Approaching Sex After an Abortion

Reengaging in the activity that resulted in a terminated pregnancy is a daunting prospect for some people. But getting an abortion does not have to spell the end of a fulfilling sex life.

What is an abortion?

An abortion is the termination of a pregnancy. In 2020, approximately 620,327 abortions were carried out in the United States, according to the Centers for Disease Control and Prevention (CDC). The reasons behind these terminations are as numerous and varied as the lives of the people receiving them.

There are two types of abortions: medical and surgical.

"Medical abortion, the abortion pill, involves using two different medications, mifepristone and misoprostol, to cause uterine contraction to empty the uterus," said Amir Marashi, M.D., a board-certified OB-GYN in New York City and the founder of Cerē, which develops physician-designed pleasure products for women. "This leads to heavy bleeding and cramping, ending the pregnancy."

The Food and Drug Administration (FDA) approves the use of mifepristone for up to 10 weeks gestation, while the World Health Organization (WHO) recommends medical abortions up to 12 weeks of pregnancy.

"Surgical abortion, an in-clinic abortion, is a surgical procedure in which the uterus is emptied and the pregnancy is ended," Marashi continued. "In this procedure, also known as a dilatation and curettage [D&C], the cervix is dilated and an instrument is used to remove the uterine lining."

Before 10 weeks, a person can typically choose between a medical and surgical procedure. Surgical abortions are used for pregnancies more than 10 weeks along. They are the only option at the 10-week point. These procedures take about 10 to 15 minutes to perform in a doctor's office, hospital or outpatient clinic.

"The patient usually waits in the recovery room for around an hour, but sometimes up to five hours; this depends on the type of anesthesia that is used," Marashi said. "Common side effects include cramping and light spotting or bleeding. Very rare side effects include a damaged cervix or blood vessels and uterine perforation."

Reproductive rights vary dramatically across the globe and across the United States. While abortions are not federally illegal, the overturning of Roe v. Wade in 2022 gave each state the power to determine the law around them.

Some states, including New York, California and Washington, have fortified protections for abortion since the ruling, whereas Texas, Oklahoma and Arkansas have passed trigger laws. These laws make abortion access nearly impossible and, in some cases, punishable.

The psychological impact

The reactions to having an abortion are as varied as the reasons for electing to undergo one. Some people go through the experience with little or no impact, others may struggle with the aftermath for months or years, and some don't recognize the effects for a long time.

The way you react is normal for you. There is no "right" way to feel after having an abortion, regardless of why you underwent the procedure.

"For some patients, abortion can have a major impact on mental health," Marashi said. "Some people, regardless of their personal background or beliefs, report feeling guilt and loss. Some people find it helpful to join support groups or communities with other people who have undergone an abortion."

The Turnaway Study examined the long-term impacts of abortion. According to the study, "Ninety-five percent of women reported that having the abortion was the right decision for them over five years after the procedure."

If you struggle with the aftermath, notify your physician and consider visiting a therapist to work through your feelings and start the healing process. There is no shame in needing help, and medical professionals are there to help. However, research your options first to avoid coming face to face with an unsympathetic person in a vulnerable moment.

"The loss isn't something that ends with a pregnancy; loss is rarely linear," added Charlotte Fox Weber, M.B.A.C.P., a psychotherapist and an author in the United Kingdom. "Abortions can bring up grief, anxiety, depression and loneliness. The sheer responsibility of having to make such a big decision can be staggering."

Take your time on the road to recovery. There is no timeline to keep or milestones to meet. Your journey is unique to you.

Physical and sexual effects

"After an abortion, it is safe to have sex again as soon as you feel ready," Marashi said. "I recommend waiting until the bleeding stops to reduce the risk of infection. Be sure to use contraception if you do not wish to become pregnant since you might be fertile after the abortion."

However, there are some potential "what ifs" to consider. While generally very safe and accompanied by minimal risk, any medical procedure comes with some risk, as Marashi explained.

"If a D&C is performed incorrectly or if a patient undergoes too many of these procedures, scar tissue can form inside of the uterus, which can sometimes cause changes in menstrual flow and infertility," he said. "This is called Asherman syndrome."

Commonly treated with hysteroscopic surgery to cut away adhesions on the uterine wall, Asherman syndrome is rare but curable, and if fertility has been affected, surgery can restore it.

Biologically, it is generally safe to have sex soon after an abortion. The psychological impact, however, might take sex "off the table" for a little while.

"Pregnancy and deciding what to do reminds us of the consequences of sex, and when people have had lonely experiences of abortions, intimacy can be a challenge," Weber said. "There may be fear, anxiety and nervousness about what sex means."

If sex feels too daunting during the immediate aftermath of an abortion, be kind to yourself and take a break. There is no rush. Your sex life is not going to disappear. Communicate the impact of the abortion to your partner and step away from sexual activity until it feels safe to engage again.

Turn to other ways to build intimacy that don't include sex.

Managing the sexual impact of an abortion

"It is normal to feel nervous about having sex again after having an abortion," Marashi said. "If you are nervous because you do not wish to become pregnant, it is important to use reliable contraception."

Undergoing an abortion does not generally affect fertility, so consult a doctor about birth control options before having sex without protection.

Wait until your body is ready. Doctors typically recommend a two-week waiting period before having sex due to an increased risk of infection. Be patient. An orgasm is not worth more than your overall well-being. Find new ways to connect.

Take it slow

Be mindful when reengaging with sex after an abortion of a wanted pregnancy. There might be internal or external pressure to try again as soon as possible, but always prioritize your well-being over babymaking.

"It's always OK to take things slowly," Weber said. "Take your time and allow space for recalibration. Sex is one of the most basic yet complicated aspects of adult life. It's important to check in and pay attention to feelings and beliefs."

The bottom line

Follow your doctor's suggestions regarding the waiting period between your medical or surgical procedure and when it's safe to have penetrative sex. Put yourself first and anyone else's sexual needs second.

If you want to work out your feelings surrounding your abortion, use Giddy Telehealth to find a new therapist. The easy-to-access online portal makes it easy. Many healthcare professionals offer same-day appointments and video consultations.