How is the MVA procedure performed? 

• The healthcare provider should discuss methods of abortion with you so you can make an informed decision about whether to proceed with MVA or medication abortion. They will typically offer you some painkiller pills to swallow before the procedure and discuss other methods of pain control such as local anesthetic injections (paracervical blocks).  
• The healthcare provider will insert a speculum into your vagina to examine and clean the cervix. They can then inject anesthetic into the cervix and surrounding tissues; this may sting initially but will numb the surrounding area. Next, the provider will insert a narrow tube through the cervix into the uterus and attach it to a suction device. This will empty the uterus. This may be uncomfortable, and most women experience mild to moderate cramping during this step of the procedure (which generally lasts 5 to 10 minutes). The cramping typically decreases once the tube is removed from the uterus.  
• The healthcare provider will ask you to stay under observation for the next 30-60 minutes after the procedure and then you should be free to go back home. You do not have to be accompanied by a relative or a friend if you have had a local anesthetic, though you may want to have someone to support. Also, do not hesitate to talk with your healthcare provider if you have any questions or feel any discomfort. They can provide or recommend analgesia for pain relief.  
• After the procedure, it is advised to rest quietly for the rest of the day. Depending on how you feel, you can restart your daily activities as soon as the following day. During the first two weeks, it is normal to experience irregular bleeding or spotting; we advise using pads instead of tampons. You might also experience cramps like your menstruations for several days after.