After an Abortion

Disclaimer: Throughout this article, we will be using the term “woman” to describe biological females who can become pregnant. We understand that sex and gender are separate, but for the sake of simplicity and consistency, these are the terms we will be using. If you would like to learn more about gender identity, visit our Sexual Orientation Gender Identity article.

    

General Information on Abortion

When performed by a trained medical practitioner in the appropriate conditions and settings, an abortion can be a safe way to end a pregnancy. There are two different types of abortion, with the first being the medical abortion and the second being the surgical abortion. The type of abortion procedure that will be performed depends on how many weeks pregnant the woman is. Women who have an abortion during the earliest weeks of their pregnancy experience fewer health risks during and after the procedure, and also benefit from a faster recovery. Most women recover fully from an abortion within a few days of taking the required medication or undergoing the surgical procedure

Choosing to have an abortion can be an extremely challenging decision and it is completely  normal to feel a range of emotions and thoughts. It is therefore very important to surround oneself with positive support from loved ones and support groups. Surrounding oneself with loving and caring people while avoiding negativity as much as possible is a crucial factor in how a woman feels about her abortion. If you have had an abortion and are not receiving the support you need, try to reach out to support groups or online forums to help you through this delicate time.

Unsafe Abortion  

We understand that not all women have access to safe, legal abortion. Unsafe abortions carry many risks including infection, hemorrhage, incomplete abortion, and organ damage. If you believe that you or someone you know are suffering from any of these symptoms following an unsafe abortion, contact a healthcare provider as soon as possible.      

Your Health Care and Abortion Provider

Your healthcare provider should go over all the exact details of your abortion with you, leaving you with the knowledge of what to expect and what to watch out for following the doses of medication or the procedure. Keep in mind that your abortion provider is there to help you with your decision to have an abortion and inform you of the risks, but they should never shame or judge you. In addition, your abortion provider should be happy to answer questions you may have about any aspect of the procedure. The more knowledgeable a patient becomes about their procedure, the more comfortable and secure the patient will feel.  

You should feel comfortable bringing up any questions or concerns you have with your health provider. A good strategy can include preparing and writing questions you have in advance, so that no questions go unanswered and so you can then feel completely comfortable and confident with your decision. Your provider should also make you aware of all of your options and provide you with their medical opinion about what the best and safest option for you is. However, if you feel an abortion provider is directing you away from the possibility of abortion, or seems disapproving of your final decision to abort, remember that you are entitled to seek medical care from another provider with whom you feel more comfortable with at any time.²

After your abortion, your provider should be equally as accommodating to answer any questions you have, and should be supportive and encouraging of your quick recovery. Your healthcare provider should provide you with all the knowledge of what to expect and what to be cautious of as well as proper self-care following the procedure. Additionally, your provider should provide you important contact information as well as a list of resources for any support you may need, including financial, emotional, and social support telephone numbers.

 

Immediately Following a Surgical Abortion

You can read about what a surgical abortion is by reading our surgical abortion article. If you undergo a surgical abortion from a reputable clinic, your provider should follow these steps:⁶

  • Immediately after your procedure, you will rest in a recovery area inside the clinic.

  • Your clinician will provide you with written after-care instructions and a 24-hour telephone number you can call if you have any questions or concerns about your recovery.

  • Depending on the clinic, you may be able to have an intrauterine device (IUD) inserted during the abortion procedure. The IUD is a method of birth control that can prevent pregnancy for 3 to 10 years (the duration of protection depends on the type of iud). If you would like an IUD inserted during the procedure, ask the clinic when scheduling your abortion if this is an option for you.

  • You may be asked to schedule a follow-up appointment 2 to 4 weeks after the abortion takes place.

  • If you are sedated for the procedure, you must arrange for someone to drive you home or find an alternate form of transportation, as it is unsafe to operate a vehicle under sedatives.

  • You can usually return to work and your normal routine by the next day. However, recovery after dilation and evacuation (D&E) abortions may take longer.⁷

  • You may shower immediately following the procedure, but you should not sit in water (e.g., take a bath), douche, or use any medication in or for your vagina.

  • For two weeks after a surgical abortion, you should also avoid vaginal sex (including usage of sex toys) and using tampons (use pads instead)

  • Consult with a physician about the appropriate times to resume these activities.

Common Side Effects of a Surgical Abortion

Immediately after the procedure and during the recovery period, you may experience some side effects. Common side effects of surgical abortions include:

  • Bleeding

  • Nausea

  • Vomiting

  • Sweating

  • Fatigue

  • Cramping

Most women experience vaginal bleeding and cramping similar to a menstrual cycle for two to four days.⁸ Although these are commonly reported side effects, you can always contact your healthcare provider for more information if have any questions or concerns about any of these side effects.

Serious and Dangerous Side Effects of a Surgical Abortion  

While there are many common side effects following a surgical abortion, some side effects may be symptoms of potentially emergent conditions.⁹ These dangerous side effects may include the following:

  • Passing blood clots that are larger than a lemon for more than two hours

  • Bleeding that is heavy enough that you have to change your pad twice in one hour

  • Foul smelling vaginal discharge

  • Fever

  • Pain or cramping that gets worse, especially after 48 hours

  • Continuing symptoms of pregnancy

You should call your clinic or seek immediate attention if you experience any of these listed symptoms.
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Immediately Following a Medical Abortion

If you receive a medical abortion from a reputable clinic, you will take the first of two pills while inside the clinic with your physician. This first pill blocks the hormone progesterone, and breaks down the uterine lining. This leaves the uterus unable to continue supporting the pregnancy.⁶

The healthcare professional will then give you antibiotics to take in addition to the second pill. The second pill is taken after your departure from the clinic. Under the guidance of your clinician, you will schedule a time (up to three days after taking the progesterone pill) and place to take the second pill.

The second pill contains Misoprostol and causes the uterus to empty itself.⁶ Many women compare this experience to an early miscarriage. You will experience cramps and heavy bleeding for several hours.  Some women even begin bleeding before the second pill, but heavy bleeding or the discharge of blood clots and tissue typically occur after the dose of Misoprostol. Over 50% of women who receive a medical abortion abort within 4 to 5 hours of taking the second pill; however, it can take longer for some women. Additionally, this type of abortion is successful over 90% of the time. In the week following your abortion, it is recommended that you only use sanitary pads and refrain from vaginal sex or penetration of any kind.

The final step to a medical abortion is the follow-up appointment, which should take place within 2 weeks of your procedure.⁷ The purpose of this check-up is to administer a blood test or an ultrasound to confirm that the pregnancy was terminated and that there are no complications.  In the unlikely event that your abortion was incomplete, you will need to discuss your options with your healthcare provider. For most women, this means scheduling an aspiration abortion (a type of surgical abortion) to end the pregnancy.

Fertility After an Abortion  

Any kind of abortion effectively ‘restarts’ your menstrual cycle. This means that you should start your next menstrual period 4 to 6 weeks after your procedure. Ovulation can occur as soon as two weeks after an abortion, which means that pregnancy can occur as soon as two weeks after the procedure which makes it  essential for you and your partner to immediately start the use of contraception when you and your partner decide you are ready to resume sexual intercourse again.² Additionally, there are no indications that either surgical or medical abortions affect a woman’s long term ability to have a baby when she is ready.⁶'

Common Side Effects of a Medical Abortion

It is common for women to bleed, cramp, or spot for up to 4 weeks after an abortion. Other common side effects may include the following:⁸

  • Dizziness

  • Strong cramps

  • Nausea or vomiting

  • Diarrhea

  • Temporary abdominal pain

  • Temporary mild fever or chills

  • Fatigue

  • Low appetite

  • Difficulty sleeping or concentrating

  • Feeling slight pressure in lower belly, lower back, or thighs

According to Planned Parenthood, acetaminophen (like Tylenol®) or ibuprofen (like Advil®) can be used to reduce the severity of these side effects.

Serious and Dangerous Side Effects of a Medical Abortion

Although there are many common side effects that are no cause for major concern, there exists numerous side effects that should act as warning signs if they occur. If you experience any of the following symptoms, contact a health provider as soon as possible.⁵

  • Severe abdominal and back pain that renders you unable to stand up

  • Bleeding that is heavier than a normal menstrual period

  • Foul-smelling discharge

  • Fever above a 100.4 F that does not respond to medication or is present for more than  48 hours

  • Continuing symptoms of pregnancy

  • Fainting

After completing the procedure, there are various activities that you must refrain from in order to heal properly and avoid infections. For up to two weeks after the procedure, you should avoid the following:¹

  • Engaging in vaginal sex or penetration of any kind (including usage of sex toys and fingers)

  • Using tampons (use pads instead)

  • Swimming in pools

  • Bathing in hot tubs or jacuzzis

  • Douching

  • Excessive exercising

Although the majority of women who have abortions recover without any problems, the risk of complications only highlights the importance of making sure that you have a checkup within the time frame prescribed by your health provider. During checkups, the clinician ensures that there is no infection in the uterus, that the cervix has closed completely, and that the patient is healing properly.² If you do not wish to have the checkup with your abortion provider, you reserve the right to go to your usual health provider.² However, it is important to tell them that you had an abortion and explain exactly what happened and what symptoms you experienced.

Emotional Health and Well-Being After an Abortion

In the days and weeks that follow the abortion, it is crucial to remember that there is no right or wrong way to feel. You may experience a range of feelings like sadness, anger, guilt, or relief. The intensity and duration of  the feelings vary from woman to woman and can be affected by numerous factors including hormonal changes and adjustments in her personal life.³ You may experience very strong feelings, or you may not, and both are normal. If the feelings are overwhelming or persist for an extended amount of time, do not hesitate to seek out a mental health care provider or support groups.

It can be very beneficial to have someone that loves and supports you present during the abortion process. It can help you feel more relaxed, safe, and confident about your decision, and you will be able to talk through your emotions and concerns with this trusted supporter. Your partner, family member, friend, or anyone who is comfortable with and supportive of your decision can help you through this time. It is common for women to feel more emotional after an abortion because of the sudden hormone shift caused by the medication in addition to remaining pregnancy hormones.² Making this decision can also be difficult emotionally, so feeling a bit sensitive or fragile in the following days and weeks is normal.

Although many women are fearful of the negative emotional consequences that are often said to occur following an abortion (such as guilt, shame, or remorse), the majority of women who have had abortions do not report any long lasting emotional trauma. In reality, it has been shown in a wealth of studies that, in addition to having a quick bodily recovery, a majority of women also have a smooth psychological recovery after an abortion. In fact, only about 1% of all women who have abortions experience lasting depression or stress following their abortion. Moreover, the 1% of women who suffer from clinical depression following an abortion are largely women who were depressed before the abortion.⁴

Experiencing mood swings and strong emotions is common. These feelings are often caused by lingering pregnancy hormones. As these pregnancy hormones continue to decline, so too will the moods swings and intense emotional states. Making the decision to have an abortion can be very difficult and emotionally draining. The after effects of the decision may continue to influence you after the procedure, contributing to your mood swings or strong emotions. However, the most reliable indicator of whether a woman will experience feelings of distress after an abortion is her emotional stability before the abortion.⁴ Regardless, the majority of clinics provide a plethora of resources for patients if they require counseling or any other services.

There are numerous coping strategies that can help women throughout their own individual healing process. However, it is equally as important to address the existence of harmful coping strategies. Some harmful coping strategies include:³

  • Abusing drugs

  • Abusing alcohol

  • Eating too much or too little

  • Spending too much money

  • Withdrawing from friends and family

  • Taking feelings out on others or lashing out

  • Hurting oneself

  • Engaging in risky sexual practices

By identifying harmful coping strategies, we are then able to shift our focus to better coping strategies.³ Good coping strategies do not necessarily have to involve making large changes to your daily lifestyle. These changes can be as small as going for a walk, eating a healthy meal, practicing deep breathing, listening to music, or engaging any behavior that can help us feel better in the moment as well as in the long run is recommended. Other positive coping strategies can include:³

  • Cultivating self-compassion

  • Practicing self-care                                          

  • Remembering our reasons                             

  • Creating a safe space

  • Choosing forgiveness

  • Finding closure

  • Surrounding oneself with positive, supportive people

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When you are cultivating self-compassion it is important to remember that you are a good person in a difficult situation and are doing the best that you can. Speak to yourself the same way you would to someone you deeply care for and extend that same kindness and care to yourself. Practicing self-care involves engaging in any activity or behavior that can help you feel better during difficult times whether it be exercise, writing, gardening, hiking, or making time to be with loved ones. Reflecting, remembering, and writing down your reasons for having an abortion can provide a great sense of affirmation to yourself so that later on you can say “I made the best choice I could.” The healing process varies from individual to individual but choosing forgiveness for yourself can go a long way as you choose to move on the best way that you can.


 

Life After an Abortion

On many measures, such as educational achievement, future income, dependence on public assistance, and domestic abuse, women younger than twenty-one who have abortions generally fare better than young pregnant women who decide to carry their pregnancy to term. Thus, the circumstances that often develop around early, unintended pregnancy and parenthood may be deterred by having an abortion. For women who are firm in their decision to have an abortion and who are comfortable with the procedure, an abortion can even have psychological benefits, including increased self-esteem.⁴

Although some women and their male partners may feel stress or sadness immediately following an abortion, long-lasting psychological harm is rare among the majority of women and couples who have an abortion. Women who are uncomfortable with the idea of having an abortion or who feel guilty or anxious about the procedure are more likely to experience negative feelings following an abortion. The psychological effects of abortion largely depend on a woman’s beliefs and values, as well as the degree of care with which she made her decision. Having a good support system from a partner, family, and friends can significantly improve one’s feelings about abortion. If you feel that you are lacking support regarding your abortion, there are resources available outside of your currently existing network to help you throughout the entire process.

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References

1, "Caring for Yourself after an Abortion." Teen Health Source. Planned Parenthood Toronto, n.d. Web. 21 Jan. 2017.

2. Jilly. "Physical Recovery After an Abortion." AfterAbortion. PASS, n.d. Web. 21 Jan. 2017.

3. "After the Abortion." Everywoman's Health Centre. EveryWoman's Health Centre, 2014. Web. 21 Jan. 2017.

4. Bazelon, Emily. "Is There a Post-Abortion Syndrome?" The New York Times Magazine. The New York Times, 21 Jan. 2007. Web. 22 Jan. 2017.

5. "What Should I Expect After the Abortion?" ProChoice.org. National Abortion Federation, n.d. Web. 22 Jan. 2017.

6. "Aftercare Instructions: Medication Abortion." CWHCColorado. Comprehensive Women's Health Center, 2012. Web. 21 Jan. 2017.

7. "What to Expect After a First Trimester Surgical Abortion." Postgraduate Obstetrics & Gynecology 31.9 (2011): 8. UWMedicine. University of Washington Medical Center, Jan. 2010. Web. 21 Jan. 2017.

8. "Possible Physical Side Effects After Abortion." American Pregnancy Association. American Pregnancy Association, 3 Sept. 2016. Web. 22 Jan. 2017.

9. Gotter, Ana. "Surgical Abortion." Healthline. Healthline Media, 30 Aug. 2016. Web. 05 Feb. 2017

 

Last Updated: 22 March 2017.

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