- Both in-clinic and medical abortions are very safe and risks are often rare and minor.
- While uncommon, risks include infection, pelvic pain, and damage to the cervix.
Ending a pregnancy by legal
Moreover, the majority of these complications are minor and may include excessive bleeding, infection, pain in the pelvis, and side effects from anesthesia.
There are two types of abortions: medical abortion, where you take a combination of pills, and surgical abortions, where a doctor will dilate your cervix and then use a suction device to remove any pregnancy tissue.
"Both options are very safe, with no negative effects on health or risks to future pregnancy outcomes," says Dr. Stephanie Grube, director of Family Planning at Northwell Staten Island University Hospital.
People in the US are 14 times more likely to die during childbirth than they are to die from complications of abortion, says Dr. Siripanth Nippita, a professor with the department of obstetrics and gynecology at NYU Grossman School of Medicine.
Still, like any medical procedure, abortion has risks. Here are the potential complications of abortion that you should weigh when deciding whether this procedure is right for you.
1. Heavy bleeding
One of the most common risks of abortion is heavy bleeding. In fact, one 2021 study found that of people who went to the hospital after a medical abortion, 78% were there because of excessive bleeding.
It's important to note that some bleeding is expected and normal for several days to weeks after an abortion. But excessive bleeding — where you're bleeding enough to soak through two maxi pads, or more, within two hours — is not.
Moreover, if you're passing clots larger than a lemon for more than two hours, that's also not normal.
About 1% of people who get an abortion will experience heavy bleeding, Grube says. And of that small percentage only one in five people will require additional treatment like a transfusion, surgery, or overnight hospital stay.
Note: Heavy bleeding is more common with medical abortions than surgical ones, since the pregnancy tissue exits the body through the vagina, similar to a period. Before getting an abortion, your doctor will tell you how much bleeding to expect afterward. If you're ever concerned about bleeding, call your doctor for guidance.
2. Incomplete abortion
In most cases medical abortion ends a pregnancy. However, there's a 2%-6% risk of the pills not working for people who are eight weeks pregnant or less.
That risk increases as pregnancy continues, rising to 13% for people who are 10-11 after the first day of your missed period.
If the abortion pill doesn't work, you may be offered another dose. That makes it effective nearly 100% of the time and is a good option for people who want to avoid surgery. You may also opt for a surgical abortion.
If you have a surgical abortion, the risk is less than 1%, as long as you see a trained medical professional who will remove all fetal tissue.
3. Infection
About 1.4%-1.7% of people who get an abortion in developed countries like the US may develop an infection.
Although this is very rare, it can be serious and lead to shock if left untreated. So, it's important to know the warning signs, Grube says. These include:
- Severe abdominal pain
- Fever
- Flu-like symptoms
- Fast heart rate a day or more after the procedure
When in doubt, always call your provider about these symptoms, since they need to be addressed quickly with antibiotics, Grube says.
4. Retained tissue
Sometimes part of the pregnancy tissue remains on the uterus, increasing your risk of infection or bleeding. This happens in about 1% of both surgical and medical abortions.
About 1 in 300 people who have second-trimester abortions experience retained tissue. In this case, they may need a second procedure to remove the residual tissue.
5. Cervical or womb damage
The risk of damage to the uterus or cervix is higher for surgical abortion than for medical abortion, but it is still extremely low.
About 1 in 90 people who have a surgical abortion will have a cut or other damage to their cervix. This can usually be treated with stitches, but may increase risk for bleeding or preterm labor during subsequent pregnancies.
About 1 in 300 people who have a surgical abortion will experience perforation of the uterus. If the doctor notices the perforation during your abortion, they may stitch it or give you antibiotics to reduce the risk of infection.
If it presents afterward, they'll monitor you for any symptoms of infection while the uterus heals. However, perforation may increase risk for uterine rupture during future pregnancies.
6. Other risks
In addition to the risk highlighted above, people who have an abortion might experience:
- Side effects from anesthesia, including headache, nausea or confusion
- Increased risk for blood clots
- Normal and expected effects of the abortion pills, including cramping and bleeding
How to have a safe abortion
Abortion is safe in the US because patients have access to legal abortions performed by trained medical professionals, Grube says.
Unfortunately, worldwide about half of people who seek abortions have unsafe abortions, which are not overseen by a trained professional and do not meet the minimum medical safety standard.
Because of this, unsafe abortions are one of the leading causes of maternal death globally, particularly in developing countries.
Therefore, a nation-wide abortion ban in the US could increase the maternal death rate in the US by 21%, according to a 2021 study.
"The biggest piece of advice for maintaining access to safe abortions, is to stop the criminalization of reproductive healthcare," Grube says.
Here's how to make sure your abortion is safe:
Find a qualified provider
If you decide abortion is right for you, talk to a trained abortion provider who can help you decide whether a medical or surgical procedure is the right choice.
Abortion access funds can help you find a provider outside your state if needed. Grube recommends www.abortionfinder.org.
Avoid misinformation
Finding information on abortion online can be tricky, since the antichoice movement publishes information meant to dissuade people from abortion.
These publications often distribute information that may be false, misleading, and even dangerous. However, it can be difficult to identify, Grube says.
Therefore, to make sure you're getting accurate, up-to-date advice, stick to well-known resources like Planned Parenthood, the Guttmacher Institute, or the American College of Obstetricians and Gynecologists. Or, speak directly with your doctor.
Earlier is better
The risk of complications from abortion increase 38% each week after eight weeks gestation. So, try to have an abortion as soon as you can after making your choice.
But remember, at any point in pregnancy abortion is safer than childbirth, Grube says.
When in doubt, call your doctor
If at any point during or after your abortion you are worried that what you're experiencing isn't normal, reach out to your doctor.
"The risks of an abortion jeopardizing your health are exceedingly low, but I always stress asking questions if you have a concern," Grube says. "It is your body and you should feel well informed and empowered to ask questions and raise concerns."
Insider's takeaway
Each year, about one million people get abortions in the US. Only 2% of them have complications, most of which are minor.
World-wide, abortion can be quite dangerous since about half of people seek unsafe abortions outside a medical setting.
The most common risk from abortion in the US are bleeding, infection, unsuccessful abortion and residual tissue.
Very rarely, additional risks like damage to the cervix or uterus can occur. However, in the United States abortion is safer than childbirth and does not affect future fertility.
"Abortion is one of the safest medical processes that occur in the United States," Grube says.