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Abortion Information

An abortion is an elective termination of a pregnancy. It can be done through the giving only of a pill or by dilating the cervix at various stages of pregnancy and evacuating the contents. Abortions are usually done at specific abortion centers that only do abortions.

If the pregnancy is early enough, less than 6 weeks or so, you can take a pill. It is considered a safe and effective way to have a spontaneous abortion at home. The major risks are heavy bleeding, an incomplete abortion, and infection of the uterus. Because the pill is taken at home, there is a chance that problems could arise that aren�t taken care of by a health professional. If you are a minor, you may need to get parental permission by at least one parent in order to get the pill.

There is more than one type of in-clinic abortion. Most women end up with an aspiration with or without a cervical dilatation. Vacuum aspirations are done up to 16 weeks after the last menstrual period. The risks of aspiration are heavy bleeding, infection of the uterus and an incomplete abortion which causes persistent bleeding, often for weeks after the procedure.

Dilatation and evacuation is another type of procedure done after sixteen weeks gestation. It requires dilating the cervix and evacuating the contents. The main risks are uterine infections, heavy bleeding and an incomplete abortion which can lead to infection and heavy bleeding.

Because the abortion is a complex and difficult decision to make, it is important to know what to expect during the procedure. Prior to the procedure, you need to do the following:

• Discuss your medical history
• Discuss your various options
• Have lab tests to confirm the pregnancy and know if you are anaemic
• Have a physical examination
• Possibly have an ultrasound
• Read and sign papers

In the aspiration abortion, the healthcare provider examines the uterus and offers you sedative medication and medications for pain. A speculum is inserted into your vagina. The cervix is numbed using numbing medication. Dilators will be placed in the cervix that progressively dilate the cervix by absorbing fluids. When they get bigger, your cervix dilates more. Antibiotics are given to prevent infection and, when the cervix is big enough, a tube will be inserted into the uterus. A suction machine or hand held machine will be used to gently empty the uterus. For some, the extraction can be more painful than in others. A curette might be used to remove anything left inside the uterus and to check to make sure the uterus is, in fact, empty. This is what�s called a dilatation and curettage or a D & C. The aspiration procedure takes about 5-10 minutes total, not accounting for the time it takes to dilate the cervix. You recover in about an hour�s time.

In a dilatation and evacuation, your uterus will be examined and you will receive pain medication and IV sedation. A speculum will be inserted into the cervix. Medication or absorbent dilators will be used to get the cervix prepared for the evacuation. You will receive antibiotics to prevent infection. The doctor will use medical instruments and a suction machine to empty the uterus. This procedure takes between 10 and 20 minutes but there is the additional time to prepare the uterus and cervix for the procedure. Some women feel mild cramping pain while others find it almost intolerable.

After the procedures, it is normal to have bleeding that is heavy but slows after a few days. Spotting will last up to six weeks and off and on spotting that lasts a bit longer. You can only use pads after an abortion.

Abortion Complications

Abortions, like any medical procedure can have its complications. Most of the complications are physical in nature but some are psychological as well. Let’s take a look at the complications of abortion.

There can be injury or puncture/perforation of the bladder. It is usually associated with perforation of the uterus as well when using a curette to clean out the uterus. This can lead to pain, further surgeries to repair it or to a fistula (tract) between the uterus and the bladder. The urine leaks into the uterus or into the pelvic space meaning less urine is passed through the actual urethra.

There can be perforation of the bowels in a similar way as when the bladder is perforated. This time, however, bacteria can leak into the pelvis and abdomen, leading to severe and possibly lethal infections in the abdomen. A portion of the bowel may need to be removed in order to heal the infection and stop the perforation. A temporary or permanent colostomy may be necessary to drain the stool through the skin on the outside into a colostomy bag. It is a severe complication that generally occurs when a curette is used to do the abortion.

You can have a higher chance for future ectopic or tubal pregnancy. The rate of ectopic pregnancy is 8 to 20 times higher after a person has had an elective termination of pregnancy. There is a 30 percent increased risk of having an ectopic pregnancy after the first abortion and a 160 percent increased risk of ectopic pregnancy if you have had two or more elective terminations. The reason for this is completely unclear.

An abortion can have a negative effect on future pregnancies. You will be more likely to bleed in the first three months of any future pregnancy. The rate of “normal” deliveries decreases in future pregnancies. The manual removal of the placenta will more often happen in subsequent pregnancies. There is increased foetal mortality after an abortion and the next baby has a higher chance of having a low birth weight or of being premature.

The consequences of a failed abortion include an unwanted pregnancy, birth and the extra cost of raising a child that was intended to be aborted. Failed abortions are more common if the pregnancy is less than six weeks gestation. The pregnancy goes on because the placenta hasn’t been removed during suction or curettage and the pregnancy simply continues.

About one to fourteen percent of women having an abortion have enough bleeding to require a transfusion. A few of these people can develop hepatitis from the transfusion or can develop a transfusion reaction. Hepatitis is generally screened for in the blood so the biggest risk is that of a transfusion reaction.

Infection, which can be fatal, can occur from bacteria getting up inside the uterus from the suction or other instrumentation devices. Infection can happen in as many as 1 in 4 people or as few as 1 in 50 people who have instrumental abortion.

A laceration of the cervix can occur in one out of 20 abortions. This laceration, if not repaired, can strongly influence the chances of having first trimester abortions in subsequent pregnancies. Second trimester pregnancies are also likely because of incompetency of the cervix. The rate is 10 times that of women who didn’t have an abortion.

The uterus can be perforated during the procedure. If this is severe and does not stop with attempted repair, a hysterectomy is required. About 1 out of 40 to 1 out of 400 abortions lead to perforation of the uterus. Infection of the abdominal contents is common with a perforated uterus, which needs significant medical care.

After an abortion, a woman has a higher rate of placenta previa (about 6-15 times more likely). This is when the placenta lies over the cervix, preventing a vaginal birth. There can be severe bleeding during pregnancy or attempted delivery at term. It is a severe condition unless it can be treated—usually with bed rest and a Caesarean section.

Post abortion syndrome is a psychological condition that leads to depression and remorse. There is a sort of post traumatic stress disorder around having the abortion and the guilt can last for a long time. Suicidal thoughts and substance abuse are both possibilities following an abortion.

There can be retained products of pregnancy following an abortion. Pieces of the fetus or the placenta can be left behind, requiring surgery in the near future to stop the chronic bleeding or infection it can cause.

There can be Rh incompatibility that can occur after the abortion. Rh incompatibility is usually checked for at the time of the pregnancy and the woman can receive Rhogam to prevent problems with future pregnancies. If this is not done, however, there can be serious problems with future pregnancies and death of foetuses born after the abortion. Rh negative mothers are the only people that need to really worry about it.

Disseminated intravascular coagulation is a disorder that can occur after a pregnancy. It involves an inability of the blood to clot so severe bleeding occurs. About 1 in 500 second trimester abortions result in disseminated intra-vascular coagulation or DIC.

A woman has a 3-4 times greater chance of being unable to conceive a child after an abortion. This is called secondary infertility. It is unknown as to why this secondary infertility occurs.

There can be an unrecognised ectopic pregnancy. If an ultrasound is not done, a pregnancy in the tubes may be lurking so that an ectopic pregnancy happens after the failed abortion. Most doctors go ahead and confirm a uterine pregnancy before going about doing the abortion.

Medical Negligence

An abortion is the medical or surgical termination of a pregnancy before the fetus has reached term. The sole purpose of an abortion is for the woman not to be pregnant any more. In an abortion, the fetus dies in the process. An abortion is done differently depending on how far along in the pregnancy that the woman is. Early in the pregnancy, there are pills to take that will end the pregnancy spontaneously. Later in the pregnancy, up until 24 weeks gestation, a dilatation and evacuation are performed using vacuum suction. Many areas forbid abortions after 24 weeks because a fetus is viable at that time. If you have any concerns about your treatment please use the helpline to speak to an abortion medical negligence lawyer at no cost and with no further obligation.

About ten percent of women who have had an induced abortion will suffer from an immediate complication. Up to one fifth of these complications were considered major. If one includes minor complications and psychological side effects, the complication rate approaches a hundred percent.

More than a hundred possible complications can occur following an abortion. The most common minor complications include:

• Bleeding.
• Minor infections.
• Chronic abdominal pain.
• Fever.
• Vomiting.
• Rh sensitivity.
• GI disturbances.

There can be major complications of abortion, including:

• Excessive bleeding.
• Serious infection.
• Perforation of the uterus.
• Blood clot.
• Seizures.
• Anesthesia complications.
• Injury to the cervix.
• Shock .

One study of over a thousand abortions revealed that 27 percent of the women had a post-abortion serious infection that lasted for longer than 3 days. These and other severe complications were often treatable but led to a long term loss of fertility that was less treatable. In fact, it is estimated that 3-5 percent of women who have had an abortion are rendered sterile as a result.

Women who develop a post-abortion infection get ectopic pregnancies at a rate of 5-8 times greater than normal women. In fact the rate of ectopic pregnancies has increased fourfold since abortions became legal. Even so, 12 percent of all maternal deaths are related to having an ectopic pregnancy.

During the dilatation of the cervix, there can be ripping of the cervix or uterus. One study showed that 12 percent of abortions in the first trimester needed stitching for laceration of the cervix. Many of these lacerations cause permanent weakening of the cervix and this can lead to premature birth. Symptoms of weakening of the cervix are present in up to 75 percent of women. The chances of miscarriage and preterm birth are increased by 300-500 percent. A total of 48 percent of first time abortion patients suffered from a complication in later gestations.

Most patients feel initial relief after their miscarriage but this emotion soon turns into a form of shell-shocked numbness in which the woman is unable to feel or express their feelings. About 40-60 percent of women begin to have a negative reaction to their abortion. Many complain of nerve disorders, sleeping problems, feelings of regret and depression. About 11 percent of women were prescribed psychotropic drugs by their doctors following their abortion.

One study indicated that women who had undergone abortions were more than 160 percent more likely to be hospitalized in the psychiatric ward in the 90 days after having an abortion. Rates of psychiatric admissions remained higher than normal for at least 4 years. In another study of 500 women who had had an abortion, it was found that half experienced negative emotions and around ten percent came down with serious psychiatric complications from their abortion.

Sexual dysfunction is common. About half of all women experienced problems with sex; some of these complications were long term. Some developed an aversion to men or an aversion to sex. Others had a loss of pleasure from sex and some had more pain from sex. Still others developed a promiscuous lifestyle.