6. UTERINE ASPIRATION PROCEDURE

^{Updated 2025 by Maria Cardenas FNP-BC, Julia McDonald, DO MPH, Fay Roepcke MD, MPH}

This chapter focuses on the use of uterine aspiration with manual and electric aspiration for both abortion and early pregnancy loss (EPL) management. It reviews use of trauma-responsive care, aspiration equipment, steps in the uterine aspiration procedure, tissue evaluation, as well as management of complex cases and complications.

Chapter Learning Objectives

Following chapter completion and hands-on experience, you should be able to:

• Approach communication, exams, and abortion care with a trauma-responsive lens
• Consistently use “no-touch technique” while performing uterine aspiration
• List the steps of uterine aspiration and tips for cervical dilation
• Safely use equipment and instruments for manual and electric uterine aspiration
• Evaluate products of conception for presence of appropriate gestational tissue
• Assess and manage challenges and complications related to uterine aspiration
• Counsel patients on and manage routine post-abortion care

Videos / Simulations

• First-Trimester Aspiration Abortion Video (IERH)
• Manual aspiration (DKT WomanCare Global)
• Animated Uterine Aspiration Simulation Workshop (IERH)
• Procedural simulation workshops:
  • TEACH
  • RHAP
• Managing Complications
  • Complications of Procedural Abortion & Prevention Strategies (IERH)
  • Managing Complications of Procedural Abortion (IERH)
  • Managing Hemorrhage Simulation (TEACH)

Readings / Resources

• WHO 2022 Abortion Care Guidelines
• Table Manners and Beyond: the Gynecological Exam for Women with Developmental Disabilities and Other Functional Limitations (Simpson 2001)
• Pelvic Exam Positions (RHAP)
• Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care (Paul 2009)
  • Chapter 10: First Trimester Aspiration Abortion
  • Chapter 13: The Challenging Abortion
  • Chapter 15: Surgical Complications: Prevention and Management