The question of whether or not to terminate a pregnancy is one that many women face for a variety of reasons. Discussing the potential side effects of abortion so you know what is considered "normal" is an important part of understanding what to expect if you are going in for the procedure, and will also help you navigate the recovery period afterward to understand whether or not additional care is needed.
In a political climate where mis-information is easily spread, and more states are passing bills to restrict access to abortion, you should know that in most cases, the risk for complications following the procedure (when it is done safely and by a qualified provider) is very low. A 2014 study done by researchers at UC San Francisco found that major complications (those requiring hospital admission, surgery or a blood transfusion) occurred in just 126 cases of the 54,911 abortions studied, which is less than a quarter of a percent. The same study revealed, "a little less than two percent of the abortions, or 1,030 cases, resulted in minor complications in the six weeks following the procedure."
That doesn't mean, however, that you won't experience a recovery period following an abortion. The common side effects below apply to both surgical procedures (dilation and curettage or dilation and evacuation) as well as medical abortions using the pills misoprostol and mifepristone, according to the experts Romper spoke to. However, the intensity of these side effects will vary depending on factors such as the type of abortion received and gestational age (how far along the pregnancy was).
1. Abdominal Pain And Cramping
One of the most common reported side effects of abortion is abdominal discomfort/cramping following the procedure. As explained on Planned Parenthood of Michigan's website, cramping is necessary in order for your uterus to return to its pre-pregnancy size. To manage the discomfort, abortion and postpartum doula Stephanie Matthias tells Romper that a heating pad and even CBD oil can be very helpful. Your provider may also recommend Motrin to alleviate the pain.
As long as your pain isn't "out of proportion," OB-GYN Christy Tabit Evans tells Romper, cramping is normal. However, she says, "If you can't eat/tolerate food, can't move much, or are experiencing a fever" it could be a sign of infection or other (rare) complications and you should follow-up with your healthcare provider.
Again, whether you bleed, and how much, will vary case to case. But even if you bleed quite a bit after your abortion, that's not necessarily a sign something is wrong. Matthias tells her patients that bleeding can last anywhere from a day or two to several weeks and can be akin to a heavy period in the amount of flow. However, she cautions that "If you are soaking through an overnight pad in an hour, and then bleed through another the next hour, you should call your healthcare professional and/or go to the E.R. because it may be a sign of hemorrhaging."
She also recommends only using pads or period underwear until you've been cleared by your doctor to resume use of tampons if that's your preference.
Tabit Evans notes that with a medical abortion, "the cramping and bleeding can be a little more unpredictable and oftentimes more intense in terms of how long and when they are experienced" as compared to the surgical procedures.
3. Irregular Periods
Tabit Evans says that typically your period should resume within two to six weeks following the procedure. She also notes that it's normal for your first one to be slightly different than what you were used to before the pregnancy, but in general, "your periods should regulate after about three months."
4. Emotional/Hormonal Fluctuations
It is challenging to discuss what is "normal" in terms of emotions following an abortion. The choice to have this procedure is certainly one that most women do not take lightly, and the factors that lead to having an abortion oftentimes are very emotional in and of themselves. Chemically, yes, as Tabit Evans notes, there will likely be hormonal fluctuations following the procedure (particularly if you were further along in the pregnancy) and this can lead to mood changes and/or intense feelings, as noted on the Women's Health Options website as your hormones regulate.
However, just as the postpartum period following a birth can be filled with a mix of emotions, so too can the period following an abortion. Matthias, who spends much of her time in support of women following their procedures, says that in her experience clinical depression after an abortion is not common. But she notes it is always important to take time to "integrate and process the experience, regardless of how you feel about the procedure itself." She cautions that by not telling your story to someone you trust (or an abortion hotline such as the one at Exhale Pro-Voice) you may end up storing those emotions and never fully processing the experience.
5. Uncertainty About Future Family Planning
While some abortion opponents have argued that abortion can negatively impact a woman's fertility, experts largely agree that abortion does not cause fertility issues, as noted by The New York Times. However, as Dr. Jen Gunter states in the article, "Only abortions that are associated with complications could potentially impact future fertility." This is precisely why access to safe abortion is so important. As Tabit Evans states, "When women have easy access to abortion care it’s very safe. But when all kinds of restrictions are placed, whether they be physical or mis-information that is propagated and the gestational age progresses, the risks can increase."
She stresses the importance of discussing future family planning following the procedure, telling her patients who had desired pregnancies but experienced complications that led them to terminating the pregnancy that they can start trying again following their first period. For those who had unplanned, unwanted pregnancies, she notes the importance of access to reliable (and affordable) contraception moving forward.
To be clear, abortion is a largely safe medical procedure that, as Tabit Evans notes, "is one of the most thoroughly studied procedures in medicine." If you need to find abortion providers in your area, you can search the Planned Parenthood website, the National Abortion Federation, and Ann Rose's Abortion Clinics Online.