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Patient education: Abortion (The Basics)

Patient education: Abortion (The Basics)

What is an abortion? — An abortion is a way to end a pregnancy. It is also called "pregnancy termination."

Why do people have abortions? — There are many reasons why a person might choose to have an abortion. For example:

They have an unplanned pregnancy and do not want to have a baby

They can't afford a baby

They don't have room in their life for a baby

They do not have help from a partner or family member and do not want to raise a baby alone

They have problems with their partner

They find out that something is wrong with the unborn baby

They have health problems that make pregnancy unsafe

People might have other reasons for their decision, too.

Is abortion legal? — The laws depend on where you live. In the United States, abortion is legal. But each state has its own laws about how far along in pregnancy you can get an abortion. If you are under 18 years old, some states require permission from a parent or guardian. But it is often possible to get permission from a judge instead.

If you are not sure about the laws where you live, you can ask a doctor or nurse. You can also get information from a clinic that provides abortions, like Planned Parenthood (www.plannedparenthood.org).

How do I decide if an abortion is right for me? — Deciding if you should have an abortion is a very personal decision. If you don't know what to do, talk to someone you trust. Your doctor, nurse, or clinic can help. It might also help to talk to your partner, family members, or friends.

How is an abortion done? — There are 2 main ways to do an abortion:

Medication abortion – You take pills to end the pregnancy. This only works until 11 weeks into a pregnancy (that means 11 weeks after your last period). It is also sometimes called "medical abortion." People who have a medication abortion often need to take 2 separate medicines.

Procedural abortion – This is also called "surgical abortion," although it doesn't involve being cut open like in some types of surgery. This can be done in the first or second trimester. The actual procedure takes 15 to 30 minutes, but most people spend a few hours at the clinic.

How is a medication abortion done? — Most people will first take a medicine called mifepristone (brand name: Mifeprex). The medicine is usually given in a clinic or doctor's office, but in some cases it is possible to take it at home. Then, 1 to 2 days later, you will take another medicine at home. This one is called misoprostol (brand name: Cytotec). The medicines cause your body to end the pregnancy. It might take 4 to 6 hours after taking the second medicine for this to happen. When it does, you will bleed from your vagina. You will probably also see large blood clots or pieces of tissue.

Will I have symptoms after a medication abortion? — Yes. Common symptoms include:

Pain and cramps in the lower belly after you take the second medicine (misoprostol). These last for up to 6 hours.

Bleeding from the vagina. Bleeding can be very heavy for a few hours after you take misoprostol. Light bleeding might go on for a few weeks.

Fever, nausea, vomiting, and diarrhea

How is a procedural abortion done? — Your doctor or nurse will give you anesthesia medicine. If you are awake during the procedure, the medicine helps to decrease pain. Or you might have the option to get anesthesia to put you to sleep until the procedure is over. The doctor will use special tools to remove the pregnancy tissue from your uterus. This is done through your vagina (figure 1), so there will be no cuts or scars on your body afterwards.

Will I have symptoms after a procedural abortion? — Yes. It is common to have:

Pain and cramping in the lower belly – This lasts for a few hours.

Bleeding from the vagina – This is usually lighter than after a medication abortion. The bleeding can last for up to 2 weeks.

Should I call my doctor or nurse after an abortion? — Call right away if:

Your bleeding is heavy enough to soak through 1 menstrual pad each hour, for at least 2 hours, and you are still bleeding

Your pain is really bad (it makes you double over or makes it hard to move), and you don't feel better with pain medicines, such as ibuprofen (sample brand names: Motrin, Advil)

You have a fever higher than 100.4°F (38°C)

Bad-smelling discharge comes out of your vagina

In some cases, abortion does not work completely to get rid of all the pregnancy tissue. This is not very common. But if it does happen, you will need to take additional medicine or have a procedure to remove any leftover tissue. Signs that an abortion was not complete include:

Not bleeding after a medication abortion

Still having pregnancy symptoms, such as nausea and tender breasts, 1 week or more after your abortion

Bleeding for more than 2 weeks after an abortion

Not having a period in the first 6 to 8 weeks after an abortion

Is abortion safe? — In general, yes, abortion is very safe. But like any medical procedure, abortion does come with some small risks.

If you decide to have an abortion, it's extremely important to go to a doctor or specially trained nurse in a clinic or hospital. Do not take any medicines, or put anything in your vagina, without talking to a doctor or nurse first. Trying to end a pregnancy on your own can be very dangerous.

Is there anything I should do differently after an abortion? — Your doctor or nurse might tell you not to have sex or put anything into your vagina for 2 weeks after an abortion. This is to lower the risk of infection.

What if I want to get pregnant again someday? — Having an abortion does not make it harder to get pregnant again. Abortions do not harm your health, and they do not harm the health of your future babies if you choose to have them.

What about birth control? — If you do not want to get pregnant again, talk to your doctor or nurse about birth control options. It is possible to get pregnant very soon after having an abortion, even before your next period. There are many different types of birth control. Your doctor or nurse can work with you to choose the type that is right for you.

More on this topic

Patient education: Choosing birth control (The Basics)
Patient education: Hormonal birth control (The Basics)
Patient education: Long-acting methods of birth control (The Basics)
Patient education: Intrauterine devices (IUD) (The Basics)
Patient education: Permanent birth control for women (The Basics)
Patient education: Emergency contraception (The Basics)

Patient education: Abortion (pregnancy termination) (Beyond the Basics)
Patient education: Birth control; which method is right for me? (Beyond the Basics)
Patient education: Long-acting methods of birth control (Beyond the Basics)
Patient education: Emergency contraception (Beyond the Basics)

This topic retrieved from UpToDate on: Sep 01, 2021.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of UpToDate content is governed by the UpToDate Terms of Use. ©2021 UpToDate, Inc. All rights reserved.
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