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Deciding when to do MVA

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HealthWiki > A Book for Midwives > Chapter 23: Manual vacuum aspiration (MVA) > Deciding when to do MVA


Women who have tissue left in the womb after an incomplete miscarriage or abortion can die from infection or bleeding. MVA can help save their lives.

But MVA is also dangerous unless it is done carefully. To do MVA, you must put something into a woman’s womb. Putting anything inside a woman’s womb is risky because if it is not done correctly, it can give her a serious infection, or injure her womb.

Also, MVA can be done safely only up to 12 weeks of pregnancy.

Before you do an MVA, you should be sure that there is not a safer alternative. Is there a medical center nearby where health workers can empty the womb? Would this be an appropriate time to use misoprostol instead of MVA? Only use MVA if it is the safest way to empty the womb. To make an MVA safe you must:

a speculum and cannula in a pot of boiling water

Have sterilized equipment
Everything that goes inside a woman’s womb must be sterilized. If you cannot sterilize your tools before doing an MVA, you cannot make it safe and you should not do it!

Be trained and experienced
You cannot learn enough from any book, including this book, to do an MVA safely. You must be trained by an experienced person. Learn as much as you can from books, classes, and teachers. Help someone more experienced when she is doing an MVA so you can watch and learn.

Know that MVA is the appropriate care for the woman
Talk with the woman about why she needs an MVA. Check her physical signs, like pulse and temperature, to see if she needs other medical care as well. Find out how long she has been pregnant. MVA is only safe during the first 12 weeks (or 3 months) of a pregnancy. That is 12 weeks after the woman’s last monthly bleeding. After that, the pregnancy is too far along for MVA to work. Only try to do MVA after 12 weeks if the woman is in serious danger after incomplete abortion or miscarriage, and you have no other way to help her. See about methods to help you know how long a woman has been pregnant .

To be sure that a woman is less than 3 months pregnant, you should do a bimanual exam before
doing an MVA.

Incomplete abortion

A woman with an incomplete miscarriage or abortion is in serious danger. The womb must be emptied right away. Look for these signs of infection or injury:

  • severe pain in the lower belly
  • heavy bleeding from the vagina
  • fast pulse (over 100 beats a minute)
  • high temperature (over 38°C or 100.4°F)
  • low or dropping blood pressure

See how to help a woman with these signs, or take her to a medical center right away.


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