Physical and emotional effects of abortion
Whatever you decide, you deserve to know what recovery is like and what the research says, including where it's still debated.
Physical recovery
After a medication abortion or an early procedure, most people have cramping and bleeding that taper off over days to a couple of weeks; spotting can continue longer. It's possible to get pregnant again before your next period.
Physical risks
Abortion early in pregnancy has a low rate of serious complications, and the risk rises the further along the pregnancy is. Complications include:
- Incomplete abortion: tissue left in the uterus, which may need medicine or a procedure. More common with medication abortion.
- Heavy bleeding that needs treatment, rarely a transfusion.
- Infection of the uterus.
- Injury to the cervix or uterus during a procedure, which is rare.
Get care right away for heavy bleeding (soaking two pads an hour for two hours), fever, severe or worsening pain, or a foul-smelling discharge. If it's an emergency, call 911.
Where researchers disagree
Mental health after abortion
Some women experience grief, sadness, regret or depression after an abortion. Across studies on every side, women who had mental health problems before, felt pressured, or had little support are at higher risk. Whether the abortion itself causes mental health problems is disputed.
Studies finding no added risk: a 2008 American Psychological Association task force, a 2011 review by the UK's Academy of Medical Royal Colleges and a 2018 National Academies report concluded that, for women with an unwanted pregnancy, having an abortion doesn't raise the risk of mental health problems compared with giving birth. The Turnaway Study followed nearly 1,000 U.S. women for five years. Women turned away and who gave birth had more anxiety and lower self-esteem at first than women who had an abortion; the groups became similar over time, and depression was similar throughout. Critics note that fewer than 4 in 10 women invited took part.
Studies finding added risk: a 30-year New Zealand study led by David Fergusson found rates of mental health problems about 30% higher after abortion, after accounting for earlier problems. The authors said abortion may be linked to higher risk but that cause and effect weren't settled. A 2011 analysis by Priscilla Coleman in the British Journal of Psychiatry reported an 81% higher risk. Other researchers dispute its methods, and a journal panel recommended retracting it; the journal's publisher declined in 2023, and Coleman says the criticism is politically motivated.
Future fertility and pregnancies
ACOG and the UK's Royal College of Obstetricians and Gynaecologists say an abortion without complications doesn't affect your chance of getting pregnant later. A 2016 analysis of studies covering 1.85 million women found that a prior surgical procedure to empty the uterus (D&C, after an abortion or a miscarriage) was linked to a modestly higher risk of preterm birth in a later pregnancy, higher after more than one. These were observational studies, so other factors may play a part. Getting pregnant again within six months is also linked to preterm birth.
Breast cancer
Some early studies suggested a link between abortion and breast cancer. The National Cancer Institute says those studies relied on people's memories in a way that could skew results, and that studies following women forward in time have consistently found no link. The NCI and ACOG both state that abortion does not increase breast cancer risk.
Support after an abortion
If you've had an abortion and are struggling, you're not alone and it's not too late to get support. Many local pregnancy centers offer free, confidential after-abortion support with no judgment. Find one near you. If you're in crisis, call or text 988.
Sources
- ACOG. Induced abortion (patient FAQ).
- FDA. Mifeprex prescribing information (2023).
- American Psychological Association. Task force report on mental health and abortion (2008).
- Academy of Medical Royal Colleges. Induced abortion and mental health (2011).
- National Academies of Sciences, Engineering, and Medicine. The Safety and Quality of Abortion Care in the United States (2018).
- Biggs MA et al. Women's mental health and well-being 5 years after receiving or being denied an abortion. JAMA Psychiatry, 2017.
- Fergusson DM et al. Abortion and mental health disorders: evidence from a 30-year longitudinal study. British Journal of Psychiatry, 2008.
- Coleman PK. Abortion and mental health: quantitative synthesis and analysis. British Journal of Psychiatry, 2011; and coverage of the 2023 retraction decision.
- Lemmers M et al. Dilatation and curettage increases the risk of subsequent preterm birth. Human Reproduction, 2016.
- RCOG. Abortion care patient information (2024).
- National Cancer Institute. Abortion, miscarriage, and breast cancer risk.