tion services. In remote areas, MVA may be the difference between safe and effective
abortion services and no services at all. MVA can be “extremely effective in improving
the accessibility of high-quality abortion services at all levels of the health system…MVA
can play a very important role in helping providers offer safe, effective abortion care that
is acceptable to women and responds to their needs—that is, care that can truly make a
difference in improving women’s health” (Greenslade et al., 1993a).
Manual Vacuum Aspiration: Clinical Overview
First-trimester surgical abortion is performed using one of two methods: Vacuum aspi-
ration (also known as “suction curettage”) or sharp curettage (also known as D&C).
Vacuum aspiration uses an electric pump or manual aspirator to create a vacuum, and
the uterine contents and lining are removed through a cannula (PATH, 1994). Because
vacuum aspiration is the safest method for performing first-trimester abortion, it is the
most common method used in industrialized countries. Vacuum aspiration is used for
about 97 percent of first-trimester abortions in the United States; Canada, China, New
Zealand, Singapore and other countries use vacuum aspiration for almost all first-
trimester surgical abortions (Greenslade et al., 1993b).
”Health service managers should
make every effort to replace
sharp curettage with vacuum
aspiration.” (IPPF, 2001)
Where vacuum aspiration is unavailable, sharp curettage is used. In this method, the
uterine lining is scraped with a metal curette, often while the patient is under general
anesthesia or heavy sedation. Medical experts do not recommend using D&C unless
vacuum aspiration and medical methods are unavailable, because sharp curettage car-
ries higher risks (IPPF, 2001; WHO, 2000).
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