Abortion Risks and Side Affects

Every medical procedure, including abortion, carries the risk of complications.  Before you have any elective procedure it’s important to know the potential impacts it could have on your body and future health. You have the legal right to give fully informed consent.  You also have the right to

  1. get an explanation of the abortion procedures available,
  2. assess abortion risks and side effects, and
  3. learn about other options for your pregnancy.

Risks and side effects vary by the type of abortion procedure and how far along you are. If you’re pregnant, Heartbeats can discuss the specific risks and side effects associated with all eligible abortion procedures. 

Common Side Effects

Most women experience some of the following after an abortion:

  • Bleeding – on average bleeding lasts 14 days, but can last as long as 21 days. 1,2
  • Cramping
  • Dizziness
  • Drowsiness
  • Nausea/Vomiting

These symptoms typically resolve within a week, sometimes longer.

Immediate Complications

  • Damage to the womb or cervix

         Cut or torn cervix:  the opening of the uterus (cervix) may be torn when the cervix is stretched                open to allow medical instruments to pass into the uterus during an abortion.

         Puncture/Tear of the wall of the uterus:  During a suction abortion, a medical instrument can cut          through the wall of the uterus.  Perforation can lead to infection, heavy bleeding or both,                        depending on the severity of the cut.  Surgery may be required to repair the cut tissue, and in                serious cases, a hysterectomy may be required.

  • Excessive bleeding

         Blood clots in the uterus:  Blood clots that produce severe cramping can occur.  The clots are                  usually removed by a repeat surgical abortion procedure. 

         Heavy Bleeding:  Some bleeding is typical after an abortion.  Heavy bleeding (hemorrhaging) is              not common and may be treated by repeat surgical abortion, medication or, rarely, surgery.  Be            sure to ask your doctor to explain heavy bleeding and what to do if it happens.

  • Incomplete abortion

         Incomplete abortion:  An incomplete abortion is when part of the fetus, or other products of                  pregnancy (placenta), do not drain completely from the uterus during the abortion procedure.              This requires further medical procedures and may result in infection and bleeding.

  • Infection of the uterus or fallopian tubes

         Pelvic infection:  Germs from the vagina or cervix may enter the uterus during the abortion and            cause an infection in the pelvic region.  Antibiotics can treat infections but, in rare cases, a repeat          suction abortion, hospitalization and/or surgery may be required.

         Fallopian Tube infection: Abortions that are complicated by infection in the reproductive tract                can cause damage, scarring and blockage of the fallopian tubes, which can cause infertility.

  • Scarring of the inside of the uterus

        Scar tissue on the uterine wall: A surgical abortion can result in the growth of scar tissue in the               uterus, a condition known as Asherman's syndrome.  This can lead to abnormal, absent or painful         menstrual cycles, future miscarriages and infertility.

  • Sepsis or Septic shock

         Sepsis:  Abortion with septic shock is a medical emergency. An abortion is a procedure that ends          a pregnancy. Septic shock occurs when an infection overtakes your body and causes very low                blood pressure.  Septic shock can affect anyone susceptible to germs that cause infection. When            linked with abortion, septic shock can be a dangerous complication. In addition, having certain              underlying conditions before an abortion can make you more susceptible to septic shock. They              include having a chronic condition such as diabetes or a weakened immune system.

  • Death

         Septic shock can be fatal if not treated promptly. It can cause organ failure and damage any part          of your body.  Typical complications include:

  • respiratory failure
  • cardiac failure
  • liver failure
  • kidney failure
  • gangrene (body tissues die due to loss of blood)

       In cases where septic shock is caused by a septic abortion, a total hysterectomy may be necessary        to remove the source of infection. A total hysterectomy removes the uterus, cervix, fallopian                  tubes, and both ovaries.

How to prevent septic shock

Many cases of septic shock can’t be prevented. You can reduce your risk by taking these precautions:

  • Consult a doctor about an elective abortion.
  • Follow the directions exactly as provided for a medical abortion.
  • Never attempt a self-induced abortion.
  • Be aware of the symptoms of bacterial infection after any type of abortion.
  • Get treatment for an infection after an abortion as soon as possible.

Future Health Risks

Future Pre-term Deliveries

  • Abortion causes a weakening of the cervix, which increases a woman’s risk of future pre-term deliveries. Two recently-published studies indicate that one induced abortion increases the risk of a subsequent preterm birth by between 25% and 27%. After two or more abortions a woman’s risk of preterm birth increases by between 51% and 62%. 3,4
  • A 2013 Canadian study found that women who have had abortions are more than twice as likely to have a very early preterm child (26 weeks gestation). The risks were 71% higher at 28 weeks gestation and 45% higher at 32 weeks. 5
  • Premature births carry serious health risks for the baby. Infants who are born before 37 weeks gestational age have a much lower chance of living to adulthood. 6Those that do survive have significant risk of serious disabilities, including cerebral palsy, intellectual impairment, psychological development disorders and autism. 7,8,9

Breast Cancer

  • Studies show that abortion increases a woman’s risk of breast cancer. A 2013 analysis revealed a 44% increased risk of breast cancer among females who had at least one induced abortion. The relative risk increased to 76% and 89% for those who had at least two or three abortions, respectively. 10
  • Often women considering abortion are experiencing their first pregnancy. It is important to note the protective effects of a woman’s first full-term pregnancy, which causes breast cells to mature, reducing the risk of breast cancer. “Among women who have given birth, an increasing number of full-term pregnancies was associated with a statistically significant decrease in the risk of breast cancer; risk was reduced by 14% for each additional birth.” 11

STDs & Pelvic Inflammatory Disease

  • “The presence of Chlamydia in the cervical canal at the time of abortion in asymptomatic women increases the risk of post-abortion PID.” 12
  • Of patients who have a Chlamydia infection at the time of abortion, 23% will develop PID within 4 weeks. 13,14,15,16
  • “PID can lead to serious consequences including infertility, ectopic pregnancy (a pregnancy in the fallopian tube or elsewhere outside of the womb), abscess formation, and chronic pelvic pain.” 17

Mental Health

  • Research suggests that women who have had abortions may be at increased risk for mental health problems. 18
  • “Women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems was shown to be attributable to abortion.” 19
  • Some women who have experienced an abortion report symptoms similar to Post Traumatic Stress Disorder. 20Some of those symptoms may include:
    • Regret
    • Grief
    • Sadness/Depression
    • Anxiety
    • Guilt/Shame
    • Suicidal thoughts

If you have had an abortion and are experiencing any of the above symptoms, it is important for your emotional and physical health that you not ignore them. Contact us for a referral to a licensed counselor.

Infertility and Future Childbearing

Complications that can arise from induced abortion, such as infection and damage to the uterus, can lead to infertility and increased risks of future childbearing.

In the case of medical abortion, the risks for these complications are increased  in women who have a high risk of uterine rupture; an intrauterine device (IUD) in place; uncontrolled high blood pressure; diabetes, certain heart or blood vessel diseases; severe liver, kidney or lung disease; take a blood thinner or certain steroid medications; or smoke heavily.21

First-trimester surgical abortion by dilation and curettage (D&C) “can result in uterine synechiae (or Asherman’s Syndrome), which increase the risk of subsequent midtrimester spontaneous abortions and low birthweight deliveries.”22  Incompetent cervix is also a preterm birth risk associated with surgical abortion. “Symptoms related to cervical incompetence were found among 75% of women who undergo forced dilation for abortion.”23

Abortion and Sexual Dysfunction

Some women experience sexual dysfunction after an abortion.24 The following issues can often be associated with early pregnancy termination:

  • Increased vaginal dryness
  • Decreased sexual desire
  • Loss of orgasm ability
  • Dyspareunia (painful intercourse)

Tell your doctor if you have had an abortion and are experiencing any of these symptoms. They may be able to help.

Contact Heartbeats for an appointment to discuss all your options. We also offer free pregnancy testing, and ultrasounds.  Pregnancy tests are not always accurate.  Get you pregnancy confirmed by a medical professional.  An ultrasound can tell if the baby has a heartbeat and how far along you are. Let us lay out your options in a safe, unpressured, nonjudgmental environment.

1 Davis A, Westhoff C, De Nonno L (2000). Bleeding patterns after early abortion with mifepristone and misoprostol or manual vacuum aspiration. J Am Med Womens Assoc 55(3 Suppl):141-4

2 Harwood B, Meckstroth KR, Mishell Dr, Jain JK (2001). Serum beta-human chorionic gonadotropin levels and endometrial thickness after medical abortion. Contraception 63(4):255-6.

3 Shah PS, Zoa J (2009). Induced termination of pregnancy and low birth weight and preterm birth: A systematic review and meta-analyses. BJOG: An International Journal of Obstetrics & Gynaecology, 116(11): 1425-42

4 Swingle HM, Colaizy TT, Zimmerman MB, Morriss FH (2009). Abortion and the risk of subsequent preterm birth. J Reprod Med, 54(2): 95-108.

5 Hardy G, Benjamin A, Abenhaim HA (2013). Effect of induced abortions on early preterm births and adverse perinatal outcomes. JOGC, 35(2): 138-43.

6 Moster D, Lie RT, Markestad T (2008). Long-term medical and social consequences of preterm birth. NEJM, 359(3): 262-73.

7 Ibid.

8 Limperopoulos C, Bassan H, Sullivan NR, Soul JS, Robertson RL, Moore M, Ringer SA, Volpe JJ, du Plessis AJ (2008). Positive screening for autism in ex-preterm infants: Prevalence and risk factors. Pediatrics, 121(4): 758-65

9 Burd L, Severud R, Kerbeshian J, Klug MG (1999). Prenatal and perinatal risk factors for Autism. J Perinat Med, 27(6): 441-50.

10 Huang Y, Zhang X, Li W, Song F, Dai H, Wang J, Gao Y, Liu X, Chen C, Yan Y, Wang Y, Chen K (2014). “A meta-analysis of the association between induced abortion and breast cancer risk among Chinese females.” Cancer Cause Control, 25(2): 227-36.

11 Andrieu N, Goldgar DE, Easton DF, Rookus M, Brohet R, Antoniou AC, et al. (2006). Pregnancies, breast-feeding, and breast cancer risk in the international BRACA1/2 carrier cohort study. J Natl Cancer Inst, 98(8): 535-44.

12 Westergaard L, Phillipsen T, Scheibel J (1982). Significance of cervical Chlamydia trachomatis infection in postabortal pelvic inflammatory disease. Obstetrics and Gynecology, 68(5): 668-90.

13 Ovigstad E, et al. (1983). Pelvic inflammatory disease associated with Chlamydia trachomatis infection after therapeutic abortion. Br J Vener Dis, 59: 189-92

14 Duthie SJ, et al. (1987). Morbidity after termination of pregnancy in first trimester. Genitourin Med, 63(3): 182-7

15 Stray-Pedersen B, et al. (1991). Induced abortion: Microbiological screening and medical complications. Infection 19(5): 305-8

16 Heisterberg L, et al. (1987). The role of vaginal secretory immunoglobulin a, gardnerella vaginalis, anaerobes, and Chlamydia trachomatis in post abortal pelvic inflammatory disease. Acta Obstetricia et Gynecologica Scandinavica, 66(2): 99-102.

17 Centers for Disease Control and Prevention (2014). Pelvic inflammatory disease (PID) – CDC fact sheet. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/std/PID/STDFact-PID.htm

18 Fergusson DM, Horwood LJ, Ridder E (2006). Abortion in young women and subsequent mental health. J Child Psychol Psyc 47(1):16-24.

19 Coleman, PK (2011). “Abortion and mental health: quantitative synthesis and analysis of research published 1995-2009.” Br J Psych, 199: 180-6.

20 Coyle CT, Coleman PK, Rue VM (2010). Inadequate preabortion counseling and decision conflict as predictors of subsequent relationship difficulties and psychological stress in men and women. Traumatology 16(1):16-30.

21 The Mayo Clinic (2010). Medical Abortion, Risks. Retrieved from: http://www.mayoclinic.com/health/medical-abortion/MY00819/DSECTION=risks

22 The Global Library of Women’s Medicine. (2011). Long-Term Risks of Surgical Abortion. Carol J. Hogue, PhD, MPH. Terry Professor of Matrenal/Child Health, Professor of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georga (Vol 6, Cap 124).  Retrieved from: http://www.glowm.com/index.html?p=glowm.cml/section_view&articleid=440

23 Dr. Ren, “Cervical Incompetence – Aetiology and Management”, Medical Journal of Australia (December 29, 1993), Volume 60. Retrieved from: http://www.gargaro.com/healthproblems.html

24 Bianchi-Demicheli F, Ortigue S (2007). Insight of women’s sexual function and intimate relationships after termination of pregnancy: A review of recent findings and future perspectives. Curr Womens Health Rev 3(1):31-41; Bianchi-Demicheli F, Perrin E, Ludicke F, Bianchi PG, Chatton D, Campana A (2002). Termination of pregnancy and women’s sexuality. Gynecol Obstet Invest 53(1):48-53; Fok WY, Siu SN, Lau TK (2005). Sexual dysfunction after a first trimester induced abortion in a Chinese population. Eur J Obstet Gyn R B 126(2):255-8.

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