Manual vacuum aspiration (MVA)

You have been offered the option of having a procedure to remove the pregnancy tissue from your uterus under local anaesthetic (awake, numbed in the area) rather than under general anaesthesia (asleep).

What is manual vacuum aspiration (MVA)?

Manual vacuum aspiration removes the pregnancy tissue by applying suction through a fine tube that has been inserted through your cervix (the neck of your womb) into your uterus (womb). 

About 1 hour before the procedure, a small tablet called misoprostol will be given to you (either to dissolve under your tongue, or administered into your vagina) which helps soften your womb to make the procedure easier and more comfortable. 

During the procedure, you will have a speculum (an instrument that allows the doctor or nurse to see your cervix) inserted into your vagina. The doctor will then usually use a numbing gel and local anaesthetic injection on your cervix to provide some pain relief. The doctor will then pass the small tube into your uterus and complete the procedure.

How successful is MVA?

The procedure is successful in 98 out of a 100 cases. If the procedure is not successful we would talk to you about other options for treatment during the same visit, or ask you to come back on another day.

Is MVA safe?

MVA has been used for over 30 years and is a normal procedure in a lot of clinics and hospitals. When it is done in the first 12 weeks of pregnancy, it has a 1 in 100 complication rate.

Can the MVA procedure fail?

2 out of every 100 procedures will fail, which means you may still be pregnant and either the same procedure, or an alternative procedure needs to be done to be successful. You will need to do a pregnancy test 3 weeks after your procedure. If it is positive, you will need to contact the Pregnancy Advisory Service on telephone 01709 424542 (between 8:30am and 6pm), Monday to Thursday.

What are the advantages of MVA?

• MVA is often quick, safe and successful. 
• You can go home after an hour as long as the procedure goes as expected and you are well.

What are the risks of having MVA? 

• The drugs given to manage pain during the procedure may cause side effects. 
• 1 in 100 people experience complications such as uterine perforation (accidentally making a hole in your uterus), a tear to your cervix, hospitalisation, infection or pregnancy tissue still left inside.

What are the alternatives to MVA?

The nurses and doctors will discuss alternatives that are suitable for you. These may include tablets to make your uterus contract, the same operation under general anaesthetic (asleep) or expectant management (waiting to see what happens naturally), depending on your circumstances.

How long does the MVA procedure take?

The procedure itself takes 5 to 10 minutes in total, but you will need to be in the clinic for a total of around 2 to 3 hours. This is because we will need to give you care before and after the procedure.

How painful is it and what pain relief is available?

The aim of the misoprostol tablet is to soften your uterus to help make the procedure easier, and we will give you paracetamol and ibuprofen alongside this, if you are able to take these. As mentioned, usually a local anaesthetic injection and numbing gel is also used during the procedure. The injection can sting a little when first given, but this then provides good pain relief. Entonox (gas and air) can also be given if you would like this.

The procedure doesn’t make a lot of noise and a nurse will be with you throughout to offer support and look after you. You will feel period like pain during the procedure, especially near the end, but in most cases this is not severe and wears off quickly afterwards. 

What happens after the MVA procedure?

We will keep you in the ward for about an hour afterwards to check you are well enough to go home. You will be given pain killers to help with any ongoing discomfort.

If your blood group is rhesus negative, you will be recommended to have an injection of Anti-D (we will give you more information on this). 

If you have had an infection in the past, or if you are likely to have an infection currently, depending on your swab results you may be given antibiotics to take. 

If you are found to be at a higher risk of developing blood clots in your legs or chest, you may be advised to take blood thinning injections after the procedure. This will all be discussed with you. 

It is advisable to be in the company of another adult for the first 24 hours after the procedure for them to care for you.

How much bleeding will occur?

Usually you will have light bleeding for the first 1 to 7 days, which may last for up to 2 weeks.

What should I look out for after the MVA procedure?

You should see your doctor or nurse as soon as possible if you have any of the following, as they may be symptoms of an infection or suggest that the procedure has failed:

• pain in your lower abdomen that does not improve with simple pain relief
• unusual vaginal discharge and any vaginal discharge that smells unpleasant
• persistent bleeding or bleeding that is getting heavier
• feeling unwell
• a high temperature or fever
• a positive pregnancy test or ongoing pregnancy symptoms (such as nausea or sore breasts)

Who should I contact if I am concerned about any of the above things after I go home? 

Pregnancy Advisory Service

01709 424542
8:30am to 6pm, Monday to Thursday 

EPAU  

01709 427072
8am to 4pm, Monday to Friday

Ward B11

01709 424349
Open 24 hours a day

Please see your own GP, call NHS 111 or if you feel unwell and cannot get through to any of the above numbers. Attend the Urgent and Emergency Care Centre in case of an emergency.

Manual vacuum aspiration patient information leaflet
Revision due: November 2025
Version 5