There is little, if any, difference between medical and surgical abortion in terms of safety and efficacy. Thus, both methods are similar from a medical point of view and there are only very few situations where a recommendation for one or the other method for medical reasons can be given.

Medical abortion may be preferred:
* if it is the woman’s preference;
* in very early gestation; up to 49 days of gestation, medical abortion is considered to be more effective than surgical abortion, especially when clinical practice does not include detailed inspection of aspirated tissue;
* if the woman is severely obese (body mass index greater than 30) but does not have other cardiovascular risk factors, as surgical treatment may be technically more difficult;
* if the woman has uterine malformations or a fibroid uterus, or has previously had cervical surgery (which may make surgical abortion technically more difficult);
* if the woman wants to avoid a surgical intervention.
Surgical abortion may be preferred:
* if it is the woman’s preference, or if she requests concurrent sterilization;
* if she has contraindications to medical abortion;
* if time or geographical constraints preclude the follow-up needed to confirm that abortion is complete.