A Guide to Manual Vacuum Aspiration (MVA)

We are sorry that you have had a pregnancy loss. To help you at this difficult time, you should have already received information on your different treatment options. This leaflet gives you information about a surgical option called Manual Vacuum Aspiration (MVA). It explains:

• what the procedure is

• what happens during the procedure

• what the risks and benefits are

• what will happen when we discharge you home

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please contact the Early Pregnancy Assessment Unit (EPAU). The contact details are at the end of this leaflet.

What is MVA?

MVA is a small handheld device, used to empty the womb for one of the following reasons.

• After a delayed miscarriage, where:

  • a pregnancy has failed but the pregnancy sac is still in the uterus; or

  • no fetal heart beat is present but the pregnancy is still in the uterus.

• After an incomplete miscarriage, where some of the pregnancy tissue remains inside the uterus.

• If management of the miscarriage using medication, to help empty the womb, has not been successful.

• When some pregnancy tissue remains in the uterus following a termination of pregnancy.

MVA is a safe procedure which has been used for more than 30 years.

Will I have a general anaesthetic?

Approximately 2 in 100 women may need a general anaesthetic for this procedure. A general anaesthetic means that you will be asleep for the procedure.

However, MVA does allow women to have this treatment without a general anaesthetic. If you do not have a general anaesthetic, it means:

• you do not have to stop eating and drinking for your procedure; and

• your recovery will be much quicker.

What happens before my procedure?

• You will have an appointment in the Early Pregnancy Assessment Unit / Gynaecology Assessment Unit (EPAU / GAU). Here we will discuss your options following your miscarriage.

• You will have blood tests to check your blood group and blood count.

• We will also ask you what you wish to happen to your pregnancy tissue after the procedure, as there are several options. We will discuss this with you and ask you to sign a consent form. Remember that you can withdraw your consent for treatment at any time.

• We will ask if you have any allergies, and we will discuss your medical history with you. It would be helpful if you could bring to the hospital a list of any medications you are taking.

• Take two pain relief medications before your procedure. This will help to reduce any pain you may feel. This will include:

  • 1mg of paracetamol (2 tablets); and

  • 400 mgs of ibuprofen (2 tablets).

  Take these 1 hour before your procedure’s appointment time. If you have not taken these, we will provide them. If you are unable to take paracetamol or ibuprofen, please let the healthcare professional know. We can prescribe another medication.

If you have any questions or concerns, please ask them this appointment.

How long will I have to stay in hospital?

An MVA is done as a day procedure, you will be able to return home after your procedure.

What happens on the day of my procedure?

• You can eat and drink as normal before your appointment.

• Please take all your usual medications at the normal times.

• The nurses will tell you where to go when you arrive at the hospital.

• You will meet a specially trained healthcare professional. They will explain the procedure to you and answer any questions that you may have. They will ask you to sign a consent form. Remember you can withdraw your consent for treatment at any time.

• We will give you two tablets of misoprostol. Some patients have these tablets placed under their tongue or they swallow them. Other patients may need the tablets placed into their vagina one hour before their procedure. This will help soften the cervix (neck of the womb). We will discuss this with you first.

  Misoprostol can give you minor side effects. These can include mild abdominal (tummy) pain, nausea (feeling sick), vomiting, and diarrhoea.

• We will give you codeine before your procedure.

What happens during my procedure?

We will take you to the procedure room and give you privacy to remove your lower clothing. Your partner or a close family member can stay with you during your procedure.

We will take you to the examination room. Your healthcare professional will give you an internal examination using a speculum, like the one used during a smear test.

They will give you a local anaesthetic injection into your cervix. This will numb any pain caused by the instrument holding your cervix. When you feel comfortable, we will gently stretch your cervix, and pass the narrow hollow plastic tube of the MVA into your womb. This will be followed by gentle suction to empty the contents of your womb.

You may have an ultrasound scan at the end of your procedure to check that it is complete. The whole procedure (preparation, local anaesthetic, and treatment) will take about 15 minutes.

Will I feel pain during the procedure?

You may have some cramps, like a period cramp, during this procedure. The pain relief we advise you to take before your procedure and the local anaesthetic injection given to your cervix will help reduce any pain. We will also offer you Entonox® (gas and air) that you can inhale during treatment. This will give further pain relief.

What happens after my procedure?

After your procedure we will take you to a room to recover. We will give you some refreshments, such as tea, coffee, or squash.

If you are Rhesus negative blood group, we will give you an injection of anti D before we discharge you home. This will stop anti-body production in your body.

Most patients are ready to go home about 1 hour after their procedure.

Can I drive myself home?

Where possible, please arrange for someone to take you home after your procedure.

What should I expect when I get home?

• You will have some period-like cramping for the first 48 hours. We will advise you what pain relief to take before you leave hospital.

• You will experience light to moderately heavy vaginal bleeding for up to 2 weeks following your procedure. This is normal. During this time, use sanitary towels and not tampons. Do not have sex until the bleeding has stopped. Both of these measures will help to reduce the risk of infection.

1. 
   The amount of bleeding you should expect
2. 
   Monitor this level of bleeding, but it should get less on its own
3. 
   If you have this level of bleeding, please go to your nearest Emergency Department immediately

• You can return to your normal daily activities the day after your procedure. Normal activities include driving and work.

• If you have severe pain and very heavy bleeding in the first 48 hours, please go to your nearest Emergency Department.

Why have I been asked to take a pregnancy test?

We advise you to take a pregnancy test 3 weeks after your procedure. If the test is positive it could mean that your womb is not empty. If your test is positive, please contact the EPAU team at the hospital that performed your procedure.

What are the risks?

• During the procedure a small amount of bleeding is common (around 1 in 10 women will experience this). We will control this using medication.

• Uterine perforation (a small tear in the uterus). This happens in less than 5 in 1000 women, and usually heals naturally. Sometimes we may need to have a look inside your tummy and control the bleeding or repair the tear. If you need this, we will re-admit you to hospital to have this done under general anaesthetic. This procedure can be done by laparoscopy (keyhole) or laparotomy (cut on your tummy).

• Infection is common, affecting 3 in 100 women, although we take every precaution during the procedure to reduce this risk. Should you develop an infection after your procedure you may have:

  • a high temperature

  • lower abdominal (tummy) pain

  • a bad smelling vaginal discharge

  • continual and heavy vaginal bleeding

  Please contact the EPAU / GAU team using the numbers listed at the end of this leaflet. We may need to prescribe a course of antibiotics.

• Retained pregnancy tissue (some tissue is left behind). This may need further surgery, and happens in approximately 5 in 100 women. Your healthcare professional will discuss your options with you. The EPAU team will be able to advise you on this.

• Scar tissue forming in the womb. This reduces the space inside the womb. It can lead to fertility issues, pain, and menstrual changes (Asherman’s syndrome). Please talk to the EPAU team about this.

When can I start trying for another baby?

You can plan for your next pregnancy when you are physically and emotionally ready. However, we would suggest waiting until after your next period. During this time, you may wish to use some form of short-term contraception, such as condoms.

Contact details

Monday to Friday 8am to 4pm, contact the EPAU or GAU for advice.

• Early Pregnancy Assessment Unit, Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
  Telephone: 01843 233591

• Gynaecology Assessment Unit, Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
  Telephone: 01843 235009

• Women’s Health Suite, William Harvey Hospital, Ashford
  Telephone: 01233 651987

Outside of these times please call the gynaecology ward / suite at the hospital you had your procedure if:

• you have heavy vaginal bleeding before your appointment

• you have any questions after your procedure

• you need urgent advice out of hours

Further information

It is normal to feel a range of emotions following miscarriage or pregnancy loss, such as distress, sadness, or even anger. Most of the time these emotions will feel easier with time and support. However, please reach out for more specialist support if:

• you feel you are not recovering emotionally from your pregnancy loss; or

• your mental health is being affected.

Local support

• Women’s Health Counselling Service

  East Kent Hospitals offers a confidential NHS funded counselling service. It is available to women and their partners, who:

  • are under the care of the Women's Health Services within the Trust; or

  • have been within the last year.

  The counsellors will use the therapeutic process, including Talking Therapy and EMDR Therapy. They will use these processes to help you understand and explore your:

  • grief

  • bereavement and loss

  • trauma

  • issues around fertility

  • pregnancy or birth; or

  • any issues you have around gynaecological and obstetric surgery.

  They will work towards improving and maintaining your mental and emotional stability.  

  To self-refer, please email the Women's Health Counselling Service.

• Kent and Medway Talking Therapies

  Talking Therapies are confidential and effective treatments for a range of mental health issues. Trained and accredited NHS practitioners deliver these treatments. You can self-refer and access them for free on the NHS.

  The range of mental health issues that NHS Talking Therapies can help with include:

  • depression

  • generalised anxiety disorder

  • obsessive-compulsive disorder (OCD)

  • panic disorder

  • post-traumatic stress disorder (PTSD)

  • social anxiety disorder

  You can self-refer to Talking Therapies using this link.

National support (including dad and partner support)

• Miscarriage UK

• Tommy’s: the pregnancy and baby charity

• Saying Goodbye

• Petals: the baby loss counselling charity

[Web sites last accessed 11 August 2026]

Urgent mental health advice and support

• Please contact 111 and select option 2.

• Go to your nearest Emergency Department.

• For life threatening emergencies, please contact 999.

We have used the term ‘women’ throughout this leaflet. When we use this term we also mean people with female reproductive organs who do not identify as a woman. East Kent Hospitals is committed to supporting people of all gender identities. Please tell your nurse or doctor how you would like them to address you, so we can be sure to get this right.

Ask 3 Questions

There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:

• What are my choices?

• What is good and bad about each choice?

• How do I get support to help me make a decision that is right for me?

Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.

What do you think of this leaflet?

We welcome feedback, whether positive or negative, as it helps us to improve our care and services.

If you would like to give us feedback about this leaflet, please fill in our short online survey. Either scan the QR code below, or use the web link. We do not record your personal information, unless you provide contact details and would like to talk to us some more.

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• Patient Voice Team
  Telephone: 01227 868605
  Email