Physical and Emotional Effects to Expect Post Abortion

Legal abortion is a safe, minor procedure that has few complications during or after. Post abortion, you can expect to have an easy, uncomplicated recovery with few restrictions. The few physical and emotional symptoms you experience rarely last long unless you have a complicated abortion.

Physical Signs and Symptoms to Expect

According to The New Harvard Guide to Women's Health (page 10), post abortion physical symptoms can include pelvic cramps, vaginal bleeding, increased breast tenderness, and fatigue. The degree of some of your symptoms will depend on how far along in your pregnancy you are.

Pelvic Pain

Facts about pelvic pain after a medical or surgical abortion include the following:

• You will likely continue to have some uterine cramps at the end of your abortion, but they will be milder than during the process.
• These cramps don't usually last long so they may be gone or only mild by the time you leave the abortion clinic if you had a surgical procedure.
• Likewise, for a medical abortion at home, you will continue to have cramps after the fetus passes, but they will decrease soon after that.
• Some women might have prolonged mild cramping for a few hours, which should be relieved by the pain medicine you are given at the clinic to take home.
• A few women might have mild, intermittent cramps for a week or two as the uterus returns to normal.

Bleeding

Some vaginal bleeding is expected after an abortion. With post procedure bleeding:

• It may be as heavy or heavier than a normal period right after the abortion. The bleeding will be less before you leave the abortion clinic.
• It can last for two to three weeks, during which it gets progressively lighter.
• It may be prolonged spotting for about a month as the uterine lining heals and become normal.
• Your normal period can return in a month or two after an abortion. If you miss a period three months in a row, call your doctor for an evaluation.

Call your doctor if prolonged or increased bleeding is associated with increased pelvic pain, especially if you have had sex before two weeks post abortion.

Pregnancy Symptoms

If you've been experiencing pregnancy symptoms, then post abortion, you may expect certain things. Some signs of pregnancy after abortion diminish rapidly, while others may take a little longer.

• Morning sickness: As your pregnancy hormones decrease, any morning sickness you had will disappear within the next day or two.
• Breast tenderness: If you had breast tenderness, it may be gone a in a week to ten days after the procedure, depending on how far pregnant you were. However, some women who have an abortion in the first trimester may have increased breast tenderness and notice a small amount of breast secretions. After a second trimester abortion, your breasts will likely become tender and engorged and leak milk.

Fatigue

You can expect to feel tired and sleepy after a medical or surgical abortion. After a surgical abortion:

• If your were given narcotics or sedative drugs to make the procedure comfortable, you will stay in the clinic until your drugs wear off enough to go home.
• If you received the sedative Versed, you may have little of no memory of the procedure.

You should feel physically fit to return to work, school, and your other usual activities the day after any abortion, although you may need a day or two more if you have a late second trimester abortion. Be aware fatigue might also come from the emotional strain of making the decision to have, and arranging for, an abortion.

Emotional and Psychological Response

Your emotional and psychological response after an abortion will depend on your circumstances, social, cultural, and religious context, support system, reasons for choosing an abortion, and how you cope with stressful situations. According to the National Abortion Foundation, the following responses are possible:

• Most women feel relieved after an abortion from the worry of carrying to term a baby they are not prepared to care for.
• Some may be comfortable with their abortion decision but still have a mixture of sadness at the loss of their baby and relief the procedure is over, and they can move on.
• Some women may require time to release the stress of coping with an undesired pregnancy and the process of arranging for an abortion procedure. Staying positive, focusing on the future, and tapping into ways to release stress and negative thoughts can help in your recovery.
• Other women may have prolonged grief and guilt because they were ambivalent about terminating their pregnancy due to their social or financial circumstances.

Mental Illness

The evidence is conflicting but, according to a 2011 Social Sciences and Medicine analysis, it appears that:

• Few women experience prolonged mental disturbances after an abortion.
• Those who do are more likely to have a mental illness, such as a major depression or anxiety illness, before the procedure.

If you have severe or prolonged symptoms of grief or depression and anxiety, such as sadness, anger, guilt, sleep disturbances, or lack of motivation, ask your abortion services provider for help or a referral to a therapist.

Birth Control Is Important Post Abortion

Effective birth control is extremely important if you don't want to risk another unintended pregnancy soon after your abortion. The following process might happen:

• Your provider will discuss all reliable birth control options before the day of your abortion.
• If you have an in-clinic or in-hospital abortion, you might be given a birth control method before you go home after the procedure.
• If you choose an IUD birth control, it can be placed immediately after the procedure, or you can return for it one week later.
• You might get your first DepoProvera shot on the day of a surgical abortion.
• If you chose the pill or a patch, expect to get a prescription at your pre-abortion appointment so you can start it on the same day you terminate your pregnancy.
• For other methods, you have to arrange a follow-up appointment.

Keep in mind it is possible to get pregnant two weeks after terminating your pregnancy.

Standard Post-Procedure Instructions

Don't drive yourself for the next 24 hours after an abortion until the procedure medications you were given wear off. In addition, to reduce the chance of uterine infection, observe the following for two weeks following a surgical or medical abortion:

• No intercourse
• No tampons
• No douching
• No baths
• No swimming

You will be told the signs and symptoms to watch for and when to contact your services.

When to Contact Your Provider

Contact your abortion services clinic if you notice the following symptoms and signs after termination of pregnancy:

• You experience moderate to severe pelvic or abdominal pain, which might mean you have an infection or a complication of the procedure, such as a tear in the uterus after a surgical abortion.
• You notice bleeding heavier than your normal period, or you soak through two super pads every hour for two hours.
• You pass big blood clots.
• You have a fever greater than 100 degrees Fahrenheit.
• You experience chills, nausea, or vomiting.
• You notice bad smelling vaginal odor.
• You experience a severe or prolonged grief response and difficulty coping with having had an abortion.

Future Fertility, Pregnancy Outcomes, and Health

You can expect that after an abortion you will have no or minor difficulties with your future fertility, pregnancy outcomes, or your health. In a 2008 review of data on surgical abortions published in the Global Library on Women's Health (GLOWN), the authors reported the following:

• There was no increased risk for ectopic pregnancies after any type of surgical abortion in the first or second trimester.
• For a first trimester abortion done by vacuum extraction, there is no significant increased risk for:
  • Future infertility, unless there was an untreated cervical, uterine, or pelvic infection at the time of, or after, the abortion, or there is scarring in the uterus
  • Miscarriages, preterm birth, and newborn low birthweight
• However, if the first trimester abortion is by dilatation and curettage (D&C), there is an increased risk for scarring of your uterine lining and risk for miscarriages and low birthweight infants in future pregnancies.
• If the abortion is in the second trimester, there is a slight risk for a pregnancy loss in the second trimester of the next pregnancy and a low birthweight baby. This risk occurs only if the doctor did not use laminaria (seaweed sticks) to dilate the cervix gradually before the abortion.
• There is no increased risk for breast cancer based on two studies.

For More Information

For more information on abortion services and procedures, you can visit the websites of:

• Planned Parenthood, a United States national abortion and other women's health services provider
• The National Abortion Foundation, which is the professional association of abortion providers

Know What to Expect

Knowing what to expect post abortion before you have the procedure will help you understand and cope with any symptoms and signs that occur afterwards. Call your abortion services provider if you are concerned about the severity or duration of any of your post abortion signs or symptoms.