The physician is not required to use the abortion method that would provide the best opportunity for the baby to live if that physician determines in his or her medical judgment that use of that method poses a significantly greater risk to the woman's life or permanent damage to any of the woman's major bodily functions. In the case of a medical emergency, a physician is also not required to comply with any condition listed above which, in the physician's medical judgment, he or she is prevented from satisfying because of the medical emergency.
Go to the emergency room if, or call the clinic or doctor that performed the abortion if:
- Heavy bleeding occurs (2 or more pads/hour)
- Pain is severe or not controlled by pain medication
- You have fever
- You have difficulty breathing
- You have chest pain
- You are disoriented
Most women can return to their daily activities within a day or so after a procedure. It is important that you return to your doctor for a checkup two to three weeks after an abortion.
The risk of complications for the woman increases with advancing gestational age.
Below is a description of the risks that have been associated with abortion:
- Pelvic Infection: Bacteria (germs) from the vagina or cervix may enter the uterus and cause an infection. Antibiotics may clear up such an infection. In rare cases, a repeat suction, hospitalization or surgery may be needed. Infection rates are less than 1 percent for suction curettage, 1.5 percent for D&E and 5 percent for labor induction.
- Incomplete abortion: Fetal parts or other products of pregnancy may not be completely emptied from the uterus, requiring further medical procedures. Incomplete abortion may result in infection and bleeding. The reported rate of such complications is less than 1 percent after a D&E; whereas, following a labor induction procedure, the rate may be as high as 36 percent.
- Blood clots in the uterus: Blood clots that cause severe cramping occur in about 1 percent of all abortions. The clots usually are removed by a repeat suction curettage.
- Heavy bleeding: Some amount of bleeding is common following an abortion. Heavy bleeding (hemorrhaging) is not common and may be treated by repeat suction, medication or, rarely, surgery. Ask the doctor to explain heavy bleeding and what to do if it occurs.
- Cut or torn cervix: The opening of the uterus may be torn while it is being stretched open to allow medical instruments to pass through and into the uterus. This happens in less than 1 percent of first trimester abortions.
- Perforation of the uterus wall: A medical instrument may go through the wall of the uterus. The reported rate is 1 out of every 500 abortions. Depending on the severity, perforation can lead to infection, heavy bleeding or both. Surgery may be required to repair the uterine tissue, and in the most severe cases a hysterectomy may be required.
- Anesthesia-related complications: As with other surgical procedures, anesthesia increases the risk of complications associated with abortion. The reported risks of anesthesia-related complications is around 1 per 5,000 abortions.
- Rh Immune Globulin Therapy: Genetic material found on the surface of red blood cells is known as the Rh Factor. If a woman and her fetus have different Rh factors, she must receive medication to prevent the development of antibodies that would endanger future pregnancies.
Post Viability Abortions
- The chance of the fetus living outside the uterus (viability) increases as the gestational age increases. The doctor must tell you the probable gestational age of the fetus at the time the abortion would be performed.
- If the fetus is viable, an abortion may only be done if your doctor reasonably believes that it is necessary to prevent your death or to preserve you
- If an unborn child is viable, the physician must take all reasonable steps in keeping with good medical practice to preserve the life and health of the unborn child, provided it does not pose an increased risk to the life or health of the woman.
- If the baby is removed alive, the attending physicians have the legal obligation to take all reasonable steps necessary to maintain the life and health of the child.
- If an abortion is performed after the doctor has determined that the fetus is viable, the following steps must be taken:
- The physician who terminates the pregnancy must certify the medical reasons making performance of the abortion necessary and the probable health consequences if the abortion is not performed;
- The physician must select a procedure that is most likely to allow the unborn child to live; and
- A second physician must be in attendance to provide immediate medical care to the child born as a result of the pregnancy termination.
Long-Term Medical Risks
Future childbearing: Early abortions that are not complicated by infection do not cause infertility or make it more difficult to carry a later pregnancy to term. Complications associated with an abortion or having multiple abortions may make it difficult to have children.
Women who have had a first full-term pregnancy at an early age have reduced risks of breast, ovarian and endometrial cancer. Furthermore, the risks of these cancers decline with each additional full-term pregnancy. Pregnancies that are terminated afford no protection; thus, a woman who chooses abortion over continuing her pregnancy would lose the protective benefit.
If you have a family history of breast cancer or clinical findings of breast disease, you should seek medical advice from your physician before deciding whether to remain pregnant or have an abortion. It is always important to tell your doctor about your complete pregnancy history.
Emotional Side of an Abortion
You should know that women experience different emotions after an abortion. Some women may feel guilty, sad, or empty, while others may feel relief that the procedure is over. Some women have reported serious psychological effects after their abortion, including depression, grief, anxiety, lowered self-esteem, regret, attachment, flashbacks, and substance abuse. These emotions may appear immediately after an abortion, or gradually over a longer period of time. These feelings may recur or be felt stronger at the time of another abortion, or a normal birth, or on the anniversary of the abortion. Counseling or support before and after your abortion is very important. If family help and support are not available to you, it may be harder for you to deal with the feelings that appear after an abortion. Talking with a professional counselor before having an abortion can help a woman better understand her decision and the feelings she may experience after the procedure. If counseling is not available to the woman, these feelings may be more difficult to handle. Many pregnancy-resource centers offer pre- and post-abortion counseling services; these centers are listed in the resource directory.