I want kids, but not right now. You may be thinking this after a positive pregnancy test. After weighing your options, you decide to pursue an abortion. Now another question pops into your head: Will this affect my ability to have kids in the future? What if I can’t have kids in the future?

ABORTION AND FERTILITY

Many medical experts conclude that elective abortion does not directly impact a woman’s fertility or future pregnancies overall. However, like all medical procedures, there are risks and complications that can occur which might negatively impact future pregnancies and fertility.

MEDICAL ABORTION

Medical abortion, also known as a chemical abortion or the abortion pill, is a procedure using two pills, mifepristone and misoprostol. After the first pill is taken orally, the second pill is taken 24-48 hours later, causing the pregnancy to be terminated and expelled. This procedure can only be used up until a woman reaches 10 weeks of gestational age (70 days since the first day of her last period). 

MEDICAL ABORTION RISKS

Based on a large US study, the overall rate of complication from a medical abortion after a thorough and appropriate in-person medical evaluation is 5.2%Risks and complications include:

  • Heavy and prolonged bleeding
  • Fever
  • Digestive system discomfort
  • Infection in the reproductive organs
  • Ongoing pregnancy if the abortion doesn’t work
  • Incomplete abortion resulting in the need for a surgical abortion 

It’s important that a woman has a thorough and appropriate in-person medical evaluation before proceeding with a medical abortion. 

SURGICAL ABORTION

If you are further along in your pregnancy, a surgical abortion is required. A surgical abortion is a procedure in which the fetus and placenta are removed from the uterus through the vagina. The most common method uses vacuum aspiration and often a surgical instrument called a curette. 

In this procedure, the cervix is dilated and the fetus and related pregnancy tissue are removed through the vagina using a suction device. A curette can then be used to scrape the endometrium, which is the inner lining of the uterus, to remove any remaining tissue.

SURGICAL ABORTION RISKS

As a surgical abortion is more invasive, the risks can be more severe and long-lasting:

  • Perforation of the uterus. Perforation occurs when a surgical instrument makes a hole in the uterus. Perforations typically heal without medical intervention. If a blood vessel or surrounding organ is also damaged, however, another procedure may be needed for repair.
  • Damage to the cervix. The cervix can tear during a surgical abortion. Heavy bleeding may occur, requiring applied pressure, medication, or sutures to manage bleeding. Lasting damage can also occur and possibly lead to cervical stenosis and an incompetent cervix. These can cause miscarriage, preterm delivery and infertility.
  • Scar tissue on the uterine wall. Surgical abortion, especially with curette use, can lead to scar tissue developing in the uterus. This is known as Asherman’s Syndrome. This can cause unusual, absent or painful periods, future miscarriages, and infertility. 
  • Pelvic Inflammatory Disease (PID): A surgical abortion increases the risk of bacteria from outside the body or from the vagina being introduced through the cervix into the uterus. Instruments passing through the infected area pick up bacteria and pass it into the reproductive system. This can be of more concern if there is an unknown or untreated STD at the time of a surgical abortion. Untreated PID can lead to ectopic pregnancy, infertility, chronic pelvic pain, and tubo-ovarian abscess.

Many studies also show a correlation between previous surgical abortions and an increase in premature birth and low birth weight. 

ADDITIONAL FACTORS

A new study found that the first-pregnancy abortion maintains a strong and persistent association with the likelihood of another abortion in subsequent pregnancies, enabling a cascade of adverse events associated with multiple abortions.

WHAT SHOULD YOU DO?

An abortion is a major decision that requires you to be fully-informed about the procedures and risks. Trained staff members can talk to you about all of your options in a free and confidential setting.

Schedule your free consultation today.

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 “Amenorrhea: Absence of Periods.” ACOG, https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods.

“Asherman’s Syndrome: What Is It, Symptoms & Treatment.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/16561-ashermans-syndrome#:~:text=Asherman’s%20syndrome%20is%20an%20acquired,medical%20procedures%20or%20cancer%20treatments.

“Dilation and Curettage (D&C).” ACOG, https://www.acog.org/womens-health/faqs/dilation-and-curettage.

“Dilation and Curettage (D&C).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 19 Oct. 2021, https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910.

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 “Medical Abortion.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 July 2022, https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687.

“Pelvic Inflammatory Disease (PID).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 30 Apr. 2022, https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594.

Studnicki, James, et al. The Enduring Association of a First Pregnancy Abortion with Subsequent … Charlotte Lozier Institute, https://journals.sagepub.com/doi/10.1177/23333928221130942.

Tobah, Yvonne Butler, MD. “Elective Abortion: Does It Affect Subsequent Pregnancies?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 3 Aug. 2022, https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/expert-answers/abortion/faq-20058551.

Upadhyay, Ushma D., et al. Incidence of Emergency Department Visits and Complications after Abortion. https://www.researchgate.net/publication/270651008_Incidence_of_Emergency_Department_Visits_and_Complications_After_Abortion.

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