An induced abortion is the intentional termination of a pregnancy through a medical procedure. This process is distinct from a spontaneous abortion, the clinical term for a miscarriage, where a pregnancy ends on its own before the 20th week of gestation. The term “induced abortion” applies whether the procedure is chosen by the individual or performed for therapeutic reasons, such as a risk to the pregnant person’s health.
Types of Induced Abortion
Induced abortions are categorized into two types: medical and surgical. A medical abortion involves using medication to end a pregnancy and is a common option in the first trimester. This method uses a combination of two drugs, mifepristone and misoprostol, to terminate and then expel the pregnancy tissue. Mifepristone works by blocking the hormone progesterone, which is necessary to sustain a pregnancy, while misoprostol is taken later to cause the uterus to contract and empty.
This non-invasive option is available up to 10 or 11 weeks of gestation. The process allows the abortion to be completed in the privacy of one’s home. The experience is often described as being similar to a heavy menstrual period.
Surgical abortions involve a procedure to remove the pregnancy from the uterus. The most common first-trimester method is vacuum aspiration, also known as suction aspiration. This procedure involves stretching the cervix and using a suction device to empty the uterus. It can be performed using a manual syringe (manual vacuum aspiration or MVA) or an electric pump (electric vacuum aspiration or EVA).
For pregnancies in the later stages of the first trimester or in the second trimester, a procedure called dilation and curettage (D&C) or dilation and evacuation (D&E) may be used. A D&C uses a scraping instrument called a curette to remove tissue, often with suction. A D&E is a more involved procedure for later abortions, combining suction, forceps, and other instruments after the cervix has been significantly dilated.
The Procedure and What to Expect
The experience of an induced abortion varies depending on whether the method is medical or surgical. For a medical abortion, the process begins with a consultation at a clinic where the first medication, mifepristone, is typically administered. Following this, the patient is sent home with the second medication, misoprostol, to be taken a day or two later.
Taking the misoprostol at home will cause cramping and bleeding to begin, usually within a few hours. This process, where the uterine lining and pregnancy tissue are expelled, can last for several hours. The experience is often compared to a heavy and more painful menstrual period, and pain medication is often recommended to manage the discomfort.
A surgical abortion is a more condensed process that takes place entirely within a clinical setting. After an initial consultation and examination, the patient is prepared for the procedure. Pain management options are discussed and can range from local anesthetic injected into the cervix to conscious sedation.
The surgical procedure itself is typically very brief, often lasting only five to ten minutes. After the procedure, the patient is moved to a recovery area to be monitored for a short time, usually about an hour. Staff will check for any immediate complications, such as heavy bleeding, before the patient is discharged to go home the same day.
Recovery and Aftercare
Following an induced abortion, the body begins a recovery process. It is common to experience bleeding and cramping for several days or even a few weeks after the procedure. The bleeding is often similar to a menstrual period and may be intermittent, sometimes stopping and starting again.
Most individuals are able to return to their normal daily activities, such as work or school, within a day or two. Strenuous physical activity and heavy lifting should usually be avoided for a period recommended by the healthcare provider. It is also standard medical advice to practice pelvic rest, which means avoiding intercourse and not inserting anything into the vagina for one to two weeks to help prevent infection.
A follow-up appointment is a standard part of aftercare. This visit, which may occur a couple of weeks after the procedure, is to confirm that the abortion was complete. This check-up can be done in person or through a telehealth visit, and it provides an opportunity to discuss birth control options for the future.
Potential Risks and Complications
While induced abortion is a safe medical procedure, particularly when performed early in pregnancy, there are potential risks and complications. These can include an incomplete abortion, where some pregnancy tissue remains in the uterus, which may require a follow-up surgical procedure to resolve.
Infection is another risk. Signs of infection include fever, chills, and persistent abdominal pain. Hemorrhage, or excessive bleeding, is a rare but serious complication. This is defined as bleeding that is significantly heavier than a normal period, such as soaking through more than two large sanitary pads in an hour for two consecutive hours.
Injury to the uterus or cervix can also occur during a surgical abortion, although this is very uncommon with modern techniques. Warning signs that require immediate medical attention include:
- Severe abdominal or back pain that is not relieved by medication
- A high fever
- Foul-smelling vaginal discharge
- Very heavy bleeding