What is Manual Vacuum Aspiration (MVA)
Manual Vacuum Aspiration (MVA) is a procedure where a healthcare provider removes the contents from the uterus using a handheld device (the aspirator). The Manual Vacuum Aspirator is critical to providing a safe abortion as recognized by the World Health Organization.
The MVA procedure is a minor surgical procedure that can be performed under local anesthesia in a hospital or health center. It has short recovery time and is typically performed on an outpatient basis. It is a safe and effective method for pregnancies up to 12 weeks since your last menstrual period.
Vacuum aspiration uses gentle suction to empty the uterus. It can be performed either with a handheld vacuum (Manual Vacuum Aspiration, or MVA) or with a machine (Electric Vacuum Aspiration, or EVA). Vacuum aspiration can be provided by any trained healthcare provider including specialists, general care providers, nurses, and midwives.
Vacuum aspiration is recommended by the world’s leading gynecological and obstetric organizations, including FIGO (the International Federation of Gynecology and Obstetrics), for abortion care and miscarriage management.
What to expect before, during, and after an MVA procedure?
The healthcare provider will typically give you some pills to swallow before the procedure. These are for reducing pain, reducing the risk of infection, and dilating the cervix (if needed) which makes the procedure easier.
The healthcare provider will begin by inserting a speculum into your vagina to examine and clean the cervix. They might also inject an anesthetic into the cervix; this may sting initially but will numb the surrounding area.
Next, the provider will insert a narrow tube through the cervix into the uterus and attach it to a suction device. This will empty the uterus. This may be uncomfortable, and most women experience mild to moderate cramping during this step of the procedure (which generally lasts five to 10 minutes). The cramping typically decreases once the tube is removed from the uterus.
The healthcare provider will ask you to stay under observation for the next 30-60 minutes after the procedure and then you should be free to go back home. You don’t have to be accompanied by a relative or a friend, though you may want to have someone for support. Also, do not hesitate to talk with your healthcare provider if you have any questions or feel any discomfort. They can provide medicine for pain relief.
After the procedure, it is advised to rest quietly for the rest of the day. Depending on how you feel, you can restart your daily activities as soon as the following day.
During the first two weeks, it is normal to experience irregular bleeding or spotting; we advise using pads instead of tampons. You might also experience cramps similar to your menstruations for several days after. Avoid sexual intercourse during the first week and do not forget to take any prescribed antibiotics to avoid infection.
How well does it work? Is it risky?
Manual Vacuum Aspiration is very effective (more than 98%) for first-trimester abortions. There are very few complications and the procedure is safe.
Nevertheless, complications may occur, and please call your doctor if you experience:
- Severe bleeding
- Signs of infection
- Severe pain in the abdomen
- Hot flushes or fever
- Pain/Swelling or redness in the genital area
What are the advantages/benefits of choosing MVA?
- It is extremely (>98%) effective
- It is a method recommended by both the World Health Organization and the Federation of International Gynecologists and Obstetricians
- It is a short procedure with a shorter recovery time than other methods
- Your pregnancy will be finished by the time you leave the facility
- More comfortable than other surgical methods as it can be performed under local anesthesia (instead of general anesthesia)
- More than 86% of women would recommend this method to a friend
Questions & Answers
No - the Ipas aspirator is used worldwide for treatment of miscarriage and for taking samples of the uterine lining (known as an endometrial biopsy).
Yes - the World Health Organization (WHO) and the International Federation of Gynecologists and Obstetricians (FIGO) both recommend vacuum aspiration as a preferred treatment option for women with a miscarriage or seeking an abortion. The safety and efficacy of manual vacuum aspiration have been supported over time by numerous studies. (*1)
When deciding how to deal with an unplanned pregnancy, it is better to act sooner than later. Manual vacuum aspiration procedures are suggested for pregnancies up to 12 weeks after your last menstrual period.
If you would like to help calculating your weeks of pregnancy, there is a good resource here: https://safe2choose.org/pregnancy-calculator/
Yes - a pilot study showed that 98% of women had a successful procedure without the need for any further surgical or medical intervention. (*2)
The cost of a manual vacuum aspiration procedure depends on the clinic you go to. That being said, MVA has significant cost-savings for the health system because procedures do not require general anaesthesia (which can be expensive) and MVA is associated with shorter recovery times than other methods. (*3) “As MVA can be performed in the outpatient setting it also reduces the cost and use of theatre facilities. It has the advantage of early recovery and reduced hospital stay compared with Electronic Vacuum Aspiration.”(*1)
It depends - some women feel almost nothing after an MVA procedure, while other women report feeling quite uncomfortable. MVA is typically performed under local anaesthesia, meaning the provider will numb the pain receptors during the procedure.
Women typically report cramping after the procedure. Taking ibuprofen (400-800mg) before the procedure can help reduce feelings of discomfort. (*4)
“Women’s experience with pain during MVA varies widely, with some women feeling almost nothing at all and other women feeling quite uncomfortable. Typically, the MVA procedure takes several minutes, during which most women will feel a moderate amount of cramping. After the procedure has ended, cramping usually decreases rapidly.”
The procedure usually takes 10-15 minutes. (*6)
No, but a woman’s preference should always dictate how care is provided. That being said, MVA can be performed at a primary level on an outpatient basis using a local anaesthetic.
If you are more than 12 weeks pregnant, please contact your healthcare provider to suggest alternatives to manual vacuum aspiration.
If you have any of the following, you should talk with your healthcare provider for further advice:
fibroid uterus >12 weeks in size
haemorrhagic disorder and treatment with anticoagulants
allergy or contraindication to the use of misoprostol or to local anaesthetic agents
postnatal retained products
inability to tolerate pelvic examination
retained products more than 5 cm.