Abortion
Topic Overview
What is an abortion?
Abortion is the early ending of a pregnancy.
- A spontaneous abortion, or miscarriage, occurs when a natural cause ends a pregnancy. If you have had or may be having a miscarriage, see the topic Miscarriage.
- A therapeutic or induced abortion is one resulting from measures taken to intentionally end a pregnancy, using medicines (medical abortion) or surgery.
Surgical abortion is most commonly used to end a pregnancy, but medical abortion is becoming more widely used. Both medical and surgical methods of abortion require follow-up visits that include a physical and pelvic examination to make sure recovery is going well, as well as birth control planning.
When should I see a doctor?
If you have had unprotected sex in the last 5 days and don't want to become pregnant, see a health professional about emergency contraception. This is most commonly in the form of hormone pills (Plan B, also referred to as the morning-after pill) to help prevent pregnancy. You can buy Plan B at a pharmacy without a prescription. If you have had unprotected sex in the past 5 to 7 days, you may be able to use a copper intrauterine device (IUD) for emergency contraception. This will also work for long-term birth control.
If you think you may be pregnant, see a health professional for a pregnancy test and examination as soon as possible. If you are pregnant, this is an important time for learning as much as you can about your options. If you are considering abortion, the earlier you are in your pregnancy, the more options you are likely to have and the lower your risk of complications.
How do I know what decision is right for me?
For your own future well-being, it's important that you make a well-informed decision when you are considering an abortion. Early pregnancy counselling helps you reach a positive outcome, regardless of whether you continue with the pregnancy or choose an abortion. Family planning clinics offer pregnancy counselling. You may also want to discuss your decision with a trusted person close to you who has a realistic view of how a pregnancy and parenthood would impact your life. Take time to think through your choices, which are to:
- Have an abortion.
- Have a baby and dedicate yourself to supporting and raising your child to adulthood.
- Have a baby and place the baby for adoption.
When can an abortion be done?
Depending on how many weeks pregnant you are, you may have a choice between two or more types of abortion procedures. Medical and surgical methods available differ at each stage of pregnancy. As a pregnancy progresses into the second trimester, only surgical abortion can be used. Risks of second-trimester surgical abortion are higher than risks for first-trimester abortion.
Options include the use of medicines, manual or mechanical vacuum aspiration, dilation and curettage (D&C), dilation and evacuation (D&E), or using medicine to start labour and delivery (induction).
Abortion choices When Medical abortion Surgical abortion Early first trimester (up to 7 weeks)
- Methotrexate with misoprostol
- Manual vacuum aspiration, as early as 3 weeks after last menstrual period (uses a tube attached to a hand-held syringe that draws tissue out of the uterus)
Late first trimester (7 to 12 weeks)
- Methotrexate with misoprostol
(Medical abortion is less effective beyond 9 weeks.)
- Manual vacuum aspiration up to 10 weeks
- Machine vacuum aspiration (uses a tube attached to an electric pump that draws all tissue from within the uterus)
- Dilation and curettage (D&C), seldom used
During the second trimester (13 to 20 weeks)*
- Misoprostol may be used if the fetus has genetic problems.
- Dilation and evacuation (D&E), a combination of vacuum aspiration, forceps, and D&C
- Induction, possibly with D&E, seldom used
*A few facilities in Canada provide abortion services between 12 and 20 weeks of pregnancy. If there is a problem with the fetus up to the 24th week or later, you may be referred to an abortion specialist in the United States. Check your local Planned Parenthood for access to services.
How safe is abortion?
Abortion procedures done by health professionals are very safe. Less than 1 in 100 women has a serious complication after an abortion.1 In countries where abortion is legal and safe, women very rarely die after an abortion—less than 1 in 100,000 women. If abortion were legal worldwide, post-abortion deaths per year would drop from 150,000 to 250.2
The safest timing for an abortion is between 3 and 10 weeks after your last menstrual period.1 This is when a low-risk medicine or vacuum aspiration procedure can be used, the placenta is still developing, and the embryo is very small. (Medicine becomes less effective after 7 weeks.)
As a pregnancy progresses into the second trimester and only surgical abortion can be used, risks increase. Complications of second-trimester surgical abortion can include heavy blood loss, infection, and moderate to severe pain. Cramping pain is more common during a medical abortion than after a surgical abortion.1
In the past, there has been concern that an abortion might increase a woman's risk of breast cancer. However, more recent, carefully done studies show that there is no link between having an abortion and getting breast cancer later in life.3, 1
Who should I see for an abortion?
Early manual vacuum aspiration and medical abortion are offered by specially trained medical professionals, such as family doctors and gynecologists. Typically, only medical doctors offer machine vacuum aspiration and other types of surgical abortion. Abortion services are most likely to be available in university hospitals and family planning clinics. However, depending on where you live, you may have to travel a long distance to see an abortion specialist.
If you choose to have a medical abortion, make sure that your health professional can also perform a vacuum aspiration (or can refer you to a health professional who does). This is important in case medicine doesn't completely remove the pregnancy, which happens after 2% to 5% of medical abortions.4, 1
What examinations or tests will I need to have?
Your health professional will ask about your medical history and will do a physical examination, including a pelvic examination. Lab tests will be done to confirm your pregnancy. An ultrasound may also be done.
Whether you are a teenager or an adult, rest assured that the law protects your privacy. Your gynecological examination and test results are your private information. Your health professional will not share your private information with anyone but you unless you give permission to do so.
Who can have an abortion?
An abortion is legal in Canada. But not all abortion services are available in all parts of Canada or around the world. Depending on what clinic or hospital you choose, there may be restrictions, such as:
- Requiring a waiting period.
- Requiring parental consent for young women under a certain age.
- Limiting options for pregnancies between 13 and 24 weeks (second trimester).
Contact your closest Planned Parenthood or other family planning clinic for more information about abortion options in your area.
Will I be able to have children in the future?
The most widely used methods for abortion do not affect a woman's future ability to become pregnant.1 In fact, it is possible to become pregnant in the weeks right after an abortion procedure. This is a good time to start a highly effective birth control method that fits your lifestyle. After taking 1 to 3 weeks to recover from an abortion, be sure to also use condoms (to prevent infection) when you start having intercourse again. Continue with this practise for several weeks, or as long as your health professional advises. For more information on birth control choices, see the topic Birth Control.
Having two or more abortions using a sharp instrument (such as dilation and curettage, or D&C, which is rarely used during the first trimester) could create enough scar tissue to affect your future ability to become pregnant as well as your risk of infertility or pregnancy complications. Such complications include implantation of a fertilized egg outside of the uterus (ectopic pregnancy), miscarriage, or growth of the placenta over the cervix (placenta previa).5
Frequently Asked Questions
Learning about abortion:
Getting treatment:
Ongoing concerns:
 Go to top of page |  Go to next section | |
| Author: | Healthwise Medical Writer | Last Updated: December 14, 2006 |
| Medical Review: | Joy Melnikow, MD, MPH - Family Medicine Lori A. Boardman, MD, ScM - Obstetrics and Gynecology Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology | |
 | ||
