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A 40-year-old woman with an IUD that had been inserted in China 15 years previously presented for a pregnancy termination with a nine-week gestation. After the suction procedure was completed, an attempt was made to remove the IUD, first with an IUD hook, and then with a narrow forceps using abdominal ultrasound visualization. The IUD could be seen on ultrasound and felt with the forceps but was not easy to remove. It was eventually removed after it broke into two pieces and stretched out. The postoperative ultrasound showed an empty uterus, and the patient’s uterus felt intact to gentle exploration with the curette. The patient was apparently well at follow-up.

Objective: To examine the differences in anxiety levels and attitudes towards abortion between women having an early medical abortion and women having a surgical (manual vacuum aspiration) abortion. Methods: Women who presented for an early medical abortion or a surgical abortion at an urban, free-standing abortion clinic were invited to participate in this study. Fifty-nine women having a medical abortion and 43 women having a surgical abortion answered questionnaires before their scheduled abortion, and again 2 to 4 weeks after the abortion. Thirty women were interviewed about their answers. Results: Anxiety levels were similar in both groups before the abortion procedure. Anti-choice views about abortion were seen in 60.5% of women having a medical abortion and in 37.3% of women having a surgical abortion ( P = .027). Women who were pro-choice had a mean anxiety score of 5.0 (range, 0–10) before and 2.7 after the abortion, whereas women who were anti-choice had a mean anxiety score of 5.2 before and 4.4 after the abortion ( P = .005). Conclusion: It is important for providers of abortion care to understand that women undergoing a medical abortion may be more ambivalent about abortion than women undergoing a surgical abortion, and women who are anti-choice but having an abortion may have unresolved anxiety after the procedure.