Complications of any abortion procedure are rare and minor. If evaluated early, most problems can be treated with a repeat procedure or with antibiotics. The Manual Vacuum Aspiration Procedure avoids the rare major complications of a surgical abortion because there is no scraping, no electric vacuum, no metal instruments and no general anesthesia.
Retained Products of Conception:
Significant cramping that is not relieved by routine pain medication, bleeding that lasts longer than three weeks and sudden heavy bleeding can indicate a problem called “retained products of conception.” For the Abortion Pill, symptoms include cramping that occurs days after taking the initial medications, sudden heavy bleeding that lasts more than 24 hours, or ongoing daily bleeding that can result in anemia.
While all of these situations can be frightening, they usually indicate a problem called retained products, which is easily treated. After any abortion procedure, some of the pregnancy lining of the uterus (“decidua”) remains attached to the wall of the uterus and passes naturally during the period. Some menstrual bleeding continues after the procedure. 99% of women pass this lining and blood naturally and don’t have a problem. Occasionally, the remaining tissue forms a clot in the uterus that does not pass naturally. The uterus contracts to “push it out” and this causes significant cramping. In this case, you will be given the option to repeat the procedure. Since you are no longer pregnant, this procedure is usually easier than the first procedure and within minutes, your symptoms are resolved.
In the case of the Abortion Pill, the retained tissue can get “stuck” in the cervix. This can cause significant cramping and a foul odor. The doctor can remove the clot with an instrument or may need to complete a Manual Vacuum Aspiration.
- The treatment for persistent cramping from Retained Products is a brief repeat procedure.
- There are no known long term consequences to having retained products of conception.
- The chances of having retained products increases if you have a “retroverted” uterus (uterus that normally tips toward your back rather than tipping forward).
- Retained products requiring a repeat procedure occurs at about the same rate (<1%) for the Manual Vacuum Aspiration Procedure, the Abortion Pill, and surgical abortion. Scraping of the uterus does not prevent retained products of conception and is not necessary to treat the condition.
- Most abortion doctors will not charge an additional fee for a follow up evaluation or for a repeat procedure, but this policy will vary depending on the office. Be sure to ask about possible additional charges when you are scheduling your appointment.
Infection after abortion
Infection is a risk of any procedure, including dental work, tattoos, piercings, etc. Signs or symptoms of an infection after an abortion usually would occur days after a procedure. Most likely you were given some antibiotics to take after your procedure. These antibiotics help prevent an infection, but aren’t 100% effective. You can also avoid infection by not putting anything in your vagina (such as tampons) for 48 hours after an Manual Vacuum Aspiration Procedure, 72 hours after bleeding with the Abortion Pill, or 2-6 weeks after a surgical abortion.
Initial signs of infection include: lower abdominal pain, fever, chills and flu-like symptoms. The pain associated with an infection is persistent, continues to get worse and does not usually respond when you take over the counter pain medications. If you suspect an infection, the best thing to do is to call the office immediately. Infections that are caught early are easily treated with antibiotics by mouth. However, if you delay care your symptoms can advance to serious infections that can require injections or even hospitalization.
- The treatment for an early infection is antibiotics by mouth
- The treatment for a serious infection (PID or Pelvic Inflammatory Disease) is antibiotics by injection or hospitalization
- There are usually no long term consequences for a mild infection. Severe Pelvic Inflammatory Disease can very rarely interfere with future pregnancies.
- There have been several cases of death resulting from unusual infections related to the Abortion Pill. See Abortion Risks.
Hematometria (“post abortal syndrome”)
Occasionally a woman will have heavy bleeding into the uterus after a procedure, but the cervix has closed tightly and the blood cannot exit. The bleeding stretches the uterus and causes a “full” or “tight” feeling in the abdomen and severe to extreme cramping. Hematometria typically occurs within hours of a procedure.
- The treatment for hematometria is a repeat procedure.
- There are no known long term consequences of hematometria
- Hematometria is much more common in surgical abortion (<1/500), compared to the Manual Vacuum Aspiration procedure (<1/5000). The reason is that the scraping of the uterus in surgical abortion causes heavier bleeding. Hematometria is not known to occur with the Abortion Pill.
Continuing pregnancy after abortion is very rare, but the rate increases with early pregnancy under 6 weeks. There are a number of causes of continuing pregnancy, including:
- The Abortion Pill didn’t work;
- There is a twin pregnancy that was not identified during the first evaluation;
- The doctor missed the pregnancy during the procedure.
In the case of the Abortion Pill, a continuing pregnancy must be treated by completing an abortion. The medications can cause serious birth defects, so it is important not to take that risk.