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What is MVA?

Manual vacuum aspiration (MVA) is a method of uterine evacuation that involves use of a hand-held plastic aspirator providing a vacuum source attached to a cannula (thin tube) and manually activated to suction the uterine contents. Plastic cannulae, which vary from rigid to very flexible, are used with MVA aspirators.

MVA is appropriate for treatment of incomplete abortion for uterine sizes up to 12 weeks from the last menstrual period (including miscarriage, spontaneous abortion and removal of retained products from an induced abortion), first-trimester abortion (menstrual regulation), and endometrial biopsy.

Is MVA Safe?

Manual vacuum aspiration is safe and effective. Most studies show that vacuum aspiration is successful in approximately 98-99 percent of cases. In a small percentage of cases (< 2%), one or more of the following can occur during or after the procedure: uterine or cervical injury, pelvic infection, vagal reaction, incomplete evacuation or acute hematometra.  Be sure to discuss the risks with your physician.

Compared with sharp-curettage method, use of MVA requires less cervical dilatation and is associated with less blood loss, shorter hospital stays and a reduced need for anesthetic drugs.

Is an MVA procedure painful?

Women undergoing an MVA generally experience three sources of discomfort: anxiety, cervical dilatation and uterine cramping. These sources require different pain-management strategies. The health-care provider should create a pain-management plan, together with the woman, in advance to reduce any physical pain and anxiety and to minimize medication-induced risks and side effects. Pain during a uterine evacuation with MVA can be reduced with a combination of verbal support, oral medications, local anesthetic to the cervix (paracervical block) and a gentle clinical technique.

Are there other options for uterine aspiration?

Alternatives to MVA include electric vacuum aspiration, medical abortion and sharp curettage. Vacuum aspiration methods and medical abortion are recommended over sharp curettage by the World Health Organization.


+ Bibliography
  • Baird, Traci L., and Susan K. Flinn. 2001. Manual vacuum aspiration: expanding women’s access to safe abortion services. Chapel Hill, NC, Ipas.
  • Bird, Sheryl Thorburn, S. Marie Harvey, Linda J. Beckman, Mark D. Nichols, Kathy Rogers, and Paul D. Blumenthal. 2003. Similarities in women’s perceptions and acceptability of manual vacuum aspiration and electric vacuum aspiration for first trimester abortion. Contraception, 67:207-12.
  • Forna, Fatu, and A. Metin Gülmezoglu. 2002. Surgical procedures to evacuate incomplete abortion (Cochrane Review). In: The Cochrane Library, Issue 1, 2002. Oxford, Update Software.

    Greenslade, Forrest C., Ann H. Leonard, Janie Benson, Judith Winkler and Victoria L. Henderson. 1993. Manual vacuum aspiration: a summary of clinical and programmatic experience worldwide. Carrboro, NC, Ipas.

    Hyman, Alyson G., and Laura Castleman, 2005. Woman-centered abortion care: reference manual. Chapel Hill, NC, Ipas.

  • Warriner, I. K., O. Meirik, M. Hoffman, C. Morroni, J. Harries, N. T. My Huong, N. D. Vy and A. H. Seuc. 2006. Rates of complication in first-trimester manual vacuum aspiration abortion done by doctors and mid-level providers in South Africa and Vietnam: A randomised controlled equivalence trial. The Lancet,  368:1965-1972.
  • World Health Organization (WHO). 2003. Safe abortion: Technical and policy guidance for health systems. Geneva, WHO.