Many women who have had an abortion or plan to get one wonder how an abortion may affect their ability to conceive and have healthy pregnancies in the future. These are incredibly common and normal questions to have when making such an important decision regarding your health. However, the stigma and lack of education surrounding abortion can leave many misinformed about abortion care and the potential for complications. This article will aim to answer your questions surrounding fertility, pregnancy, and abortion with scientific evidence.
Do abortions affect fertility?
Experts have confirmed that having a safe abortion does not usually affect your fertility. One study, for example, evaluated over five thousand women who had previously gotten an abortion. Study results indicated that having an abortion did not cause infertility1.
What can affect fertility and future pregnancies?
When Abortions are done using the correct procedure and following the approved protocols by the World Health Organisation, the risks are minimal. Self-managed abortions whe managed with the safe and approved protocols by the World Health Organisation (WHO) are considered safe. However, there may be a small risk that some abortion procedures can potentially cause an infection.
To reduce this risk, many providers will prescribe and give antibiotics to their patients prior to performing an abortion, however its also okay not to be prescribed antibiotics especially with self managed abortions. Its good to keep in mind that doctors may prescribe antibiotics, so dont be alarmed when this happens. That said, complications are very uncommon when it comes to safe abortions. One study, for example, evaluated the complication rate out of 54,911 abortions. Findings indicated that the complication rate was 0.23% out of all abortions. As for types of abortion, the rates of complications were 0.31% for medication abortion, 0.16% for first-trimester aspiration abortion, and 0.41% for second-trimester or later abortion procedures. Thus, complications are extremely rare when the abortion is performed correctly3.
What are the signs and symptoms of infection I should look out for?
Some signs and symptoms are common after having an abortion. However, if you receive a procedural abortion, it is important to be wary of the signs and symptoms of infections and it is crucial to seek medical advice:
- Having a fever (of more than 38°C or 100.4F) for more than 24 hours after the procedure;
- Serious, worsening abdominal and pelvic pain
- Continued signs of pregnancy (increasing nausea, breast tenderness, etc.)
- Heaving vaginal bleeding (e.g., using two pads per hour for two hours in a row)2
Who is at increased risk of infection?
Infection is more likely when an abortion is done via unsafe methods. Unsafe abortions are abortions that are not performed under currently accepted clinical guidelines. For some women unsafe abortions may seem like they only option available. However, such abortions can have detrimental effects on the mother’s health.
Unsafe methods of abortion can be very dangerous, and a major concern with unsafe abortions is infection. Unsafe abortions not only pose a threat to future fertility and pregnancies but also the health of the mother. In fact, more than 22,000 girls and women wild die annually after receiving an unsafe abortion. Even in non-fatal cases, there are many health complications that can occur as a result. Here are some safe abortion methods.
Do abortions affect future pregnancies?
Abortions do not affect future pregnancies. Fertility comes back as soon as 8 days after an abortion and contraceptive methods should be started soon after an abortion to prevent a pregnancy. Society is still very judgemental to women who have more than one abortion, however, as fertlity is not impacted by abortions, you can have more than one. One study, for example, found that getting an abortion did not cause an increased risk of future pregnancy complications, such as gestational diabetes, preeclampsia, high blood pressure, and more1. Additionally, there is no data suggesting that one method of abortion has an increased risk of complications. Both medical and surgical abortion had similar incidences of complications, including ectopic pregnancy, spontaneous abortion, low birth weight, or preterm birth4.
Does the number of previous abortions increase your risk for future complications?
This answer is less clear. One study from 2012 evaluated 300,858 births of first-time parents. Results demonstrated that the incidence of preterm birth and low birthweight increased with an increased number of previous abortions. However, most of these abortions were procedural. Additionally, it was an observational study, meaning causation cannot be confirmed.
In conclusion, safe abortion does not affect fertility or future pregnancies when done safely and when complications are appropriately managed. Therefore, it is encouraged to actively practice self care for a safe abortion, guided by approved protocols by the WHO.
- Holmlund, S., Kauko, T., Matomäki, J., Tuominen, M., Mäkinen, J., & Rautava, P. (2016). Induced abortion – impact on a subsequent pregnancy in first-time mothers: A registry-based study. BMC Pregnancy and Childbirth, 16(1), 325. https://doi.org/10.1186/s12884-016-1109-3
- Can having an abortion affect my fertility? (2018, June 27). Nhs.Uk. https://www.nhs.uk/common-health-questions/womens-health/can-having-an-abortion-affect-my-fertility/
- Upadhyay, U. D., Desai, S., Zlidar, V., Weitz, T. A., Grossman, D., Anderson, P., & Taylor, D. (2015). Incidence of emergency department visits and complications after abortion. Obstetrics & Gynecology, 125(1), 175–183. https://doi.org/10.1097/AOG.0000000000000603
- Virk, J., Zhang, J., & Olsen, J. (2007). Medical abortion and the risk of subsequent adverse pregnancy outcomes. New England Journal of Medicine, 357(7), 648–653. https://doi.org/10.1056/NEJMoa070445