Chapter 23: Manual vacuum aspiration (MVA)
The womb is too big to empty using MVA
Sometimes you may think that a woman’s womb is small enough to do MVA, but
after you start the MVA, you find out that it is too large. She may think she became
pregnant later than she actually did. Or her womb may have felt smaller than it
If you start to do an MVA, but you cannot empty the womb all
the way, first try using a larger cannula. But if you still cannot
empty the womb, you must find someone else to empty her
womb right away. Even if you must go to a distant hospital,
you must get help. She is in serious danger.
You may also:
• give misoprostol to empty the womb (see page 408).
• watch for signs of infection (see page 409).
Problems that MVAcan cause
MVA can cause problems if it is done incorrectly. Even experienced midwives will
sometimes see problems after MVA. The most common problems are:
• incomplete MVA (see page 407).
• infection (see page 409).
• injury to the womb (see page 413).
After the MVA
For the next day and night, check on the woman regularly to make sure she is OK.
Check her temperature and pulse for signs of infection and check to see how much
she is bleeding.
Tell the woman what to expect after the MVA. She should know to get help if
she has any warning signs.
• Bleeding about as much as regular monthly bleeding for
a few days to a week.
• Some cramping for 2 or 3 days.
A Book for Midwives (2010)