It is important to understand the difference between an effect and a complication. An effect is an expected reaction and at least partially inevitable, whereas a complication not expected. Common effects of abortion include abdominal pain and cramping, nausea, vomiting, and diarrhea. In most abortions, no serious complications occur. However, complications may happen in as many as 1 out of every 100 early abortions and in about 1 out of every 50 later abortions.
Complications may include:
Some bleeding after abortion is normal. However, there is a risk of severe bleeding known as hemorrhaging. This may result from cervical tears, uterine punctures, retained tissue, or when the uterus fails to contract after it is emptied. When this happens, a scraping of the uterus (D&C), or other surgical procedure may be required to stop the bleeding. Infrequently, a blood transfusion may be necessary. Rarely, removal of the uterus (known as a hysterectomy), may be required to stop the bleeding.
The insertion of instruments or retained fetal tissue may lead to infection. Infrequently, total body infection, known as sepsis, happens and can be life-threatening. Pelvic infection can cause scarring of the pelvic organs. Antibiotics my be prescribed to fight infection and/or additional surgery may be required to fully empty the uterus.
This occurs when fetal tissue remains in the uterus after the abortion is over. It can cause severe bleeding, infection, and a D&C may be required to complete the procedure.
Local anesthetics, sedatives, and pain medications may cause allergic reactions of varying degrees of severity. Convulsions, heart complications and – in extreme cases – death, are known risks of general anesthesia regardless of the procedure preformed. Use of general anesthesia for abortion has decreased.
The cervix and/or uterus may be cut, torn, or punctured by instruments. This may cause excessive bleeding requiring surgical repair or result in scarring of the uterine lining. If the uterus is punctured, the bowel and bladder may be injured. The risk of these types of complications increases with the length of the pregnancy.
Clots may form in the bloodstream. If they break off and travel, they are known as “emboli”. These emboli can lodge in the lungs, causing illness and even death. Another form of emboli, known as “amniotic fluid embolism”, is a rare cause of death in later term abortions. In a process not well understood, amniotic fluid gets into the mother’s bloodstream and causes a severe allergic-type reaction.
Pregnant women should be tested to determine if their blood type is Rh positive or Rh negative. All pregnant women who are Rh negative should receive an injection of Rhogam to prevent the formation of antibodies that may harm current or future pregnancies.
In extreme cases, other physical complications from abortion including excessive bleeding, infection, organ damage from a perforated uterus, and adverse reactions to anesthesia may lead to death. This complication is rare and occurs, on average, in less than 20 cases per year.