After dilating the cervix, the ObGyn inserted a semi-rigid
vacuum aspiration curette to suction the uterine contents, but received nothing.
Since June 2011 alone, more than 60,000 abortions have taken place in government facilities in Mexico City and there has been increased provision of medical abortion and manual
vacuum aspiration. Contrary to popular belief, over two-thirds of the women already had children and 44% were married or in union.
While claiming that early surgical abortion such as suction or "
vacuum aspiration" is "one of the safest procedures when done by a trained provider," the authors note that "developing countries do not usually have enough trained staff and cannot provide safe abortion services." Their solution?
Of the 202 accredited advanced practice clinician training programs that responded to a survey, 53% reported that they offer didactic instruction in at least one abortion procedure--surgical abortion, manual
vacuum aspiration, or medical abortion.
Although medical abortion is a "low-tech" procedure, provision of this service may require several pieces of equipment--notably, those needed to perform ultrasonography (to date a pregnancy) and manual
vacuum aspiration (to treat incomplete abortions).
In contrast, the cost at primary-level private clinics, which provide outpatient services only and routinely use manual
vacuum aspiration and medication abortion, was only $45.
Nurses and health officers in nine health centres provide manual
vacuum aspiration and medical abortion up to 12 weeks.
Waxman's report declares that
vacuum aspiration abortion "does not pose an increased risk of infertility or other fertility problems." It cites the statement of the author of one textbook (that "Fertility is not altered by an elective abortion") and "one authority" from a 1990 medical text asserting that researchers looking at studies from all over the world had concluded that a single
vacuum aspiration abortion did not increase the risk of future complications, miscarriage, stillbirth, ectopic pregnancy, infant death, or congenital malformation of subsequent pregnancies.
The standard of care has become dilatation and curettage (D & C), increasingly done as an office procedure using
vacuum aspiration.
Many providers require that a woman wait until at least the sixth week of gestation before they will perform a
vacuum aspiration, although earlier aspiration abortions are becoming available.