Abortion

Overview

What is an abortion?

Abortion is the early ending of a pregnancy. This can be done with medicines (medical abortion) or a surgical procedure (surgical abortion). It can also be done using medicines to start labour and delivery (induction abortion). When a pregnancy ends on its own, it's called a miscarriage.

How will you know what decision is right for you?

For some, the choice to have an abortion is clear. For others, it's more complicated. Your other options are to continue the pregnancy and either become a parent or arrange an adoption. You may need some time to think about your choices.

Talking to people you trust may help you to decide what's best for you. If you're comfortable, you might talk with your doctor. You may also want to talk with someone close to you who understands how the different choices would affect your life.

When can an abortion be done?

The earlier you are in your pregnancy, the more options you are likely to have.

Before 10 weeks, you may have a choice of taking medicine to end the pregnancy or having a procedure such as vacuum aspiration.

After 10 weeks, surgical abortion is usually the only option.^{footnote 1} Abortions are rarely done after 24 weeks of pregnancy (during the late second trimester and entire third trimester).

How safe is abortion?

Medical and surgical abortions are generally very safe. Both are low-risk options. The risk may be less if the abortion is done before 14 weeks of pregnancy.

Will you be able to have children in the future?

Having an abortion usually won't keep you from getting pregnant later.

It will probably take you a day to a few weeks to feel better after an abortion. Ask your doctor when it's okay to have vaginal sex.

Keep in mind that you can get pregnant in the weeks right after an abortion. If you don't want to get pregnant, talk with your doctor about birth control options.

Choices: Medical or Surgical Abortion

Comparing medical and surgical abortion

There are two types of abortions. One type is done with medicines (medical abortion). The other is a procedure (surgical abortion). The best type for you may depend on things such as your past health, where you live, and how many weeks pregnant you are.

In a medical abortion, you take medicines to end the pregnancy. This may be done at home. Your doctor will explain how to take the pills. They can be taken as soon as you know that you are pregnant. These medicines usually cause bleeding and strong cramps for 3 to 5 hours. You may need to take pain medicine. After 3 to 5 hours, the cramps and bleeding usually lessen. Then for about 1 to 2 weeks, you will probably bleed like you do when you have your period.

You will have an ultrasound or a lab test to make sure the abortion worked. You will be told when to do this. In a few cases, the medicine doesn't work. If that happens, you may need to take a second dose of medicine or have a surgical abortion.

In a surgical abortion, a doctor gently widens the opening of your cervix and puts a tube in your uterus. The tube uses suction to remove the contents of the uterus. This procedure takes less than an hour. Before the procedure, you may get medicine to relieve pain and help you relax. After, you may have strong cramps and light bleeding. They don't usually last more than a few days. But cramping may last for up to a few weeks.

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When to Call a Doctor

Your doctor will give you information about what to expect after an abortion. Normal symptoms that most often occur include:

• Irregular bleeding or spotting for as long as the first few weeks.
• Cramping for up to a few weeks.
• Nausea and vomiting for 4 to 6 hours after using abortion pills.
• Fever for up to 4 hours after using abortion pills.

Follow your doctor's instructions on what to do at home.

Call 9-1-1 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You have severe vaginal bleeding along with light-headedness or nausea.
• You have chest pain, are short of breath, or cough up blood.

Call your doctor now if you have any of these symptoms after an abortion:

• Severe bleeding. Any abortion usually causes bleeding that is different from a normal menstrual period. Severe bleeding can mean:
  • Passing clots that are bigger than a golf ball, lasting 2 or more hours.
  • Soaking more than 2 large pads in an hour, for 2 hours in a row.
  • Bleeding heavily for 12 hours in a row.
• Signs of infection in your whole body, such as headache, muscle aches, dizziness, or a general feeling of illness. Severe infection is possible without fever.
• Severe pain in the belly that isn't relieved by pain medicine, rest, or heat
• Fever of 38°C (100.4°F) or higher 
• Vomiting lasting more than 4 to 6 hours
• Sudden belly swelling or fast heart rate
• Vaginal discharge that has increased in amount or smells bad

Call your doctor for an appointment if you have any of these symptoms after a recent abortion:

• Bleeding (not spotting) for longer than 2 weeks
• No menstrual period within 6 weeks after the procedure
• Still feeling pregnant or having pregnancy symptoms
• Signs of depression. Hormonal changes after a pregnancy can cause depression that requires treatment.
• You are not getting better as expected.

Self-Care

Carefully follow all of your doctor's instructions after you've had an abortion.

If you didn't get instructions, follow this general advice.

• Do not rinse your vagina with fluids (douche).

  This could increase your risk of infections that can lead to pelvic inflammatory disease.

• Take any medicines your doctor has prescribed.

  Take them exactly as instructed.

• Ask your doctor when you can return to normal activities or strenuous exercise.

  Most people can return to normal activities 1 to 2 days after an abortion.

• Ask your doctor when it's okay to have vaginal sex.

  You can get pregnant in the weeks after an abortion. If you don't want to get pregnant, talk to your doctor about birth control options.

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