Getting ready for the MVA

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HealthWiki > A Book for Midwives > Chapter 23: Manual vacuum aspiration (MVA) > Getting ready for the MVA

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In this chapter:

 

In this chapter:

Help the woman to be comfortable

Tell the woman what you will be doing. Answer any questions that she has.

You should find a private place to do the MVA where others are not watching, and be sure to keep everything about her care confidential.

Preventing pain during MVA

MVA can be painful. There are some things you can do to reduce the pain:

The touch of a supportive friend can do a lot to lessen a woman's pain.

• Always tell the woman what you are doing and encourage her to ask questions.
• Move smoothly and do not rush.
• Show the woman how to take slow,
  deep breaths. This can help her body relax. You can take slow deep breaths too! This will help you be gentle and careful.
• Give pain medicine.

Even when you are very gentle, there can be pain. Medicine to stop pain can be expensive and may cause unhealthy side effects, but you may want to offer it to women if you can get it. Women should not have to suffer pain unnecessarily.

And remember — pain medicine cannot replace gentle and respectful care.

There are 2 types of medicine to lessen pain from MVA. You can give pills by mouth or give an injection near the cervix to numb that part of the body. This is also the time to give medicines to prevent infection.

To prevent pain
give 400 to 800 mg of ibuprofen and			by mouth, 30 minutes before you start the MVA
see instructions on giving an injection to numb the cervix
To prevent infection
give 200 mg of doxycycline or if the person is breastfeeding:			by mouth
give 500 mg of azithromycin			by mouth

Prepare tools and supplies for doing MVA

There are several different devices used to do MVA. In this chapter, we explain how to use an MVA kit made by an organization named Ipas. (See more information about how to purchase MVA kits.)

MVA kits have 2 main parts:
One part is a 60 cc syringe with a wide opening that creates a vacuum to pull the contents of the womb out.	The other main part of the kit is a set of plastic tubes called cannulas. One end of the cannula will be attached to the syringe. The other end will be put inside the womb.
plunger barrel button (pinch valve) opens and closes valve arm of plunger syringe	Easy Grip Cannulas

How the syringe works

When the button on the syringe is pushed in, the valve is opened and the contents of the womb are sucked through the cannula into the syringe.

syringe

cannula

	A 1-valve syringe
	A 2-valve syringe
	The MVA plus syringe

Note: Most MVA syringes can now be used for pregnancies up to 12 weeks. Some older, smaller syringes were good only for pregnancies up to 8 weeks. Read and carefully follow the instructions that come with your syringe to learn how to use and care for it.

Disinfect or sterilize your tools

Disinfect or sterilize all the tools that you will put inside the vagina or the womb and lay them out on a sterilized cloth, paper, or dish. You must wear sterile gloves any time you touch a sterile tool.

plastic gloves

gauze or a
long swab

ring forceps

MVA syringe

tenaculum

speculum

cannulas

You will also need a small bowl of antiseptic like Hibiclens (chlorhexidine) or Betadine (povidone iodine) to clean the outside of the cervix. And be sure you have a good source of light.

This page was updated:28 Aug 2024