Induced Abortion

Induced Abortion

Each year, about 1.3 million women in the United States have an abortion to end a pregnancy. The procedure is low risk when done early and in the proper setting. Having an abortion is a big decision that should be well thought out. Talking with your partner, a family member, or a close friend can be helpful.

What Is Induced Abortion?
Abortion occurs when the fetus is expelled from a woman's uterus. When a procedure is done to end a pregnancy, it is called "induced abortion." Most abortions are done in the first 12 weeks of pregnancy.

Types of Abortion
Induced abortion can be done in several ways. Some are done by surgery, and others are done with medication.

Menstrual Aspiration
Menstrual aspiration can be done within 1-3 weeks after a missed period. With this method, a syringe is used to remove the pregnancy from the lining of the uterus.

Suction Curettage
Suction curettage is the most common type of abortion. The contents of the uterus are removed by a suction device that is inserted into the uterus. It also may be called vacuum curettage. It can be done up to 12 weeks of pregnancy. After that time, this procedure may be called dilation and evacuation (D&E).

Medical Abortion
With a medical abortion, certain drugs are taken to cause an abortion. It only can be done early in pregnancy. For this option, a woman must be no more than 9 weeks pregnant.

Mifepristone and misoprostol pills. This is the most common type of medical abortion. It must be performed within 49 days (7 weeks) of the first day of the last period. A woman must visit her doctor three times to take the medications

Mifepristone pills and vaginal misoprostol. This type of medical abortion must be performed within 63 days (9 weeks) of the first day of the last period. It uses the same drugs as the first method, but in different doses. Instead of taking a misoprostol pill, the misoprostol is placed in the vagina after the mifepristone is taken.

Methotrexate and vaginal misoprostol. This type of medical abortion must be performed within 49 days (7 weeks) of the first day of the last period. It is very effective, but it may take up to 4 weeks for abortion to occur.

Do I Need Anyone's Permission or Consent? Abortion has been legal in the United States since 1973. However, no doctor is required to perform an abortion.

Vaginal misoprostol alone. This type of medical abortion must be performed within 56 days (8 weeks) of the first day of the last period. This method uses only misoprostol, given vaginally.

Labor-Inducing Abortion
For abortions later in pregnancy, labor may be induced with drugs that can be put in the vagina, injected into the uterus, or given through an intravenous (IV) line. Prostaglandins, the most widely used drugs for labor-inducing abortions, cause the uterus to contract.

Where Is the Abortion Performed?
Where an abortion is done depends on a number of factors:

• How it will be done
• Then length of the pregnancy
• The health of the woman

After the abortion, counseling (including information on birth control) and recovery care should be available.

Risks
Abortion is a low-risk procedure. An early abortion has less risk than a later one. Fewer than 1 in 100 women have complications from an early abortion. Although an abortion is low risk, as with any surgery or medicine, problems may occur.

Incomplete Abortion
Although rare, in some cases the pregnancy is not removed completely. Bleeding and infection may occur. If the abortion is incomplete, the doctor may need to perform follow-up curettage.

Infection
An infection can occur if bacteria from the vagina or the cervix get into the uterus after an abortion. The doctor will prescribe drugs to prevent this and can treat the infection if it happens.

Hemorrhage
Some bleeding after an abortion is normal. Bleeding is rarely heavy enough to require a blood transfusion.

Damage to the Uterus
During a surgical abortion, the tip of a device may pass through (perforate) the wall of the uterus or tear the cervix. If this happens, further surgery may be needed. Other organs, such as the bowel and bladder, also can be injured if this occurs.

Death
The risk of death from abortion is lower than 1 in 100,000 women who have suction curettage. For women who have a medical abortion, the risk of death is about 1 in 100,000. The risk of a woman dying from giving birth is at least 10 times greater than the risk from an early abortion.

Afterward
Effects after abortion vary. Many women have a wide range of feelings about having an abortion. It can be a stressful time. Some women may feel relieved, sad, or both at the same time. If unhappy feelings do not go away, counseling may be needed.

Normal menstruation usually starts again 4-6 weeks after an abortion. Pregnancy is possible soon after the abortion, so birth control is needed right away.

There have been reports that women who have an abortion have an increased risk of breast cancer. Recent studies have not found a link between abortion and breast cancer.

Finally ...
An induced abortion is a procedure with few risks. The earlier you seek advice, the better. Get care as soon as possible. Make sure that all your questions are answered before, during, and after any procedure.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.