Abortion explained – types of abortion, risks and recovery

28th September, 2022 • 21 min read

*Disclaimer: The legal status of abortion may vary depending on the country of your residence and may be illegal. For example, in the United States, the right to abortion is no longer protected by the Constitution. This means that individual states are now able to decide their own abortion laws.

Abortions are really common. According to the World Health Organizsation, 6 out of 10 unwanted pregnancies, and 3 out of 10 of all pregnancies, end in abortion. *

‘If you’re considering an abortion, you probably have lots of questions surrounding your decision, such as what will happen during whatever procedure you choose. It can feel overwhelming and isolating especially if you feel you can’t talk to anyone about it,’ says doctor and Healthily expert,

Dr Ann Nainan
.

‘As a starting point you’ll need an appointment with a doctor or healthcare professional at an abortion provider either in person or through telemedicine. This is a good time to find out more about what options are available to you, even if you haven't yet made a decision.’

What is an abortion?

An abortion is a procedure to end a pregnancy either by using abortion pills (this is called ‘medical abortion’) or surgery. It’s sometimes called termination of pregnancy or the formal name is induced abortion. These names may sound clinical and like they don’t take into account the emotional and physical recovery process. But an abortion is a medical procedure and these names reflect that.

All the evidence shows abortion is safe when it’s done after medical assessment using methods with scientific evidence to back them. Abortion is legal in many countries, even if some religions or societal codes don’t approve of it. It is not legal in some countries or in

some states of the US, so always check the local guidance
.

Find more useful information on abortion care with our

complete Guide
.

Reasons to have an abortion

There are many different reasons why you might choose to have an abortion and you may have more than one reason.

US research has found that most women have multiple reasons:

  • 40% of women felt they couldn’t afford to look after a child
  • 36% of women said it wasn’t the right time for them to have a baby
  • 31% said their decision was partner-related
  • 29% said they needed to focus on other children
  • 25% said the pregnancy would interfere with future opportunities
  • 19% said they weren’t emotionally prepared

There are also health-related reasons for having a termination – especially in late pregnancy. These could be:

  • health problems with the baby, such as an inherited fetal abnormality or genetic abnormality
  • a threat to your own health if the pregnancy continued – for example, if there was a severe threat to your mental health, if you needed life-saving cancer treatment that wasn’t compatible with pregnancy or because of a rare medical event such as severe preeclampsia
  • cases of rape and incest

Abortion law

Abortion is legal in many countries and it’s safe, provided that an approved method is used at the appropriate stage of pregnancy by a skilled health professional.

The different types of abortion available to you may depend on how far along with the pregnancy you are, your medical history, personal choice, the cost, plus what’s available in your area or through your health insurer or healthcare system. You can read

how to get an abortion in the US
and
how to get an abortion the UK
for more information on the laws in your country.

Abortions are free in some countries such as the UK, although some women choose to pay privately. In other countries such as the US you will need to pay, or make an insurance claim if abortion is covered by your plan. Some charities in the US also provide funding.

If you live a place where access to safe abortion is difficult, speak to your doctor for help with yourl options. There are also charities that may be able to help, such as

MSI Reproductive Choices
.

When to speak to a healthcare professional

In general, the earlier in pregnancy the procedure is done the safer it will be. So it’s a good idea to get advice about an unintended or unwanted pregnancy as soon as you can. You may not have decided abortion is definitely the right option for you and you might be considering alternatives such as adoption.

Whatever you’re thinking, you can get advice from your family doctor, healthcare professionals such as a specialist nurse from an abortion care provider, or from charities and support groups, such as:

They can give you unbiased advice about the pros and cons of abortion from a health perspective and explain the different methods and how to arrange the procedure, plus any risks involved, and arrange counselling if you need or want it.

If you’re considering continuing with pregnancy after a screening or diagnostic test has detected fetal anomaly/abnormality, you might find it helpful to get in touch with a group like

Family Voices
, a family-led organization for families of children with disabilities and special healthcare needs.

What happens before you have an abortion

There are a number of steps you need to take in the US or UK before you have an abortion. Other countries may have different processes:

  • you should have a medical consultation either in person at a hospital or clinic, or via telemedicine for the abortion pill, where you speak to a healthcare professional via video link or by telephone

  • you’ll talk through your pregnancy options. No one will try to influence you either way, it will be your decision and the healthcare professional’s role is to support you in whatever you decide

  • you will be asked about the reasons why you want an abortion and how far along your pregnancy is. Be reassured they are not judging you, these are questions they are legally obliged to ask

  • you might be very clear about wanting an abortion, or you may want time to think about your decision before you go ahead or to discuss an abortion with your partner if you have one, a friend or family member, or a specialist counsellor. Or you might decide it’s best to tell no one, the choice is yours. If you need more support read our article on emotional support surrounding abortion

  • if you decide on abortion, the healthcare professional will explain the options available to you and arrange a medical assessment, including dating your pregnancy – you may need an ultrasound scan for this, in some cases and in some places – and taking your medical history

  • your abortion treatment will be booked and you’ll be asked to sign a consent form in person or electronically

  • they will talk you through your

    future contraceptive needs
    and you may be offered a
    sexually-transmitted infection (STI) screening test

Decision-making support

If you decide to go ahead with an abortion, it may help to find out as much as you can about the procedure and what to expect in advance. If you’re worried about anything, you could write a list of questions to ask your healthcare professional. Think about having someone come with you to the clinic or who is available to be there for you afterwards – it’s important to think about aftercare.

You can change your mind about having an abortion at any point before the procedure, the decision is yours alone.

You can read about decision-making support available to you in our mental health and abortion article.

Types of abortion

You might be wondering, how does an abortion work? There are 2 main types of abortion – medical abortion and surgical abortion.

Medical abortion, also known as the abortion pill

  • medical abortion – or the abortion pill – is when you take 2 medicines to end the pregnancy, usually in the form of tablets taken 1 to 2 days apart

  • medical abortion is usually recommended if you’re less than 10 weeks’ pregnant. It can also happen after 10 weeks but you’re more likely to need a further procedure to complete the abortion so a surgical abortion (see below) might a better option for you

  • medical abortions can usually be arranged quite quickly after your initial medical consultation, but it varies depending on where you live. The charity MSI Choices aims to offer consultations within 48 hours of you getting in touch with them, either by phone, video or in a clinic. Read more about time frames in the

    US
    and
    UK

What happens during a medical abortion?

  • if you’re less than 10 weeks pregnant and depending on where you live, you may be able to have an at home abortion. This is where you take the abortion pills at home after having a telemedicine consultation with a medical professional without having to go to a hospital or clinic. This is not the same as buying an abortion pill online – which is illegal in many countries and not safe

  • if you’re more than 10 weeks pregnant, you’ll need to take the pills at a clinic or hospital, but you can usually go home between the 2 doses

  • the first medication contains a medicine called mifepristone, which blocks progesterone, the main hormone needed for your pregnancy to grow. You take this orally. Most people can carry on with their daily activities after taking mifepristone – occasionally you might get some pain and bleeding

  • the second medication is called misoprostol. You’ll take misoprostol right away or up to 48 hours after the mifepristone, either orally – place them between your cheek and gum and keep them there for 30 minutes – or by placing them inside your vagina – this has fewer side effects. You may be advised to take a painkiller before taking misoprostol, such as ibuprofen, paracetamol, or codeine

  • within a few hours hours of taking the misoprostol pills, the abortion itself starts and finishes within 1–2 days. The lining of your uterus should break down and the pregnancy will be passed out through your vagina. You will feel cramping pains, you’ll bleed and may pass blood clots. These clots can be up to the size of a lemon – this is normal

  • if you haven’t had any cramping pains, bleeding and you don’t think you have passed the pregnancy you may need to take more misoprostol. Your doctor or abortion provider will tell you exactly what to do

What does medical abortion feel like?

You may be wondering: is abortion painful? The truth is, it feels different for everyone. For some people, abortion can feel very painful while for others, it feels uncomfortable. Most women who’ve had an abortion say it feels like having strong period cramps.

What can you expect after a medical abortion?

You’ll need sanitary towels that can absorb heavy flow – the type of bleeding varies from person to person and can be light, moderate or heavy, but it’s not normal to have no bleeding at all. Occasionally, it can take up to 2 weeks to fully pass all the pregnancy tissue. Once you’ve passed the pregnancy the pain should ease and the bleeding should be like a heavy period. It’s normal to have some bleeding for up to 4 weeks.

Risks of medical abortion

These complications are usually easy to treat and they don’t usually have long-term health effects:

-pregnancy tissue being left in your uterus, where your pregnancy isn’t growing anymore but some of the tissue is left behind – 2 in 100

  • abortion hasn’t worked and your pregnancy continues – less than 1 in 100

  • infection of your uterus or fallopian tubes – 2 in 1,000

  • heavy bleeding - 2 in 1,000

Can a pregnancy test show positive after abortion?

You may need to take a special pregnancy test or have a scan to check that the pregnancy has ended after medical abortion. You should do this after 3–4 weeks. If you take a pregnancy test too soon after your abortion, you might get a false positive because the pregnancy hormone can still be in your body. Your doctor may give you a special kind of pregnancy test that’s different from store-bought tests. If your pregnancy test is positive after 3–4 weeks, talk to your abortion provider for advice.

Surgical abortion

There are 2 main types of surgical abortion:

  • vacuum aspiration
  • dilation and evacuation

Vacuum aspiration

Vacuum aspiration removes the pregnancy with gentle suction. A tube is inserted into your uterus through your cervix (the neck of your uterus). Vacuum aspiration is possible up to 14 weeks of pregnancy.

Depending on your stage of pregnancy and your personal preference you may be given:

The procedure itself is pretty quick – usually 5-10 minutes – and you should plan to be in the clinic for around 3 to 4 hours in total.

Dilation and evacuation (D&E)

This type of surgical abortion is usually recommended if you’re in your second trimester of pregnancy, from 14 weeks up to 24 weeks of pregnancy.

Dilation and evacuation is normally done under sedation – where you’re drowsy but awake – or general anesthetic.

You may need to go to the abortion clinic the day before to help prepare your cervix to open. This is done by gently widening your cervix with dilators – these are thin rods – and/or applying medication to soften your cervix.

During the abortion itself, your cervix may also be widened with dilators. The pregnancy is removed using an instrument called forceps, inserted into your uterus through your cervix, and also with a tube gently inserted through your cervix using suction.

It may sound scary, but you won’t feel pain and healthcare professionals will be there to explain everything and reassure you. The treatment itself takes 10–20 minutes.

You’ll usually be able to go home the same day, after a couple of hours of rest and recovery. You shouldn’t drive for 24 hours after having a general anesthetic.

What to expect after surgical abortion

  • as with a medical abortion you can expect to feel cramping pains and have vaginal bleeding after a surgical abortion. Bleeding usually lasts a week or 2 and sometimes lighter vaginal bleeding can last for a month

  • take painkillers to ease pain and discomfort

  • as with

    medical abortion
    , you’ll need sanitary pads that absorb heavy flow

  • you don’t usually need to take a pregnancy test after a surgical abortion. Your doctor at the hospital or clinic should tell you if it’s needed

  • you should be able to get back to activities such as exercise, bathing and showering and heavy lifting when you feel up to it

Risks of surgical abortion

It’s important to know that you’re at most risk of complications if you have an unsafe abortion. Around 45% of all abortions carried out worldwide are unsafe. Of all these unsafe abortions, one third were performed under the least safe conditions – that means by untrained people using dangerous and invasive methods.

When surgical abortion is carried out safely, there may be a small risk of:

  • pregnancy tissue being left in your uterus, which will need to be removed: You would notice this days or weeks after the abortion and signs usually include heavy bleeding that goes on for longer than you’d expect. The risk of this happening with vacuum aspiration is 1 in 600. The risk with D&E is 1 in 800
  • infection: The risk is 1 in 6,500 for vacuum aspiration and 1 in 2,500 for D&E
  • injury to your cervix: The risk is 1 in 11,000 for vacuum aspiration and 1 in 5,000 for D&E

When abortion is done unsafely, the risks include:

  • the abortion not working
  • hemorrhage (heavy bleeding)
  • infection
  • uterine perforation – when your uterus is pierced by a sharp object
  • damage to your genitals and internal organs because of dangerous objects being put into your vagina or anus

How long after abortion do pregnancy symptoms go away?

Pregnancy symptoms don’t disappear immediately after an abortion and it’s normal to have sore breasts and still ‘feel’ pregnant for a few days or so. Nausea and vomiting are usually the first pregnancy symptoms to fade away. If you still have tender breasts after 3 weeks get medical advice from your doctor or abortion provider.

Self-care after an abortion

Look after yourself after an abortion by following some of the following self-care tips:

  • you may feel lightheaded after an abortion so avoid taking a bath or shower right away

  • drink plenty of water and don’t drink alcohol for 24 hours after treatment

  • take painkillers regularly following dosage instructions (ibuprofen, paracetamol or codeine, if pain is severe)

  • apply a hot water bottle wrapped in a cloth to your abdomen to ease pain

  • use sanitary towels – not tampons or menstrual cups – until the pregnancy has passed. This avoids infection and lets you keep track of your bleeding

  • avoid having sex for 2 weeks afterwards to reduce the risk of an infection

  • don’t use vaginal douches as your vagina cleanses itself and douches increase the risk of infection

  • get support for your psychological health if you are feeling depressed or anxious. Your abortion provider may be able to help with specialist counselling – read our articles on

    how to get an abortion in the US
    and
    UK
    for services in your area

When to see a doctor after an abortion

Most people recover quickly physically after an abortion, but some people have more pain and bleeding than others. Talk to your doctor if you’re worried, or if you:

  • have pain or heavy bleeding that doesn’t improve after a few days
  • have light bleeding or spotting that suddenly gets heavier or doesn’t stop after 4 weeks
  • have no bleeding or only light spotting 24 hours after taking misoprostol for medical abortion
  • still feel pregnant 1 week after the abortion
  • have unusual or unpleasant smelling vaginal discharge

A high temperature or vaginal discharge could mean you have an infection, which may need treating with antibiotics.

Go the the emergency department if you:

  • have heavy bleeding and are soaking through 2 or more high-absorbancy pads per hour for 2 hours in a row
  • develop a fever or flu-like symptoms after 24 hours
  • get worsening pain or pain under your ribs, towards one side of your abdomen or pain that goes up to your shoulders
  • have a combination of dizziness, feeling confused, shivering and feeling very unwell

These are some of the signs of

sepsis
, a severe, life-threatening reaction to an infection. It’s a very rare complication of abortion but it can be serious.

As well as physical symptoms, it’s common to feel a range of emotions before, during and after an abortion. If you’re worried or want to discuss how you’re feeling, get in touch with an abortion provider or doctor. They may be able to refer you for counselling, or provide details of free, confidential support groups.

Terminating a pregnancy for medical reasons (TFMR)

If your baby is found to have a life-limiting condition in the uterus, you may be faced with the difficult decision of whether to end your pregnancy by bringing on (inducing) labour.

This type of abortion might be offered if your baby has been diagnosed with an illness or condition that could cause death or serious disability, or if continuing with the pregnancy could be harmful for you – for instance, if there was a severe risk to your mental health or if you needed life-saving cancer treatment that wasn’t compatible with pregnancy.

You’ll be given medicines to bring on contractions and labour. If you’re more than 22 weeks’ pregnant, an injection to stop the baby’s heartbeat will be given before the induction.

Coping with termination of pregnancy for fetal abnormality

Deciding whether to have a termination for medical reasons can be very difficult for you, and you’ll be advised to talk to a range of healthcare professionals to ensure you have all the information you need. You may also need counselling if you need extra support to help you make up your mind and wonder if it will affect future pregnancies. Read our article on abortion and your emotions for more on this.

What is late term abortion?

You might have heard of ‘late term abortion’ but it doesn’t have any clinical meaning. That’s because in pregnancy, ‘term’ means the 3 weeks before and 2 weeks after your due date – when abortion doesn’t happen.

What most people mean when they talk about ‘late term abortion’ is ‘abortion later in pregnancy’ – this is a more accurate description, according to the American College of Obstetricans and Gynecologists (ACOG).

Abortions later in pregnancy usually happen from 21 weeks – these are unusual and account for just 1% of abortions in the US. Fetal abnormalities can be a reason for abortion later in pregnancy because you may be offered a fetal anomaly scan around 20 weeks into your pregnancy.

Around 93-95% of abortions carried out after 21 weeks are performed by dilation and evacuation (D&E).

If you’re in the US, check the legal status in your state on abortion later in pregnancy – the federal government’s Department of Health & Human Services website suggests visiting

abortionfinder.org
.

Your questions answered

What are the signs of womb damage after abortion?

Abortion doesn’t usually cause any womb damage but having any kind of surgery on your uterus (the medical term for ‘womb’), including a surgical abortion, can rarely result in scar tissue, called adhesions, forming in your uterus. The extra scar tissue means there is less space inside your uterus.

This is known as Asherman’s syndrome – it’s thought to be rare but exact figures aren’t known. Adhesions may cause future problems such as:

  • light periods
  • not having a period or getting abnormal bleeding
  • severe cramping or pelvic pain
  • problems getting pregnant and increase the risk of miscarriage

If you plan to get pregnant in future or if you’re experiencing cramps or pelvic pain, adhesions can be treated using hysteroscopy. A hysteroscope is a thin tool that’s inserted into your uterus through your cervix. It can be used to look at your uterus and to remove scar tissue.

At home remedies for abortion – are they safe?

Home remedies for abortion don’t work, but worse than that some can be dangerous and cause serious, life-threatening complications such as infections, liver failure and scarring.

The World Health Organization says there are 39,000 deaths a year worldwide from unsafe abortions and millions more women are hospitalised with complications, so always get professional medical help rather than trying to end your pregnancy yourself.

In most countries it’s also against the law to try to cause your own abortion, and this includes buying abortion pills online.

Can abortion affect fertility and future pregnancies?

There’s no evidence that a medical or surgical abortion can affect your future fertiity or pregnanices, but there’s a small chance that if you develop an infection during the procedure and it’s not treated properly, this could spread to your fallopian tubes.

This could lead to

pelvic inflammatory disease
, an infection of the upper female genital tract – your uterus, ovaries and fallopian tubes – which increases the risk of infertility and an
ectopic pregnancy
, where a pregnancy develops outside your the uterus and ends in miscarriage and can damage yourto the fallopian tubes.

Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.