Types of Abortion by Week: Complete Guide to Your Options

Your abortion options depend on how far along you are in pregnancy. Medication abortion (the abortion pill) is available up to 11 weeks from your last period. Surgical abortion works from 4 weeks through the second trimester and beyond. The earlier you schedule, the more options you’ll have and the less expensive abortion will cost.

Quick Facts: Abortion Types by Gestational Age

Understanding Gestational Age: How to Calculate How Far Along You Are

Gestational age is counted from the first day of your last menstrual period (LMP), not from when you had sex or when you missed your period. This is the medical standard used by all healthcare providers worldwide, and understanding how to calculate it correctly is crucial for determining which abortion options are available to you. The confusion around pregnancy dating is one of the most common reasons people schedule abortion appointments later than necessary or mistakenly believe they have more time to access certain methods than they actually do. Your last menstrual period provides a known, verifiable date that doctors can use consistently, while the exact day of conception is usually unknown because sperm can survive in the reproductive tract for up to 5 days and ovulation timing varies from person to person and cycle to cycle. This standardized dating method ensures that everyone from your local clinic to major medical centers is using the same reference point when discussing how far along you are in pregnancy.

To calculate your gestational age, count the number of weeks from the first day of your last period to today. For example, if your last period started on January 1 and today is February 26, you are approximately 8 weeks pregnant even though you probably conceived around January 15 (about 6 weeks ago) and didn’t miss your period until February 1 (about 4 weeks ago). This is why many people are shocked to learn they’re further along than they thought when they come in for their ultrasound. The difference between counting from your last period versus counting from sex or a missed period can be 2-4 weeks, which is significant when medication abortion is only available up to 11 weeks. Understanding this dating method helps you make informed decisions about scheduling your appointment and choosing your abortion method before you run out of options.

If you’re unsure about when your last period started, don’t panic many people don’t track their periods precisely or have irregular cycles that make dating difficult. Do your best to estimate the first day of bleeding from your last period (not just spotting, but actual menstrual flow). If you truly can’t remember or your cycles are very irregular, note that an ultrasound at your appointment will provide accurate dating within 3-5 days. However, don’t use uncertainty as a reason to delay scheduling if anything, err on the side of scheduling sooner rather than later. The earlier you call for an appointment, the more options you’ll have available, and you can always reschedule if the ultrasound shows you’re earlier than expected. Waiting “just to be sure” or hoping you’ll remember your LMP more clearly next week often results in losing access to medication abortion or ending up in a higher cost bracket.

At Serenity Choice Health in Matteson, we perform ultrasounds at every single abortion appointment to confirm exactly how far along you are before proceeding with any treatment. Ultrasound dating is remarkably accurate in the first trimester accurate to within 3-5 days and ensures you receive the most appropriate abortion method for your specific gestational age. The ultrasound also confirms that the pregnancy is in your uterus (ruling out ectopic pregnancy, which requires different treatment), that the pregnancy is viable and developing normally, and that you’re not further along than you initially thought based on your LMP. This comprehensive assessment protects your health and ensures you get the right care. You are absolutely NOT required to view the ultrasound image if you don’t want to just tell our staff your preference and we’ll turn the screen away or cover it during the exam. We respect your autonomy and will never force you to see something you don’t want to see.

Learn about how early can you have an abortion.

Weeks 4-6: Very Early Pregnancy—Maximum Options and Flexibility

At 4-6 weeks pregnant, you have the maximum flexibility in choosing your abortion method because both medication abortion and surgical abortion work excellently at this early stage. This is the ideal time to access abortion care if you’re certain about your decision, as the procedures are simplest, the costs are lowest, the physical experience tends to be easier, and you have time to carefully consider which method feels right for you without the pressure of approaching cutoff dates. Many people discover they’re pregnant around 5-6 weeks (about 1-2 weeks after a missed period), which gives them the full range of options and the opportunity to schedule an appointment that works with their schedule rather than rushing to get in before losing access to certain methods.

What’s happening in the pregnancy at 4-6 weeks:

At this very early stage, the embryo is about the size of a sesame seed (4 weeks) to a lentil (6 weeks). The pregnancy sac is visible on ultrasound as a small dark circle in the uterus, but the embryo itself is tiny barely visible even with high-quality imaging equipment. There may or may not be a visible heartbeat on ultrasound at this stage, depending on exactly how far along you are and the quality of the ultrasound machine. The pregnancy at this stage consists mostly of the gestational sac and very early embryonic tissue, which is why abortion procedures at 4-6 weeks involve removing very little tissue and tend to be the simplest physically. Understanding the developmental stage helps some people feel more comfortable with their decision, though others prefer not to think about it in detail either approach is valid and we support whatever helps you feel most at peace.

Medication Abortion at 4-6 Weeks: The Abortion Pill Experience

Medication abortion works exceptionally well at 4-6 weeks, with a success rate of approximately 98% at this early gestational age. The process involves taking two different medications in sequence: mifepristone (one pill) at the clinic or immediately after your appointment, which blocks progesterone and stops the pregnancy from developing, followed 24-48 hours later by misoprostol (usually 4 pills) at home, which causes your uterus to contract and expel the pregnancy tissue. The timing between medications is important because mifepristone needs 24-48 hours to block progesterone receptors and prepare your uterus for the cramping and expulsion that misoprostol triggers. Taking both medications on the same day is less effective, while waiting more than 48 hours between them is still effective but not ideal for optimal results.

The physical experience of medication abortion at 4-6 weeks tends to be somewhat easier than at later gestational ages, though individual experiences vary widely based on pain tolerance, previous pregnancy history, and other factors. Most people at this early stage describe cramping similar to moderate to strong period cramps more intense than a normal period but not unbearable. The cramping typically begins 1-4 hours after taking misoprostol, peaks around 2-4 hours after taking the pills when the pregnancy tissue is being expelled, and then gradually decreases over the next 4-6 hours as the uterus empties. Some people at this early stage experience relatively mild cramping and are surprised that it wasn’t worse, while others find the pain quite intense and need to use maximum doses of ibuprofen plus heating pads to manage. The bleeding at 4-6 weeks is heavy for 4-6 hours with blood clots ranging from grape-sized to golf ball-sized, then decreases to something more like a heavy period for several days before tapering to light bleeding or spotting that can continue for 1-4 weeks total.

The pregnancy tissue at 4-6 weeks is extremely small often too small to see or distinguish from the blood clots you’re passing. Most people don’t notice anything that looks identifiably like pregnancy tissue, just heavy bleeding with clots. This can actually be easier emotionally for some people compared to medication abortion at later weeks when the tissue is more visible and recognizable. However, the small size of the pregnancy also means that some people worry they didn’t pass anything and the abortion didn’t work, which is why follow-up care (either a return visit with ultrasound or a home pregnancy test 2-3 weeks later) is essential to confirm the abortion was complete. At Serenity Choice Health, we provide clear instructions on what to expect, what’s normal, and when to be concerned, plus 24/7 nurse hotline access so you can call with questions at any time during the process.

Common side effects of medication abortion at 4-6 weeks include nausea (about 50% of people experience some nausea), vomiting (about 20%), diarrhea (about 30%), chills or feeling cold (very common, up to 80%), low-grade fever under 100.4°F (normal from the misoprostol), headache, dizziness, and fatigue. These side effects are temporary and typically resolve within 6-12 hours after taking misoprostol. The chills can be quite dramatic some people shake visibly and pile on blankets but this is a normal response to misoprostol and doesn’t indicate anything is wrong. Having a heating pad, comfortable clothes, plenty of fluids, light snacks, and ibuprofen ready before taking misoprostol helps you manage symptoms more effectively. Most people feel physically back to normal within 2-3 days, though lighter bleeding continues for weeks.

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

Surgical Abortion at 4-6 Weeks: Quick and Effective

Surgical abortion also works excellently at 4-6 weeks, though some providers prefer patients to wait until at least 6 weeks when the pregnancy is slightly larger and easier to visualize on ultrasound to ensure complete removal. The procedure at this early stage takes only 5-10 minutes and uses gentle suction through a very thin tube (cannula) to remove the tiny pregnancy from the uterus. Because the pregnancy is so small at 4-6 weeks, very minimal cervical dilation is needed sometimes just the width of the suction tube itself which means less cramping during the procedure compared to surgical abortion at later weeks. The entire experience from check-in to discharge typically takes 2-4 hours including paperwork, consultation, the procedure itself, and 30-60 minutes of recovery time, but the actual abortion procedure is over in less time than a typical dental cleaning.

During surgical abortion at 4-6 weeks, you’ll lie on an exam table with your feet in stirrups similar to a pelvic exam or Pap smear. The provider inserts a speculum to visualize your cervix, cleans the cervix with antiseptic solution, and injects local anesthetic to numb the area (this feels like a pinch or bee sting for a few seconds). Once the cervix is numb, the provider gently dilates (opens) the cervix just enough to insert a thin suction tube at this early stage, minimal dilation is needed so this step is very quick. The suction tube is inserted through the cervix into the uterus, gentle suction is applied, and the pregnancy tissue is removed through the tube. The actual suction part takes about 30 seconds to 2 minutes at this early stage. You’ll feel cramping during the cervical dilation and suction most people describe it as strong menstrual cramps that peak for 1-2 minutes during the suction, then immediately improve once the procedure is complete. The pain is intense but very brief, unlike medication abortion where cramping lasts for hours.

At Serenity Choice Health, we offer two pain management options for surgical abortion: local anesthesia (numbing injection to the cervix) or conscious sedation (IV medication that makes you drowsy and relaxed). With local anesthesia alone, you remain fully awake and aware throughout the procedure, can drive yourself home afterward, and pay no additional cost beyond the base procedure price. You’ll feel cramping during the procedure but the local anesthetic reduces pain significantly compared to no anesthesia. With conscious sedation, IV medications are given through a small IV in your hand or arm that make you very drowsy, relaxed, and significantly less aware of what’s happening most people remember very little of the procedure and report minimal discomfort. Conscious sedation adds $50-150 to the cost and requires someone to drive you home because the medications impair your reflexes and judgment for several hours. You can choose which option feels right for you based on your anxiety level, pain tolerance, desire to be aware or not, and whether you have someone available to drive you home.

Recovery from surgical abortion at 4-6 weeks is typically very straightforward. After the procedure, you’ll rest in a recovery area for 30-60 minutes while staff monitor your bleeding and vital signs to ensure you’re stable. You’ll have mild to moderate cramping for a few hours after the procedure (much less intense than the procedure itself), managed easily with ibuprofen. Bleeding is similar to a light to moderate period for 1-2 weeks significantly less total bleeding than medication abortion. Most people return to work, school, and normal activities the very next day, though you should avoid strenuous exercise for a few days. The restrictions after surgical abortion are the same as medication abortion: no tampons, no sex, no swimming or baths (showers are fine), and nothing inserted in the vagina for 1-2 weeks to allow your cervix to close completely and prevent infection.

The success rate of surgical abortion at 4-6 weeks is over 99%, making it slightly more effective than medication abortion at this stage (98%). The main advantage of surgical abortion is that the provider can visually confirm during the procedure that the pregnancy tissue was completely removed, giving you immediate certainty that the abortion worked. With medication abortion, you have to wait 2-3 weeks and take a pregnancy test to confirm success. For people who would spend those 2-3 weeks worried about whether the medication worked, surgical abortion provides peace of mind. However, some people strongly prefer avoiding a procedure and find medication abortion’s at-home process more comfortable and private despite the longer bleeding and waiting period for confirmation.

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

Choosing Between Medication and Surgical at 4-6 Weeks

At 4-6 weeks, the choice between medication and surgical abortion is truly based on personal preference rather than medical factors, since both methods are highly effective and safe at this stage. Consider what matters most to you: Do you want to avoid a medical procedure even if it means managing hours of cramping at home? Do you prefer quick completion with professional medical support even if it means having a brief procedure? Do you have 1-2 days you can dedicate to recovering at home privately? Do you have someone who can drive you home if you choose sedation for surgical abortion? Can you handle the uncertainty of waiting 2-3 weeks to confirm medication abortion worked? Your answers to these questions will guide you toward the method that fits your situation and comfort level best.

Many people at 4-6 weeks choose medication abortion because the pregnancy is so early that the physical experience tends to be manageable, the process feels more natural and private, they can have it at home with a support person of their choosing, and they want to avoid any medical procedure. The ability to be in your own home, in comfortable clothes, watching TV or resting in your own bed, with control over your environment appeals strongly to many people. However, other people at 4-6 weeks choose surgical abortion specifically because they want the abortion over in one day, they prefer the brief intense discomfort of the procedure to hours of cramping at home, they want immediate confirmation it worked, they have anxiety about managing symptoms at home alone, or they simply want professional medical staff present throughout the process. There’s no right or wrong choice both methods achieve the same outcome (ending the pregnancy) through different processes.

At Serenity Choice Health serving Homewood, Tinley Park, and Park Forest, we spend time during your consultation discussing both options in detail, answering all your questions, and helping you make the decision that feels right for you. We never push one method over the other our job is to provide you with complete information and support whatever choice you make. You can even change your mind at your appointment if you scheduled medication abortion but decide you want surgical instead after hearing more about both options.

Cost at 4-6 weeks: $400-$550 for either medication or surgical abortion, making this the most affordable time to access abortion care.

Read about abortion pills vs surgical abortion.

Weeks 7-11: First Trimester Standard—Still Strong Options

Weeks 7-11 represent the most common time period when people seek abortion care, as most people discover they’re pregnant and make their decision during this window. You still have both medication and surgical abortion available throughout this entire period, though the effectiveness of medication abortion begins to decrease slightly as you approach 11 weeks while surgical abortion remains consistently over 99% effective throughout. The physical experience of abortion whether medication or surgical tends to be more intense at 8-11 weeks compared to earlier weeks because there’s more pregnancy tissue to expel or remove, but both methods are still very safe and manageable with proper pain management. Understanding what to expect at different points within this 7-11 week window helps you prepare appropriately and make informed decisions about timing and method.

What’s happening in the pregnancy at 7-11 weeks:

The embryo grows significantly during this period, from about the size of a blueberry (7 weeks) to a lime (11 weeks). By 8 weeks, all major organs have begun forming, though they’re not yet functional. By 10-11 weeks, the embryo (now called a fetus) is about 1.5-2 inches long. The amount of pregnancy tissue increases substantially between 7 and 11 weeks, which is why medication abortion becomes progressively more physically intense during this period and why surgical abortion requires slightly more cervical dilation at 10-11 weeks compared to 7-8 weeks. This developmental information can be emotionally difficult for some people to think about, while others find it helpful for making peace with their decision we provide this information so you’re fully informed, but you’re not required to focus on it if you’d rather not.

Medication Abortion at 7-11 Weeks: What to Expect

Medication abortion continues to work well through 11 weeks, though the success rate gradually decreases from 97-98% at 7-8 weeks to 93-95% at 10-11 weeks. The process is identical regardless of gestational age within this window: you take mifepristone first (either at the clinic or immediately after leaving), then misoprostol 24-48 hours later at home. However, the physical experience becomes progressively more intense as you get further along because there’s more pregnancy tissue to expel and your uterus has to work harder to contract and push it out. At 7-8 weeks, most people describe medication abortion as similar to very strong period cramps with heavy bleeding. By 10-11 weeks, many people compare the cramping to labor contractions rhythmic, intense waves of pain that peak and subside repeatedly over several hours. This doesn’t mean medication abortion at 10-11 weeks is unbearable, but it does mean you need to prepare mentally and physically for a more challenging experience than at earlier weeks.

The cramping pattern at 7-11 weeks typically follows this timeline: symptoms begin 1-4 hours after taking misoprostol, starting as mild cramping that gradually intensifies. The cramping peaks 3-6 hours after taking misoprostol when you’re actively passing the pregnancy tissue this is when pain is most intense and when most people need maximum pain management (800mg ibuprofen plus heating pad plus rest in a comfortable position). The cramping continues but begins decreasing in intensity once the main pregnancy tissue has passed, usually 6-8 hours after taking misoprostol, and then gradually subsides over the next 4-6 hours to mild cramping or pressure. The entire active phase (heavy cramping and bleeding) lasts about 6-10 hours, with the middle 3-4 hours being the most difficult. After that, you’ll have continued bleeding similar to a heavy to moderate period for several days, tapering to light bleeding or spotting that can continue for 1-4 weeks total.

The bleeding at 7-11 weeks is noticeably heavier than at earlier weeks, with blood clots that can be quite large lemon-sized or even larger clots are not uncommon at 9-11 weeks. You’ll also pass visible pregnancy tissue at this gestational age, which appears as white, gray, or pink material that’s firmer than blood clots. Some people see recognizable tissue (the gestational sac looks like a small white or clear membrane with the embryo visible as a small dark spot), while others just see what looks like fleshy material mixed with clots. Seeing this tissue can be emotionally difficult for some people, even when they’re absolutely certain abortion is the right decision. Having someone with you for emotional support, preparing yourself mentally for what you might see, and remembering that you can flush everything down the toilet without examining it closely all help make this more manageable.

Side effects of medication abortion become more common and more intense at 7-11 weeks compared to earlier weeks. Nausea and vomiting affect about 60-70% of people (compared to 50% at earlier weeks), diarrhea occurs in about 40%, chills are almost universal (80-90%), and low-grade fever under 100.4°F is very common. The chills at this gestational age can be quite dramatic violent shaking, teeth chattering, and needing multiple blankets even in a warm room. This is a normal response to misoprostol and typically resolves within a few hours, though it’s unsettling when it’s happening. Fatigue after medication abortion at 9-11 weeks is more pronounced than at earlier weeks, and many people need 2-3 days of rest before feeling physically normal again. Emotionally, the days following medication abortion at this gestational age can be challenging as you process both the physical experience and the finality of your decision, so having support from friends, family, or counseling resources helps many people through this period.

When to call the clinic during medication abortion at 7-11 weeks:

Soaking through 2 or more maxi pads per hour for 2+ consecutive hours is a medical emergency requiring immediate attention call the clinic or go to an emergency room. High fever (100.4°F or higher) that persists beyond 24 hours could indicate infection. Severe pain that doesn’t improve with 800mg ibuprofen or that gets progressively worse instead of better may indicate a problem. Foul-smelling vaginal discharge (distinct from normal blood smell) suggests infection. If you have no bleeding at all within 24 hours of taking misoprostol, the medication may not have worked. Continuing or worsening pregnancy symptoms (nausea, breast tenderness) more than one week after taking the medications suggests the pregnancy may still be viable. At Serenity Choice Health, we provide 24/7 nurse hotline access specifically so you can call anytime day or night if you’re concerned we would rather you call with a question than worry alone or ignore a potential problem.

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

Surgical Abortion at 7-11 Weeks: Aspiration Procedure

Surgical abortion works excellently throughout the 7-11 week period with a consistent 99%+ success rate. The procedure takes 5-15 minutes (slightly longer at 10-11 weeks than at 7-8 weeks because there’s more tissue to remove), but the process and experience are essentially the same across this entire gestational range. You’ll have more cervical dilation at 10-11 weeks compared to 7-8 weeks because the pregnancy is larger and requires a slightly wider suction tube, which means you might feel more cramping during the dilation portion of the procedure. However, with proper pain management (local anesthesia plus optional sedation), most people find surgical abortion at 10-11 weeks very tolerable even though it’s somewhat more intense than at earlier weeks.

The procedure itself follows these steps: you’ll lie on an exam table with your feet in stirrups, the provider inserts a speculum and applies antiseptic to clean your cervix, local anesthetic is injected to numb your cervix (feels like a pinch or brief stinging), the cervix is gently dilated using progressively larger dilators until it’s wide enough for the suction tube, a thin plastic tube (cannula) is inserted through the dilated cervix into your uterus, gentle suction is applied to remove the pregnancy tissue, and the provider checks with a curette (a small spoon-shaped instrument) to ensure the uterus is completely empty. At 7-8 weeks, the actual suction takes about 1-2 minutes. At 10-11 weeks, it may take 3-5 minutes because there’s more tissue to remove and the provider needs to be thorough.

The cramping during surgical abortion at 7-11 weeks peaks during the cervical dilation and suction portions of the procedure. Most people describe it as intense menstrual cramps that are very strong for 1-2 minutes during the most active part of the suction, then immediately improve once the procedure is complete. The local anesthetic significantly reduces the pain, but it doesn’t eliminate it completely you’ll still feel pressure, cramping, and discomfort, just much less than you would without any numbing. For people with high anxiety about pain or who had very painful experiences with IUD insertion or previous pelvic procedures, we typically recommend conscious sedation, which makes the experience much more comfortable. The IV sedation medications don’t put you completely asleep (that would be general anesthesia, which is rarely used for first trimester abortion), but they make you very drowsy, relaxed, and significantly less aware of pain and discomfort. Most