June 11, 2017

Abortion - the risks, consequences and how it affects your health

An abortion is the medical process of ending a pregnancy so it doesn't result in the birth of a baby. It is also sometimes known as a termination of pregnancy (TOP). The pregnancy is ended either by taking medications (medical abortion) or having a minor surgical procedure (surgical abortion). One in three women will have an abortion in their lifetime.

In certain cases, abortion is necessary to save a woman's life, for example a woman who continues to bleed uncontrollably per vagina after a spontaneous abortion which occurred naturally. In other cases, and for varied reasons, a woman may request the abortion of a normally progressing pregnancy. In the latter case, women have been known to end up with guilt feelings and the abortion becomes a life changing event with emotional, spiritual, and sometimes physical, complications.

Generally, abortion is a safe procedure, however, there are recognized risks of something going wrong. Some of these risks are discussed below.

Possible complications of an abortion

1). Womb infection

This is the most common risk, occurring in 1 in 10 abortions. If not treated promptly, infections following an abortion can involve other pelvic organs. Treatment is with antibiotics.

2). Incomplete abortion

This is the next most common, occurring in 1 in 20 abortions. Some times the abortion can be incomplete with unwanted fetal parts left inside the uterus. Any incomplete abortion can lead to complications after the abortion. Further treatment to evacuate the remaining fetal parts is warranted if this is suspected.

3). Continuation of the pregnancy (failed abortion)

This occurs in less than 1 in every 100 abortions; further treatment will be needed if this happens

4). Damage of the entrance to the womb (cervix)

This occurs in up to 1 in every 100 surgical abortions. Cervical puncture or tear is a small risk in abortion. Damage or injury to cervix can cause vaginal bleeding which may need a simple surgical repair.

5). Damage to the womb

This occurs in 1 in every 250 to 1,000 surgical abortions and less than 1 in 1,000 medical abortions carried out at 12 to 24 weeks. The puncturing or perforation of the uterus during abortion is a major complication. In a surgical abortion, this would be due to improper use of instruments by untrained personnel (quacks). In extreme cases, removal of the uterus (hysterectomy) may be required.

6). Heavy bleeding

Slight bleeding after an abortion procedure is quite common and not serious, however, excessive bleeding requiring treatment is rare, occurring in 1 in 1000 abortions. If your cervix is torn or punctured, or your womb perforated this may lead to abnormal excessive bleeding. Depending on cause and severity, a blood transfusion may be required. Only rarely, is surgery needed.

7). Infertility

Having an abortion won't affect your chances of becoming pregnant and having normal pregnancies in the future. Many women are able to get pregnant immediately afterwards, so you should start using contraception right away if you don't want this to happen.

However, there's a very small risk to your fertility and future pregnancies if you develop a womb infection that isn't treated promptly. The infection could spread to your fallopian tubes and ovaries – known as pelvic inflammatory disease (PID). This is very rare if the abortion is done by a qualified medical personnel.

PID can increase the risk of infertility or ectopic pregnancy, where an egg implants itself outside of the womb.

8). Premature delivery

Having several abortions is associated with a slightly increased risk of giving birth prematurely, before the 37th week of pregnancy, in future pregnancies.

Talk to your doctor or an abortion advice service for more information if you're concerned about the possible risks of an abortion.

9). Scars in the uterus lining

Asherman syndrome is the formation of scar tissue in the uterine cavity, causing adhesions. It is a rare condition, occurring in women who have had several dilatation and curettage (D&C) procedures. This is not necessarily for an abortion, as D&C procedures are also done for non-abortion reasons.

Also severe pelvic infections unrelated to surgery may also lead to Asherman syndrome. Intrauterine adhesions can form after infection with tuberculosis or schistosomiasis.

Other concerns about abortion

10). Mental health

Women who have an abortion are no more likely to experience mental health problems than those who continue with their pregnancy. So generally speaking, women are not affected mentally.

However, a very small proportion of women are plagued with guilt feelings after an abortion. These develop emotional and psychological problems including depression, grief, fear of disclosure, eating disorders, suicide thoughts, anxiety and increased consumption of alcohol.

11). Breast cancer

There is no link between having an abortion and an increased risk of breast cancer.

12). Anaesthesia

The general anaesthesia in current use are safe. General anaesthesia with potential for serious complications are very rarely, if ever, used.

13). Pelvic inflammatory diseases

Womb infection could spread to the fallopian tubes and ovaries – PID (see above). This can be life threatening or lead to infertility and ectopic pregnancy after an abortion. A PID can be identified by the presence of persistent fever.

But most infections are treated before they reach this stage and you'll often be given antibiotics before an abortion to reduce the risk of infection.

The above-listed are the risks involved in abortion. In general, abortions are safe procedures in the hands of well-trained and qualified medical personnel. However, they can be a disaster if not properly done, or if handled by a quack. So think before you go for an abortion. Avoid abortion, unless it is obligatory to salvage your health; and if it must be done ensure it is by a qualified well-trained medical personnel.

Also read: Preventing Unsafe Abortions Amongst Women

1). UK NHS Choices. Abortion. Downloaded 10th June 2017. Available here: http://www.nhs.uk/Conditions/Abortion/Pages/Introduction.aspx
2). US National Library of Medicine. Medline Plus: Asherman syndrome. Downloaded 11th June 2017. Available here: https://medlineplus.gov/ency/article/001483.htm
3). Wikipedia. Dilation and curettage. Downloaded 11th June 2017. Available here: https://en.wikipedia.org/wiki/Dilation_and_curettage

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