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An abortion ends early pregnancy. Unintended loss of a fetus before pregnancy has reached 20 weeks is often called a miscarriage or a spontaneous abortion. Some women choose to end pregnancy using medicines (medical abortion) or by surgery (surgical abortion). Surgical abortion is often done after the ninth week of pregnancy as the only option.

A surgical abortion is a minor procedure that involves the specialized services of a trained health professional such a gynecologist, a certified nurse-midwife, a nurse-practitioner, a physician assistant, or a family medicine doctor. Women often experience vaginal spotting or irregular bleeding as well as lower abdominal cramping for a few weeks after the procedure. Emotional reactions are common as well.

Complications of Medical or Surgical Abortion

Possible complications of abortion (medical or surgical) include:

  • fever

  • heavy bleeding

  • severe lower abdominal pain

  • laceration of the cervix

  • retained placental or fetal tissues in the uterus

  • blood retained in the uterus

  • injury to the bladder or bowel

  • injury to the uterus

  • pelvic infection

  • circulatory shock (low blood pressure, increased heart rate)

  • DIC or Disseminated intravascular coagulation, a potentially fatal condition

Complications usually occur more frequently in late abortions, especially in the second trimester, where the mortality (death) rates are also higher.

When to Call a Doctor

Less than one percent of women have serious complications after an abortion. However, you should call your doctor if you experience vaginal bleeding which is more than just spotting for more than two weeks. If the medicines you used in treatment cause new symptoms, ask your doctor about it. You may also feel depressed after the procedure, which may be worsened by the hormonal changes associated with it, for which professional help may be necessary. Furthermore, if your menstrual period does not return within six weeks after an abortion, call your doctor for an appointment.

You must see help immediately if you experience severe bleeding after an abortion. This may mean that you are passing out large clots for more than two hours or soaking more than two sanitary pads per hour. Continuously bleeding for several hours may be a life-threatening complication.

Severe infection affects the whole body and can cause headaches, dizziness, and muscle aches, with or without fever. You may have severe abdominal pain which is not relieved by rest, heat or pain relievers. Vomiting continuously, abdominal swelling, rapid heart rate, high fever and foul-smelling vaginal discharge are other symptoms for which you should call your doctor immediately since these are signs of serious complications after an abortion.

If you have signs and symptoms of complications, further laboratory work-up may be needed, which includes various blood exams and urine tests. You may be asked to stay in the hospital for monitoring, oxygen and and intravenous fluid administration. Depending on the cause of complications, a repeat D and C or other appropriate procedure may be done. Aggressive antibiotic therapy is usually administered to prevent serious complications and death.

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