manage the cramping and bleeding yourself, the experience is more intense the further along you are, and a small number of women need an in-person procedure because the pills didn’t work. Also, the process is more unpredictable. There is more woman-to-woman variation in the experience. And it is more disruptive to your life What Abortion Really Feels Like
Who chooses an in-clinic procedure?
Women who choose a procedure most often tell us they want:
- It is done in one visit : You leave knowing it’s over.
- To Avoid Pain : With fully asleep, most women feel nothing.
- To Avoid a Memory of the Abortion : Asleep patients remember nothing. Twilight patients remember little, and it’s blurry. Awake and Pill patients remember everything. Forever.
- Less disruptive to their life : Procedures are quick, certain, effective and over in one visit. Pill patients have bleeding and cramping for days, sometimes weeks, and it doesn’t always work.
- Less bleeding at home : Bleeding afterward is usually lighter and shorter than with the pill.
- Certainty : Almost 100% effective (99.9%), with no waiting at home to see if it worked. No fear or uncertainty.
- An option later in pregnancy : After 14 weeks and 6 days, a procedure is the only option we available - through 27 weeks and 6 days.
- To avoid being denied emergency care or being arrested (for women in banned/restricted states) : Women in banned states have died as a result of being denied medical care by the ED because they are abortion patients. Also, since Roe fell, 412 women have been arrested (so far) for pregnancy and abortion related charges. Most of these women were from the US South.
The trade-offs: you must come in-person to our office; if you choose to be asleep or have twilight, you can’t eat beforehand and you need someone to drive you home; After 18 weeks you need a 2-day visit. How Long Is an Abortion Appointment?
How do I decide?
A few questions usually settle it:
How far along are you?
Past 14 weeks and 6 days, a procedure is the option. Close to that limit, a procedure avoids the more intense experience of the pill later in pregnancy.
Where do you want to be?
At home, or done and finished at our office?
How do you feel about pain and memory?
If you want to feel nothing and remember nothing, choose an asleep or twilight procedure. If you’d rather manage cramps at home, then choose the pills.
How much time do you have?
A procedure is one visit. The pills are a process, not a procedure, and they can take a few hours or a few days (or in some cases a few weeks). They are more unpredictable.
Is cost an important factor?
If money is a critical factor, then choose the pills because they are cheaper.
Who will be with you?
With the pill, have someone with you or nearby for the first several hours.
Are you in a state where abortion is banned or restricted? Do you want to avoid the risk of arrest? The risk of being denied medical care?
Unfortunately, since Roe vs Wade fell, more than 412 women have been arrested and charged with crimes related to pregnancy and abortion, largely in the US South (see https://www.pregnancyjusticeus.org/post-dobbs-pregnancy-criminalization/ ) And many of these women were arrested after their interaction with a healthcare system or the Emergency Department of a Hospital. A medical system that they should have been able to trust. And for women traveling to us from restricted or banned states like GA, NC, SC, FL, AL, TX, sometimes legal considerations must override what should be a purely medical decision. Many women from those states choose to undergo an abortion procedure, rather than pills, so that they can get the abortion “over-and-done-with” before returning to their home state with hostile laws and sometimes hostile police. Even worse, on top of the risk of arrest, there is also the risk of being denied needed medical care or even dying. Tragically, there are numerous reports of women from states such as NC, GA, FL, TX, who have died as a result of being denied medical care due to abortion bans/restrictions (see https://reproductivefreedomforall.org/resources/the-human-cost-of-abortion-bans/ ) We find this heart-breaking. The risk of death is even more frightening than the risk of arrest. And, as a result, we have seen an influx of women traveling to our office who can only be described as “fleeing” their home state merely to get what should be their right - safe, legal medical care. And for many of these women, they elect to undergo an abortion procedure, rather than pills, not just to prevent the risk of arrest, but even to avoid the risk being refused needed medical care in their home state.
There is no wrong choice between two safe options. Our counselors and clinicians will talk it through with you and tell you what’s medically right for you – and the choice is yours.
Why women choose Virginia Women’s Wellness
- Every option under one roof the pill in person or by telehealth, and procedures through 27 weeks and 6 days.
- Your choice of anesthesia awake, twilight, or fully asleep.
- One visit, no waiting period
- Clear fees from $295 quoted before you come.
- FAQ’s
Questions Women Ask
Which is safer, the abortion pill or a procedure?
Which hurts less?
Can I switch if I change my mind?
Is one better for future pregnancies?
Neither affects your ability to get pregnant in the future for the great majority of women.
Don’t wait – call 757-540-1595 or book online now. Women in Virginia can also start a telehealth visit.
Sources
This page is educational and is not a substitute for individual medical advice.