Manual Vacuum Aspiration (MVA)

Posted on : August 16, 2022 by Clinic One Team on Ob Gyn

According to the WHO, abortion is a safe medical procedure when it is carried out by a qualified medical provider (doctor) with the appropriate equipment and in conformity with sanitary standards (WHO, 2003).

Manual Vacuum Aspiration (MVA) is recommended by World Health Organization as a safe abortion method that can be performed in the first trimester.

What is MVA?

MVA is the process through which the content of the uterus is evacuated by using a special syringe that produces negative pressure.

It involves the use of a self-contained vacuum syringe which can be used in place of electric vacuum aspiration for suction curettage in the first trimester.

This method avoids the trauma of the cervix and endometrium.

MVA medical abortion service is available in Kathmandu Nepal at Clinic One under the supervision of Senior Gynecologists.

Book an appointment for medical abortion at Clinic One

Indication (Requirements)

MVA is performed under the following conditions:

– Incomplete abortion before 13 weeks of the last menstruation cycle.

– Termination of pregnancy before 13 weeks (3 months) LMP

– Molar pregnancy


  • Pelvic infection and purulent cervicitis: start antibiotics before performing the procedure.

  • Coagulation disorders: risk of hemorrhage.
    MVA must be performed in a facility where blood transfusion and emergency surgery are available.

  • Must be performed under the supervision of senior medical personnel in the authorized medical center only.
    For instance: Clinic One provides safe MVA medical abortion services under the supervision of Senior Gynecologists.


Medical abortion in Nepal

Before your procedure

  • Before your appointment, you will be able to drink and eat as normal.

  • You might expect to have a 3-4 hour appointment.

  • The manual vacuum aspiration should be performed in a clinic setting using a local anesthetic. You will be awake.

  • About 1 hour before the procedure painkillers will be given to you.

  • You will be given a vaginal pessary, to help soften and open the neck of your womb. This makes the MVA procedure safer and easier.

  • You will then wait in one of the clinic rooms and will be given vaginal pessary and painkillers until your procedure.

  • At this stage, some women might get period-like pain, bleeding, or diarrhea due to vaginal pessary.

During your procedure

The manual vacuum aspiration will take place in one of our clinic rooms within the Gynecology Outpatient Department.

  • You will be asked to wear a hospital gown and then be made comfortable on the clinic bed.

  • Your nurse will be with you till the completion of the procedure.

  • There will also be a nursing assistant in the room with the doctor who will carry out your procedure.

  • When you are ready, then the doctor will give you a local anesthetic that will be injected into the neck of your uterus (womb) to numb the area. This may feel uncomfortable but it will not last long.

  • You might also be given Entonox (gas and air) for pain relief during your procedure if required.

  • A small flexible tube attached to a syringe (needle) is gently passed through the neck of your uterus (womb) and the pregnancy tissue will be gently removed.

  • The procedure only takes a few minutes but towards the end, we expect you might have period-like cramps or pains as your uterus empties and contracts.

  • Your pain will settle soon, but if you need further pain relief we may provide a painkiller.

  • We might do an ultrasound scan to check whether the removal is complete or not.

After the procedure

  • One should rest on the bed for a short time immediately after the procedure.

  • Then the patient can change her clothes and the nurse will transfer her to the recovery area.

  • You can rest in a chair and we will bring you something to eat and drink.

  • We will ask you to remain with us for 30 minutes to 1 hour for observation.

Before discharge, we will check if:

  • You feel well

  • Your pain is manageable

  • You have passed urine

Advantages of the MVA:

  • This method avoids trauma to the endometrium and cervix.
    Before 7 weeks of pregnancy, the cannula can be inserted without the dilation of the cervix, and a follow-up curettage of the uterus is not required.

  • Immediate examination of the aspiration product (fetal egg) allows the provider to confirm the complete evacuation of the uterine contents and to diagnose early ectopic pregnancy.

  • The procedure takes much less time than dilation and curettage and can be performed under local anesthesia.

  • The results of many (over 80) scientific studies, in which about 80,000 women have been included, have shown that the number of severe complications and sterility is much lower in the case of manual vacuum aspiration as compared to dilation and curettage.
stomach pain abortion

You should visit the doctor if the following symptoms are seen:

  • Severe abdominal (stomach) pain

  • Persistent vomiting or feeling of nausea

  • Severe weakness, you became unconscious(you fainted), or you have difficulty in breathing

  • Purulent vaginal eliminations or bad smell

  • Severe bleeding for about 2-3 hours

  • Fever over 38 C or chills

Request an appointment with an Obs. Gynecologist at Clinic One>>>

What Should a Patient Know Following MVA?

  • After MVA, for 2 weeks it is normal to have pain in the form of spasms in the lower abdomen and slight bleeding

  • Most women can return to normal activity virtually immediately after abortion (MVA)

  • The patient should avoid sexual intercourse during bleeding

  • Places where the women can get the chosen contraception method (contraceptive devices) and how to use it correctly

NOTE: There are no contraindications for MVA up to 12 weeks of pregnancy if you are not suffering from any medical disorders.


Hence, it is clear that MVA is one of the safe methods to end pregnancy in the first terminal if performed by medical personnel in the authorized medical center.

But unsafe abortion can even lead to sterility (inability to conceive).

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