Manual vacuum aspiration (Surgical termination of pregnancy under local anesthetic)
Date issued: May 2026
Review date: March 2028
Leaflet section: SHiP
PDF: Manual vacuum aspiration.pdf [pdf] 183KB
This leaflet has been prepared to guide you through the treatment you have chosen and the time after your procedure. If you have any questions regarding your procedure, please call us using the numbers below and our staff will be happy to help you.
Pregnancy Advice Service (PAS) 01752 431129
Counsellor 01752 431129
Emergency Services 999
Step 1:
3 vaginal Misoprostol tablets administered at home 2 hours before arrival.
Step 2: Same day at time
30 minutes before arrival self-administer analgesia as advised.
Step 3: Same day at time
Arrival time at SHiP for your appointment.
Step 3:
Start your antibiotics post procedure for 7 days.
Step 4:
Start your post procedure contraception (if applicable)
Follow up 1:
You can complete a normal pregnancy test no sooner than 6 weeks after your procedure.
Contact us if you feel your procedure has not been successful on 01752 431129.
If you have booked antenatal care for this pregnancy it is your responsibility to cancel this. If you have any questions you can discuss this with the nurse.
During the clinic appointment you will have an ultrasound scan to confirm how many weeks pregnant. If you are between 6 weeks and 11-12 weeks (surgeon dependent) pregnant you can choose to have a surgical termination of pregnancy under local anaesthetic. You will be given all the medications and advice to complete this safely. We hope this information is useful for you in preparing to come into hospital for your procedure.
Prior to your procedure
Step 1
At home 2 hours before your arrival time.
Insert three 200mg misoprostol tablets to the top of your vagina. These will have been supplied at your clinic appointment and the insertion procedure explained. Misoprostol is used to soften the cervix to make it easier to open the cervix during your procedure. Misoprostol is not licensed to be used in this way but is used widely in the UK for this purpose.
The side effects of misoprostol are:
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period cramping,
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vaginal bleeding,
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sickness,
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diarrhoea
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feeling flushed and sweaty.
It is a good idea to place a sanitary pad in your underwear in case you experience any bleeding before your procedure. It is advisable not to change your mind about having the procedure after you have inserted the vaginal tablets, as we cannot reverse the effects of the drug on your body.
Step 2:
Approximately 30 minutes before you arrive:
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Take 800mg ibuprofen (4 x 200mg OR 2 x 400mg) by mouth (if you do not have any reaction to non-steroidal anti-inflammatory medications such as Ibuprofen, Nurofen, Diclofenac, Naprosyn, Aspirin and you are not already taking these medications)
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Take two 500mg paracetamol by mouth (if you can take paracetamol)
Step 3
Arrival at the SHiP for your appointment.
Please come to the SHiP at the arrival time and check in at reception. This is on level 5 of the hospital, where you came for your initial appointment.
Before your operation it is advisable to have a shower or bath, remove nail polish or acrylic nails, bring any regular medication with you, and sanitary pads. Do not bring anything valuable to the hospital as there are no lockers
It would be a good idea to bring a supportive friend / relative / partner with you. They don’t have to come into the room when we do the procedure, but are welcome to do so if you wish. Most women find it useful to have someone to sit with after the procedure and to take you home, (usually, you are fine to leave after about 20 minutes after the procedure but occasionally you may need to stay longer).
You will be seen by a nurse and later by a doctor to go through the procedure and to check that the details we have are correct.
The procedure
For the procedure you will be positioned on a gynecology couch (similar to the one used when you had your scan). You will be offered a range of pain relief, local anaesthetic injections as well as Penthrox- which is an inhaled medicine which helps reduce pain for these types of procedures before we start the procedure.
A speculum is placed into the vagina, and the local anaesthetic is injected into the cervix (opening of womb). This is gently dilated (stretched). A flexible catheter is inserted into your womb and then the pregnancy is removed using non electrical suction.
The actual suction procedure takes about 5 minutes, but you will be in the treatment room for around 30 minutes whilst we are getting you positioned correctly and giving you pain relief to be comfortable. Some women can feel a bit lightheaded and dizzy for a short while afterwards, so you need to stay lying down until this has settled.
You will experience some pelvic cramps during the operation. This can be severe for one to two minutes whilst the procedure is being carried out. You will be given further pain relief if needed.
Anti-D injection
During this appointment if your blood group is Rhesus (RhD) negative, you will need an anti-D injection. This is to prevent a condition called Haemolytic Disease of the Newborn (HDN) in any future pregnancy.
It is very important for the safety of any future pregnancies that you have anti-D injections when advised.
The risks
This is a very safe procedure, but occasionally, as with any operation, there can be complications. These include infection, heavy bleeding requiring a blood transfusion and perforation (making a hole) in the womb with the instruments used. If this happened, it may be necessary to look in your tummy with a camera and if there was internal bleeding, even do a further operation to repair it. Occasionally the pregnancy is not all removed and there may be the need for further treatment. An uncomplicated termination of pregnancy has not been shown to affect future fertility.
After the procedure
You can usually go home the same day, normally within 20 minutes after the procedure. Sometimes it can take a while longer to feel well enough to go home, so be aware you may need to stay longer.
The post procedure bleeding may last for up to three weeks but usually less. It should get lighter, like at the end of a period. Do not use tampons for bleeding, just sanitary pads. It is normal to experience some tummy cramps and even some small clots after the procedure.
If you have the following you should contact 111/999 or attend your nearest emergency department for medical advice:
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the bleeding becomes very heavy i.e. using more than 4 heavy flow pads in 2 hours
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the pain becomes very severe
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you have a fever/temperature/feel unwell
Please contact us for advice if
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you have an unpleasant smelling discharge
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you still feel pregnant
Prevention of infection
You will have been given antibiotics by the clinic to take after the operation to try to prevent infection, it is very important that you finish the course of tablets.
Having a bath or shower after the procedure is safe, but avoid swimming until after the bleeding has stopped. Avoid intercourse for 2 weeks after the procedure and until after the bleeding has stopped. Physically, you should be fine to return to work a few days after your procedure.
Sensitive disposal of fetal remains
At the time of your clinic appointment the doctor will discuss with you how you wish the pregnancy remains to be disposed of. The options are; burial, incineration or making your own arrangements.
Some women will feel unable to discuss this as they find it too upsetting. If this is the case, please let us know and we will continue with the standard procedure which are:
- Under 12 weeks- sensitive incineration
You will have a 4-week period of time to change your mind about this option. If you change your mind you need to contact us on the following email:
plh-tr.pregnancylossarrangements@nhs.net and we will call you back to discuss your options. Please note this email is only monitored between Monday and Friday 9am till 4:30pm
Confidential counselling service
This service is provided for Pregnancy Advice Service (PAS) by a professional counsellor. Counselling may be helpful to address the emotions and thoughts that can arise prior to a termination. The counsellor can also talk with you about the emotional processes that might follow the termination and what signs to watch out for, indicating that further counselling may be of benefit to you. Some women may wish for a further opportunity to speak to the counsellor after their clinic visit and before their procedure. This can be arranged and will take place at the clinic premises or over the telephone.
The Pregnancy Advice Service (PAS) also offers a post termination counselling session for up to a year after your procedure; you may arrange this by telephoning the Pregnancy Advice Service (PAS) on the telephone number on the front of this booklet.
You could also ask your GP if confidential counselling is available through the surgery.
Future contraception
You will have had the opportunity to discuss contraception at your clinic appointment.
If you have chosen to take the oral contraceptive pill you need to start within 5 days of the procedure in order to be protected immediately, but please remember if you suffer from sickness and diarrhoea, this will affect the way the pill works. You must follow the instructions for your specific pill if you suffer from vomiting and/or diarrhoea to know when you will be protected again from.
If you request the injection, called the Depo Provera, this can be given to you at the clinic and should be repeated at 12-13 weekly intervals by SHiP or your GP.
If you have had an IUS/IUD or implant fitted during the procedure then this is effective immediately.
We can provide free condoms from SHiP at your initial appointment.
EMERGENCY CONTRACEPTION can be obtained from many local pharmacies, the SHiP or your GP. If taken correctly it can be effective at preventing pregnancy, but we would recommend alternative methods for the longer term. We can support you to find something appropriate for your circumstances.
Antenatal appointment cancelling
If you have booked antenatal care for this pregnancy you are responsible for cancelling this. You can do this by calling the Midwifery administration team on 01752 433256 and letting them know you are no longer pregnant. We do not share information with any other services as routine.
If you need our team to inform the antenatal booking please inform the nurse and give your consent for us to share that you have been into our service and no longer require antenatal care.
Other formats
If you need this leaflet in another format such as Braille, large print, high contrast, British Sign Language or translated into another language, contact the Patient Advice and Liaison Service (PALS):
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01752 439694
