Surgical abortion may be recommended in pregnant women under 20 weeks of their pregnancy in the following cases:

1. Physical or mental health complications for the pregnant woman or the baby
2. Abnormal fetus growth
3. Pregnancy as a result of sexual abuse or rape
4. Pregnancy resulting due to the failure of contraceptive methods
5. Unplanned pregnancy
6. Financial constraints
7. Unwanted pregnancy 

1. Physical examination: The expecting mother is examined physically by the doctor.
2. Pelvic exam: The doctor will insert one or two lubricated, gloved fingers into the vagina of the pregnant woman to evaluate her internal reproductive organs, as well as her pregnancy.
3. Blood test: Certain underlying medical illnesses and the blood type of the expecting mother can be evaluated using a blood test.
4. Urine pregnancy test: The presence of HCG (Human Chorionic Gonadotropin) may indicate a pregnancy.
5. Ultrasound: This is a type of imaging test that uses sound waves to obtain images of the internal female reproductive organs.

Surgical abortion can be performed in the following different ways depending on the duration of the pregnancy:

1. Vacuum aspiration:

• This procedure is generally performed till the 14th week of pregnancy.
• The procedure may be done under local anesthesia (the surgical site is numbed) or general anesthesia (the patient is made unconscious during the procedure).
• It involves the use of a vacuum source to detach and remove the fetus through the cervix (lower end of the vagina).
• A thin cannula is attached to a pump and then passed into the womb (uterus).
• After the pump is turned on, the fetus tissues get removed gently from the wall of the uterus.

2. Dilation and Curettage (D & C):

• This is a rapid, painless, bladeless procedure that ensures the complete expulsion of the fetus.
• The patient is first given medication to dilate the cervix. This may take 30 to 40 minutes or more.
• Once the cervix gets dilated, a curettage instrument is used by the surgeon to remove all the pregnancy tissues from the uterus.
• After a couple of hours, the cervix will contract naturally and the pregnancy is terminated without the need for any cuts or sutures.

3. Induction abortion:

• In this procedure, the doctor will provide you with medicine to induce labor so that the uterus will contract and release the pregnancy.
• A suction may be used by the doctor to clear out the uterus.

The complications associated with surgical abortion are:

1. Uterus damage
2. Damage to the uterine lining
3. Cervical (lower part of the vagina) damage 
4. Infection 
5. Hemorrhage
6. Allergic reaction to the anesthesia used 
7. Blood clot formation 
8. Uterus perforation 
9. Nausea
10. Stomach cramps
11. Vomiting
12. Incomplete tissue removal from the uterus

1. Most patients can go home on the same day after surgery.
2. You can resume your daily work within one or two days of surgery. However, some patients may take a little longer to resume work.
3. It is normal to have abdominal cramps for a few days after the procedure.
4. Many women may have vaginal bleeding with abdominal cramps after the procedure. If you experience heavy bleeding, contact your doctor immediately.
5. The doctor will recommend pain-relieving medications and antibiotics to ease your pain and reduce the chances of infection after the procedure.
6. It is normal to experience depression, mood swings, nausea, vomiting, diarrhea, and tiredness after the procedure.
7. It may take a month or two before you are completely back to your normal self, physically and mentally.

Home remedies:

The following home remedies can help in a smoother recovery after surgical abortion:

• Avoid strenuous activities after the procedure.
• Use a heating pad to relieve the abdominal cramps.
• Use pain-relieving medications recommended by your doctor.
• Massage the stomach and lower back gently.
• Avoid any sexual activity till your doctor permits the same.
• Go for a follow-up consultation with your doctor to ensure that you are doing fine.

Benefits:

The advantages of surgical abortion include:

• More effective than a medical abortion
• Can be performed in the later part of pregnancy
• Can return home on the same day after the procedure
• Less bleeding and cramping than a medical abortion
• Safer for anemic patients 
• Quick recovery 

Cost of Surgical Abortion in India- 

The cost of surgical abortion in Mumbai is between INR 10,000 to INR 40,000.
The cost of surgical abortion in Delhi is between INR 8,000 to INR 35,000.
The cost of surgical abortion in Bangalore is between INR 8,000 to INR 35,000.
The cost of surgical abortion in Chennai is between INR 5,000 to INR 30,000.