Vacuum aspiration, either manual or electrical, are minor surgical procedures. During the procedure a woman is positioned as if she is having a pelvic exam.  A woman is given a local anesthetic and if necessary the cervix is dilated.  A thin tube is then inserted into the uterus and attached either to a manual, handheld syringe (MVA) or an electric vacuum (EVA) which suctions out the contents of the uterus. 

The procedure is generally completed within 15 minutes.

D&C is a minor surgical procedure.  Women are often given general or local anesthesia.  A woman will be asked to position herself on the table as if she were having a pelvic exam.  The cervix will be dilated sometimes starting the night before the procedure with special osmotic dilators (a tube or small sponge that absorbs moisture from the surrounding tissues of the cervix and swells to slowly expand the cervix) and/or with mechanical dilators used during the procedure.  Once the cervix is sufficiently dilated, a curved instrument will be inserted to scrape the lining of the uterus to remove the contents of the uterus.

The D&E procedure begins in a similar fashion to the D&C procedure. Dilation of the cervix is usually begun 24 hours in advance. After the cannula (curved instrument) and sometimes other surgical instruments, depending on gestation of the fetus, are inserted to scrape and remove the contents of the uterus. Any remaining tissue is removed using vacuum aspiration.