Is surgical or pill abortion better?

The abortion pill works up to 11 weeks with 95% effectiveness, while surgical abortion is available through the second trimester with 99%+ success rates.

Quick Comparison: Abortion Pill vs Surgical Procedure

What Is the Abortion Pill (Medication Abortion)?

The abortion pill uses two medications taken in sequence to end a pregnancy up to 11 weeks from your last menstrual period.

You take the first medication (mifepristone) at the clinic or at home after your consultation. This pill blocks progesterone, the hormone needed for pregnancy to continue. 24-48 hours later, you take the second medication (misoprostol) at home, which causes your uterus to contract and expel the pregnancy.

The abortion happens at home over several hours. You’ll experience heavy cramping and bleeding similar to a miscarriage. The process typically takes 4-6 hours of active symptoms, though lighter bleeding continues for 1-4 weeks.

At Serenity Choice Health in Matteson, we provide medication abortion to patients from Chicago’s south suburbs and northwest Indiana. Our location makes us easily accessible from communities like Homewood, Tinley Park, Munster, IN, and Dyer, IN.

Abortion pill effectiveness: 95-98% effective when used correctly. In 2-5% of cases, a follow-up surgical procedure is needed to complete the abortion.

Learn more about medication abortion explained and how to know if the abortion pill worked.

What Is Surgical Abortion (Abortion Procedure)?

Surgical abortion uses gentle suction to remove the pregnancy from your uterus. The procedure is performed at a clinic and takes only 5-15 minutes.

You’ll lie on an exam table similar to a pelvic exam. The provider inserts a speculum, numbs your cervix with local anesthesia, gently dilates (opens) your cervix if needed, then inserts a thin tube through the cervix into the uterus. Gentle suction removes the pregnancy tissue through the tube.

Most people experience strong menstrual-like cramping during the procedure, with the worst discomfort lasting 1-2 minutes. You can choose sedation for additional comfort, which makes you drowsy and relaxed during the procedure.

After the procedure, you’ll rest in the recovery area for 30-60 minutes before going home. Most people return to normal activities the next day.

Surgical abortion effectiveness: Over 99% effective. Surgical abortion has the highest success rate of any abortion method.

At Serenity Choice Health, we offer both local anesthesia and conscious sedation options so you can choose the level of pain management that feels right for you.

Read about what happens during a surgical abortion and surgical abortion procedures explained.

How Far Along You Are Matters?

Your gestational age determines which options are available:

Under 6 weeks: Both medication and surgical abortion are available. Some people prefer medication abortion this early because it can be done as soon as pregnancy is confirmed.

6-11 weeks: Both options remain available. This is the most common timeframe when people choose between methods based on personal preference rather than medical necessity.

11-14 weeks: Only surgical abortion is available. Most clinics don’t offer medication abortion past 11 weeks because effectiveness decreases and the process becomes more challenging.

14+ weeks (second trimester): Only surgical abortion is available, specifically a procedure called dilation and evacuation (D&E). Not all clinics offer second trimester care.

How to calculate how far along you are:

Count from the first day of your last menstrual period, not from when you had sex or when you missed your period. For example, if your last period started 8 weeks ago, you’re 8 weeks pregnant even though conception probably happened about 6 weeks ago.

If you’re unsure, an ultrasound at your appointment will determine exactly how far along you are.

The earlier you schedule your appointment, the more options you’ll have. Learn about how early can you have an abortion and abortion by gestational weeks.

Comparing the Experience: What Each Method Feels Like

Abortion pill experience:

After taking misoprostol, you’ll feel cramping start within 1-4 hours. The cramping intensifies as your uterus contracts to expel the pregnancy. Most people describe the pain as similar to very strong menstrual cramps stronger than a typical period but manageable with pain medication.

You’ll pass blood clots (some quite large, up to lemon-sized) and pregnancy tissue. The heaviest bleeding and worst cramping typically last 4-6 hours, then gradually ease. You might also experience nausea, vomiting, diarrhea, chills, or low-grade fever.

Many people appreciate being at home in a comfortable, private setting with control over their environment. You can have a support person with you, watch TV, rest in your own bed, and manage the experience on your own terms.

Surgical abortion experience:

At the clinic, you’ll receive pain medication before the procedure. With local anesthesia, you’ll feel pressure and strong cramping during the cervical dilation and suction the worst discomfort lasts 1-2 minutes. Most people describe it as very uncomfortable but brief.

With conscious sedation, you’ll feel drowsy and relaxed. You may not remember much of the procedure. The medications significantly reduce anxiety and discomfort.

Immediately after the procedure, the intense cramping stops. You’ll have mild cramping for a few hours, but nothing like the procedure itself. Most people feel relief that it’s over quickly.

Learn about abortion pain management and anesthesia options for surgical abortion.

Choose the Abortion Pill If You…

Want to avoid a surgical procedure:

Many people prefer medication abortion because it doesn’t involve surgical instruments or a procedure. The abortion happens through your body’s natural processes triggered by medication.

Prefer privacy and comfort of home:

Medication abortion allows you to complete the abortion at home in your own space. You control your environment—you can be in your bedroom, wear comfortable clothes, have whoever you want with you, and manage the experience privately.

Want the process to feel more natural:

Some people feel medication abortion is more natural because it’s similar to a miscarriage. Your body expels the pregnancy through cramping and bleeding rather than through surgical removal.

Are early in pregnancy (under 8 weeks):

The earlier you are, the more effective medication abortion is and the easier the experience tends to be. If you’re under 8 weeks, medication abortion is a straightforward option.

Can handle several hours of intense symptoms:

Medication abortion requires enduring 4-6 hours of heavy cramping and bleeding. If you’re prepared for this and have time to dedicate to the process, medication abortion works well.

Have reliable access to medical care if needed:

Though complications are rare, you need access to emergency medical care if severe bleeding or other problems occur. You should be within an hour of a hospital.

Don’t mind seeing the pregnancy tissue:

With medication abortion, you’ll see blood clots and tissue being expelled. Some people find this emotionally difficult, while others feel it provides closure.

Read our complete guide on abortion pills vs surgical abortion.

Choose Surgical Abortion If You…

Want it over quickly in one day:

Surgical abortion is completed in 5-15 minutes at the clinic. Within a few hours, you’re done with the physical process. There’s no waiting for symptoms to start or wondering if it worked.

Prefer less total bleeding:

While you’ll have bleeding for 1-2 weeks after surgical abortion, the total amount is less than with medication abortion. Many people find this easier to manage.

Don’t want to see tissue being expelled:

With surgical abortion, the procedure happens while you’re on the exam table. You don’t see the pregnancy tissue being removed. For some people, this is emotionally easier.

Need to return to work/activities quickly:

Most people return to work, school, and normal activities the next day after surgical abortion. If you can’t take several days for recovery, surgical abortion is more practical.

Want immediate confirmation it worked:

With surgical abortion, the provider confirms the pregnancy was completely removed during the procedure. You have immediate certainty rather than waiting days to weeks to confirm success.

Prefer medical setting and professional support:

Some people feel more comfortable having the abortion done by medical professionals in a clinic rather than managing it at home. The medical setting provides immediate support if anything unexpected happens.

Are further along in pregnancy:

If you’re past 11 weeks, surgical abortion is your only option. Even if you’re under 11 weeks but getting close to that limit, surgical abortion might be recommended because it has a higher success rate.

Want sedation available:

With surgical abortion, you can choose conscious sedation to significantly reduce anxiety and discomfort. This option isn’t available with medication abortion.

Learn about what are the different abortion procedures.

Cost Comparison: Abortion Pill vs Surgical Abortion

Medication abortion cost: $400-$600 at most Illinois clinics, including Serenity Choice Health.

This includes:

• Consultation and counseling
• Ultrasound
• Both medications (mifepristone and misoprostol)
• Aftercare instructions
• Follow-up care

First trimester surgical abortion cost: $400-$800 depending on gestational age and anesthesia choice.

Cost breakdown:

• 6-10 weeks: $400-$550
• 10-12 weeks: $500-$650
• 12-14 weeks: $600-$800
• Local anesthesia: Included
• Conscious sedation: Add $50-$150

Why costs differ:

Medication abortion appears cheaper at first glance, but remember that 2-5% of medication abortions require a follow-up surgical procedure. Most clinics (including ours) cover this in the original cost, but it’s worth confirming.

Surgical abortion costs slightly more upfront but has a 99%+ success rate with no additional procedures needed.

Both methods are covered by:

• Illinois Medicaid (zero cost)
• Most private insurance plans
• Abortion fund financial assistance

At Serenity Choice Health, we offer sliding scale fees based on income, payment plans, and connections to financial assistance programs. We work with every patient to make abortion affordable regardless of which method you choose.

Learn about abortion pills cost and find abortion financial aid programs.

Recovery Time: What to Expect After Each Method

Recovery after medication abortion:

First 24 hours: Heavy cramping and bleeding, passing clots and tissue, feeling tired and unwell. Plan to stay home and rest.

Days 2-7: Cramping decreases significantly. Bleeding similar to a moderate period. Most people return to work/school by day 2-3. Energy returns.

Weeks 2-4: Light bleeding or spotting. Occasional mild cramping. First period usually returns in 4-6 weeks.

Activity restrictions: Avoid tampons, sex, swimming, and baths for 1-2 weeks. Showers are fine. Light exercise okay after a few days.

Recovery after surgical abortion:

First 24 hours: Mild to moderate cramping. Light to moderate bleeding. Most people feel well enough for normal activities by the next day.

Days 2-7: Cramping mostly gone. Light bleeding similar to end of a period. Energy normal.

Weeks 2-3: Spotting or light bleeding. Minimal cramping. First period returns in 4-6 weeks.

Activity restrictions: Same as medication abortion—avoid tampons, sex, swimming, and baths for 1-2 weeks.

Time off work/school needed:

• Medication abortion: 1-2 days minimum, 3-4 days ideal
• Surgical abortion: 0-1 days (many return next day)

Read about second trimester abortion recovery guide.

Success Rates and What Happens If It Doesn’t Work

Medication abortion success rate: 95-98% when used correctly.

Breakdown by gestational age:

• Under 8 weeks: 98% effective
• 8-9 weeks: 96-97% effective
• 9-10 weeks: 95-96% effective
• 10-11 weeks: 93-95% effective

If medication abortion doesn’t work completely:

In 2-5% of cases, the medication doesn’t fully end the pregnancy. This means either the pregnancy continues (very rare, less than 1%) or some tissue remains in the uterus (more common, 2-4%).

You’ll need a follow-up surgical procedure to complete the abortion. Most clinics, including Serenity Choice Health, include this follow-up in the original cost—you won’t pay twice.

Signs medication abortion didn’t work:

• No bleeding within 24 hours of misoprostol
• Very light bleeding with no clots
• Continuing pregnancy symptoms after one week
• Positive pregnancy test 2-3 weeks later

Surgical abortion success rate: Over 99% effective.

Surgical abortion has the highest success rate of any abortion method. The provider can visually confirm the pregnancy was completely removed during the procedure, giving you immediate certainty.

Incomplete surgical abortion (where tissue remains) occurs in less than 1% of cases and is easily treated with a repeat procedure.

Learn about when abortion pills don’t work and check our abortion pill effectiveness chart.

Medical Considerations: When One Method Is Recommended

Choose medication abortion if:

• You’re under 11 weeks pregnant
• You’re in good general health
• You don’t have severe anemia
• You don’t use an IUD (must be removed first)
• You don’t have ectopic pregnancy
• You can access emergency care if needed

Medication abortion may not be recommended if you have:

• Chronic adrenal failure
• Long-term corticosteroid therapy
• Bleeding disorders or anticoagulant use
• Severe asthma
• Allergy to mifepristone or misoprostol

Choose surgical abortion if:

• You’re past 11 weeks pregnant
• You have medical conditions that make medication abortion risky
• You can’t access emergency care easily
• You need immediate certainty
• You’ve had medication abortion fail before

Surgical abortion works for almost everyone:

Surgical abortion has fewer medical contraindications than medication abortion. Even people with medical conditions that prevent medication abortion can usually have surgical abortion safely.

At Serenity Choice Health, we review your complete medical history during your consultation and recommend the safest, most appropriate method for your specific situation.

Learn about abortion procedures explained complete guide.

Making Your Decision: Questions to Ask Yourself

Practical considerations:

Can you take time off for recovery?

• Medication abortion: Need 1-2 days minimum at home
• Surgical abortion: Can return to activities next day

Do you have a private space at home?

• Medication abortion: Need private space for 4-6 hours
• Surgical abortion: Recovery happens at clinic

Can you get to a clinic for an appointment?

• Medication abortion: One clinic visit
• Surgical abortion: One clinic visit
• Both: Might need follow-up visit

Do you have transportation after the procedure?

• Medication abortion: Can drive yourself home
• Surgical with local anesthesia: Can drive yourself
• Surgical with sedation: Need someone to drive you

Emotional considerations:

How do you feel about seeing pregnancy tissue?

• Medication abortion: You will see tissue and clots
• Surgical abortion: You won’t see anything

Where do you feel most comfortable?

• Medication abortion: At home in private
• Surgical abortion: At clinic with medical staff

How important is immediate certainty?

• Medication abortion: Confirm success after 1-2 weeks
• Surgical abortion: Immediate confirmation

What’s your pain tolerance?

• Medication abortion: Manage pain yourself at home
• Surgical abortion: Medical pain control available

Financial considerations:

What’s your budget?

• Medication abortion: $400-$600
• Surgical abortion: $400-$800
• Both: Financial assistance available

Do you have insurance?

• Both methods usually covered by insurance
• Illinois Medicaid covers both at zero cost

Can you afford time off work?

• Factor in lost wages if unpaid time off
• Surgical abortion requires less time off

Learn about how to support a loved one during abortion.

How We Help You Decide at Serenity Choice Health?

Your consultation includes:

When you come to our Matteson clinic, we spend time discussing both abortion methods with you. Our goal is to help you make the decision that feels right for your situation.

We’ll review:

• How far along you are (confirmed by ultrasound)
• Your medical history and any conditions
• Your preferences about privacy, pain, and timing
• Your practical situation (work, childcare, support)
• Cost and insurance coverage
• Questions and concerns you have

You’re never pressured: Some clinics push one method over another. We don’t. Both methods are safe and effective, and the right choice depends on your individual circumstances.

You can change your mind: If you schedule medication abortion but decide you want surgical instead (or vice versa), you can change your decision at your appointment. We’re flexible and want you to feel confident in your choice.

We serve patients from:

• Chicago’s south suburbs: Harvey, Dolton, Calumet City
• Northwest Indiana: South Haven, IN, Porter, IN
• Surrounding areas: Joliet, Aurora

Read about abortion clinics in Indiana.

Common Myths About Choosing Between Methods

Myth: “The abortion pill is safer because it’s not surgery.”

Reality: Both methods are extremely safe. Serious complications are rare with both medication and surgical abortion. The complication rate for both is less than 1%. Neither method is inherently safer than the other.

Myth: “Surgical abortion is more painful.”

Reality: Pain is subjective and varies by person. Medication abortion involves hours of cramping at home. Surgical abortion involves brief intense cramping during the procedure. With sedation, surgical abortion can actually involve less total pain than medication abortion.

Myth: “The abortion pill is easier.”

Reality: “Easier” depends on what you mean. Medication abortion is easier in that you avoid a procedure, but harder in that you manage hours of intense symptoms at home. Surgical abortion is harder in that you have a procedure, but easier in that it’s over quickly with professional support.

Myth: “You can’t get pregnant after surgical abortion.”

Reality: Both methods have zero impact on future fertility. You can get pregnant as soon as 2 weeks after either method. Neither causes infertility.

Myth: “The abortion pill always fails.”

Reality: The abortion pill works 95-98% of the time. The 2-5% failure rate is low, and failed medication abortions are easily treated with surgical abortion.

Myth: “Surgical abortion is only for later pregnancies.”

Reality: Surgical abortion is available as early as 4-5 weeks and works well at all gestational ages. Many people choose surgical abortion even very early in pregnancy because they prefer the quick completion.

Learn about pregnancy risks after abortion and can you get pregnant after an abortion.

Frequently Asked Questions

Which abortion method is less painful: pill or procedure?

Pain is subjective and varies by person. Medication abortion involves strong cramping for 4-6 hours at home that most people describe as worse than menstrual cramps. Surgical abortion involves intense cramping for 1-2 minutes during the procedure, then mild cramping afterward. With sedation, many people find surgical abortion less painful overall. However, some people prefer managing pain at home rather than during a procedure.

Can I switch from medication to surgical abortion after starting?

If you take mifepristone but haven’t taken misoprostol yet, you can choose surgical abortion instead—though the pregnancy may continue if you don’t complete the medication abortion. If you’ve already taken both medications and the medication abortion didn’t work completely, you’ll need surgical abortion to complete it. Discuss any concerns with your provider before taking the second medication.

How do I know if the abortion pill worked or if I need surgical abortion?

Signs medication abortion worked include heavy bleeding with large clots within 1-4 hours of misoprostol, decreasing pregnancy symptoms over the next week, and a negative pregnancy test 2-3 weeks after. You’ll have follow-up care to confirm. If you have no bleeding within 24 hours, very light bleeding, or continuing pregnancy symptoms, the medication may not have worked completely and you’ll need surgical abortion.

Does surgical abortion hurt more than the abortion pill?

The pain pattern is different. Medication abortion involves hours of strong cramping similar to labor contractions. Surgical abortion involves brief intense cramping during cervical dilation and suction (1-2 minutes), then relief. Total pain duration is shorter with surgical abortion, but some people find the procedure environment more stressful than being at home. Sedation options make surgical abortion significantly more comfortable for most people.

Which abortion method has fewer side effects?

Both methods have similar side effects (cramping, bleeding, nausea), but the intensity and duration differ. Medication abortion causes more bleeding (1-4 weeks vs 1-2 weeks), more cramping overall, and more gastrointestinal side effects (nausea, vomiting, diarrhea). Surgical abortion has fewer side effects that resolve faster. However, surgical abortion with sedation can cause drowsiness and dizziness for a few hours. Neither method causes long-term side effects.

Ready to Choose Your Abortion Method?

At Serenity Choice Health in Matteson, we’re here to help you make the decision that’s right for you. Both medication and surgical abortion are safe, effective options the best choice depends on your individual situation.

Call us today to:

• Discuss your options
• Get personalized recommendations
• Ask all your questions
• Schedule your appointment
• Verify insurance coverage
• Explore financial assistance

We offer:

• Medication Abortion
• Same-day and next-day appointments
• Sliding scale fees
• Insurance acceptance (only Illinois Medicaid)
• Compassionate, judgment-free care
• Support for out-of-state patients

You don’t have to decide alone. Our experienced staff will help you understand both methods and choose the one that feels right for you.

Additional resources:

• How does an abortion actually work
• What happens during in-clinic abortion
• Abortion and mental health

Your choice. Your body. Your decision. We’re here to support you.