Resources

Insights: Equipment needed to provide in office MVA

What equipment do I need to provide manual vacuum aspirations in my office-based setting?

 

Many providers in the US who have been trained in office-based early abortion care and miscarriage care do not provide first-trimester aspiration procedures in their offices. One of the barriers to providing aspiration abortions in the office is uncertainty about what equipment and materials are needed. Fortunately, the equipment required for first-trimester procedures under local anesthesia is minimal, and generally inexpensive.

What is needed prior to the procedure?

  • A way to confirm pregnancy and gestational age (e.g. urine pregnancy test, confirmed LMP and bimanual exam, out-of-office ultrasound, or in-office ultrasound)
  • Evidence-based consent and patient information forms (see “Resources” section below)
  • Blood pressure and pulse measurement
  • Prophylactic antibiotics (can be given post-procedure)
  • Contraception counseling
  • Consent and patient information forms for IUD (for patients who choose this method)

What is needed for the procedure?

  • Sterile instruments: speculum, single-tooth tenaculum, ring forceps, needle extenders, metal cup, 4x4s, sterile gauze, scissors if IUD will be inserted
  • Local anesthesia: 18g needle to draw up medication, 22g 1 1/2 to attach to syringe, two 10 mL syringes of combined anesthetic
    • 5 mL of 1% lidocaine
    • 5 mL of 0.9% bacteriostatic NaCl
    • 1 mL of 8.4 % sodium biocarbonate
  • Uterine Evacuation Kit: Dilator set, cannulas (sized 5-12), MVA aspirators (these can be purchased as part of a disposable kit), adapters (if needed)
  • Equipment for tissue inspection: Clear glass dish, strainer and backlight
  • Medication to manage rare bleeding complications (e.g. methergine or misoprostol)

What is needed post-procedure?

  • Rh typing
  • Micro-Rhogam if patient is found to be Rh negative
  • Sterilizing capabilities for any re-usable

 

Resources

Manual Vacuum Aspiration (MVA) Equipment and Supplies List

Toolkit for Integrating Abortion Into Primary Care

Manual Vacuum Aspiration Consent Form

Manual Vacuum Aspiration Pre-Procedure Note

Nursing Policy and Procedure for Manual Vacuum Aspiration

Where to find MVA Supplies

WomenCare Global

HPSRx Enterprises

 

References

National Abortion Federation. 2016 Clinical Policy Guidelines. National Abortion Federation, Washington, D.C.

World Health Organization. Safe abortion: technical and policy guidance for health systems. Second Edition. 2012.

 

Pharma-free

Insights into abortion and miscarriage care is a publication of the Reproductive Health Access Project and Innovating Education in Reproductive Health, a project of the Bixby Center for Global Reproductive Health, UCSF.  The Reproductive Health Access Project and Innovating Education in Reproductive Health do not accept funding from pharmaceutical companies. We do not promote specific brands of medication or products. The information in the Insights is unbiased, based on science alone.