Merck Manual

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The Manual's Editorial Staff

Reviewed/Revised May 2023
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What is abortion?

Abortion is ending a pregnancy using medicine or surgery.

  • Abortion is one of the most common surgeries in the United States

  • Abortion is very safe when it’s done by a trained doctor in a medical facility

  • The earlier an abortion is done in your pregnancy, the easier and safer it is

  • Abortion is dangerous if it's done by untrained people (for example in an area where abortion is illegal)

  • You should start birth control right after having an abortion

What are the types of abortion?

There are 2 types of abortion:

  • Surgical

  • Medical

In a surgical abortion, the fetus is removed from your uterus through your vagina. Usually the doctor puts a suction device through your cervix (the opening to your uterus). A surgical abortion is often called a dilation and evacuation (D & E) or a dilation and curettage (D & C) with suction.

In a medical abortion, the doctor gives you medicine that makes your uterus contract and push the fetus out.

What happens before an abortion?

Before you have an abortion, the doctor will:

After this, you may be able to have your abortion right away. However, some states require a waiting period between your counseling and the abortion. Also, for a surgical abortion, you may need treatment for a day or two to open up your cervix. Whether you need this treatment depends on how far along your pregnancy is.

What happens during a surgical abortion?

A surgical abortion is usually done in an office or clinic.

Before starting, the doctor will:

  • Give you an antibiotic by mouth to prevent infection

  • Unless you're very early in pregnancy, give treatments to open your cervix

Opening your cervix is called dilation. To open your cervix, your doctor may:

  • Give you medicine by mouth or in your vagina

  • Put a small piece of material in your cervix

The material the doctor puts in the cervix absorbs water and swells up to open your cervix. Sometimes this works in a few hours, but it may take a day or two.

For a surgical abortion, the doctor will:

  • Give you medicine by vein to make you sleepy so you don’t feel the surgery

  • Inject numbing medicine inside your vagina next to your cervix

  • Put a small, flexible vacuum tube through your cervix into your uterus to empty your uterus and end your pregnancy

  • Sometimes scrape the inside of your uterus with a metal instrument to make sure it's empty

What happens during an abortion with medicine?

Abortion with medicine (pills) is usually only done in the first 9 to 11 weeks or so of pregnancy. Later in pregnancy, abortions are more complicated and usually have to be done surgically.

For a medical abortion before you're 9 to 11 weeks pregnant, you'll usually:

  • Take a medicine by mouth

  • Take another medicine in a day or two

The medicine causes your uterus to contract (squeeze). You'll have cramping, feel sick to your stomach, and bleed through your vagina as your uterus empties. Usually, your pregnancy ends within 24 to 48 hours of taking the medicine.

How safe is abortion?

Legal abortions done by doctors in medical facilities are very safe. Also, having an abortion doesn’t raise your chance of problems with future pregnancies.

More women have complications from delivering a baby than from having an abortion. However, you should keep in mind that using birth control to prevent pregnancy is safer than having an abortion.

When serious problems occur from an abortion, they usually occur in the first week after having an abortion. Problems are more likely the further along you are in your pregnancy when you have an abortion. Serious problems include:

  • Getting a hole in your uterus or a tear your cervix from the abortion instruments

  • Heavy bleeding

  • Infection in your uterus

You should go back to your doctor if you have:

  • Fever

  • Heavy bleeding

  • Pain in your abdomen (more than just cramps)

To help avoid infection, you shouldn't have vaginal sex for 2 weeks after an abortion.

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