Types of Abortions and Their Side Effects
Getting an abortion can be a scary time for many women, and it can be difficult to know what to expect. The risks are spoken about and highlighted often, but they shouldn't sway anyone's decision without also hearing about the benefits.
A 2020 study in the journal Social Science & Medicine found more than 95 percent of women who had an abortion didn't feel regret about their decision across the five years post-procedure, and relief was the most commonly felt emotion.
Anyone considering an abortion should have all the necessary information in front of them before making a decision. Here's what you need to know.
How to obtain an abortion
There are many reasons you might seek an abortion. In some cases, continuing with the pregnancy could have a detrimental impact on your mental and/or physical health. In other cases, financial worries could be the main factor in your decision to terminate the pregnancy.
Everyone has a different reason for getting an abortion, and every reason is valid. It's your choice and you shouldn't feel guilty about it.
As soon as you've made your decision, begin looking into your options. Julia Arnold VanRooyen, M.D., a board-certified gynecologic surgeon and women's health and reproductive rights advocate in Wayland, Massachusetts, said you can request an abortion from your doctor. They may provide services themselves or be able refer you to a clinic that offers these services.
Since June 2022, it has become more difficult for many women to access abortion services in the United States. That's when the U.S. Supreme Court's Dobbs v. Jackson Women's Health Organization decision effectively overturned Roe v. Wade, which had affirmed the constitutional right to an abortion since 1973. But there are still options for many women.
"Once a patient finds a clinic that provides abortion care, they can call to schedule an appointment," VanRooyen said. "They do not need a referral from anyone."
Insurance doesn't always cover abortion services, she added. If yours doesn't, be sure to obtain information about the costs of abortions, which the doctor or clinic should provide.
"There are funds that can assist patients who are seeking abortion but cannot afford one. Abortion clinics can provide patients with this information," VanRooyen said.
Once you talk through your options, you have the choice of medical or surgical abortion.
Medical abortions are often the preferred option because many patients prefer a less invasive approach and often want to avoid surgery. Medical abortions require the patient to take two medicines, mifepristone and misoprostol, to terminate the pregnancy. These medications can often be taken at home.
Mifepristone must be taken orally; 24 to 48 hours later, you must take the misoprostol either vaginally, sublingually (beneath the tongue) or buccally (inside the cheek), according to VanRooyen. The earlier the medication is taken, the more effective it will be.
"Patients should expect bleeding and cramping," she said. "This is how the medication works and is necessary for the pregnancy to be expelled from the uterus."
The bleeding is heavier than during a normal period, and you may experience strong cramping, but this should subside after a few hours. Other side effects, which should also subside after a few hours, include:
Medical abortions don't usually require any in-person follow-up, which may benefit many women. You usually are asked to conduct a follow-up phone call and an at-home pregnancy test four weeks later to confirm a negative test. Assuming everything is in order, no further action is needed.
Some women may need a surgical abortion if they are further into the pregnancy or the medical abortion fails. However, some women simply prefer to have a complete abortion performed in a clinic. The benefit to this is if there's a problem during the procedure, it can often be handled in the moment by a professional.
VanRooyen said there is often less bleeding with a surgical abortion, which can appeal to many women.
Surgical abortions can be performed with the patient under local anesthesia, IV sedation, general anesthesia or a combination of these methods, VanRooyen explained.
"Patients will have an exam where a speculum is placed in the vagina, numbing medicine is injected in the cervix and then the cervix will be gently dilated enough so that a small suction catheter can be placed inside the uterus," she added.
It typically takes less than 10 minutes for the procedure to be completed, but patients will be at the clinic for several hours if they receive sedation and/or general anesthesia.
The most common side effects are bleeding and cramping, which can be relieved with anti-inflammatory medications. You may be prescribed a two- to three-day course of antibiotics as well.
Most side effects improve after 24 hours, but you should speak to a doctor if your symptoms don't improve or you need urgent help. Patients usually need to have a follow-up exam two weeks after a surgical abortion.
Risks of abortion
"Approximately 2 percent of women experience complications following abortions," VanRooyen said.
Adverse effects are usually mild and subside after 24 hours. In rare cases, however, there may be serious complications that require urgent medical care. Hemorrhaging that requires a blood transfusion accounts for less than 0.1 percent of cases, and uterine perforation occurs in less than 0.19 percent of cases, VanRooyen explained.
Additionally, the fatality rates remain very low, with approximately 0.4 deaths per 100,000 abortions, according to the Centers for Disease Control and Prevention.
A few of the commonly cited risks aren't supported by evidence.
"Abortion does not increase your risk of breast cancer, depression or infertility," VanRooyen said.
The National Cancer Institute, the American Cancer Society and the American College of Obstetricians and Gynecologists have all examined the scientific literature and concluded that abortion is not associated with an increased risk of breast cancer. Furthermore, the risks do not increase with subsequent abortions.
Editor's note: Abortion is a medical procedure that is currently illegal or restricted in some portions of the United States. For more information about the legality of abortion in your area, please consult a local healthcare provider.