Abortion (Termination of Pregnancy)

Written by Kristianne Hannemann, PharmD on Sep 20, 2024.

What Is an Abortion (Termination of Pregnancy)?

An abortion, also known as termination of pregnancy, refers to the removal of pregnancy tissue, products of conception, or the fetus and placenta (afterbirth) from the uterus. Before eight weeks of pregnancy, the term "pregnancy tissue" is often used, while after eight weeks, the terms "fetus" and "placenta" are more common. Other names for abortion include elective abortion, induced abortion, and therapeutic abortion.

What It Is Used For

Abortion is most commonly performed to end an unintended pregnancy. This may occur when contraception fails or is not used. It is also used in situations where prenatal tests reveal severe fetal abnormalities or when the mother's health is at risk. Therapeutic abortion is specifically recommended when continuing the pregnancy poses a risk to the woman's health. The majority of abortions occur within the first 12 weeks of pregnancy.

Preparation

Before the procedure, your healthcare provider will review your medical history and conduct a physical examination. A pregnancy test will often be performed to confirm the pregnancy, and an ultrasound may be necessary to determine how far along the pregnancy is and rule out an ectopic pregnancy (a pregnancy outside the uterus). Additionally, a blood test will check your Rh factor, which determines whether you need an injection of Rh immunoglobulin to prevent complications in future pregnancies if you are Rh-negative.

How It’s Done

The method of abortion depends on how far along the pregnancy is, your medical history, and your preferences. There are two main types of abortion: medical (using medications) and surgical.

Medical Abortion

Medical abortions are most effective within 70 days of gestation, which is calculated from the first day of your last menstrual period. The most commonly used medications are mifepristone (Mifeprex) and misoprostol (Cytotec). Mifepristone blocks the hormone progesterone, which is necessary for pregnancy, while misoprostol causes the uterus to contract. Together, these medications result in the termination of pregnancy. In some cases, methotrexate may be used if mifepristone is unavailable or contraindicated.

Surgical Abortion

There are several surgical methods for terminating a pregnancy:

• Menstrual aspiration (manual vacuum aspiration): Used within 1-3 weeks after a missed period or for incomplete miscarriages. A flexible tube is inserted into the uterus to suction out pregnancy tissue.
• Suction or aspiration abortion (dilation and curettage, D&C): This method is most common for pregnancies up to 14 weeks. The cervix is dilated, and a suction device removes the pregnancy tissue.
• Dilation and evacuation (D&E): This procedure is used between 14 and 24 weeks of pregnancy and involves larger instruments to remove the pregnancy tissue.
• Abdominal hysterotomy: A rare surgical method where the fetus is removed via an incision in the abdomen.

Drugs used to treat this and similar conditions

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• misoprostol
• Mifeprex
• Pitocin
• Hemabate
• mifepristone

View more treatment options

Follow-Up

After a medical abortion, several follow-up visits may be required to ensure all pregnancy tissue has been expelled. For surgical abortions, recovery is generally quicker, with most women able to resume daily activities within hours or days, depending on the anesthesia used. Your healthcare provider may recommend avoiding sexual activity for at least two weeks to reduce the risk of infection.

Risks

The risks of medical abortion include infection, heavy bleeding, and incomplete abortion, which may require a follow-up surgical procedure. Surgical abortions have low risks, though complications like infection, excessive bleeding, or incomplete removal of tissue may occur. Serious complications, such as uterine perforation, are rare but may require further surgery.

When to Seek Medical Attention

Contact your healthcare provider if you experience any of the following:

• A fever of 100.4°F (38°C) or higher.
• Heavy bleeding (soaking a pad every hour or passing large clots).
• Severe abdominal or back pain.
• Foul-smelling vaginal discharge.
• No bleeding within 24 hours after a medical abortion.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer