What You Should Know about Abortions and Women’s Health

Dr. Jolene BrightenPublished: Last Reviewed: Pregnancy, Sexual Health Leave a Comment

I hear so many questions about abortions because let’s face it, there’s a whole lot of misinformation out there. If you only listen to the chatter, it’s hard to sort out the actual facts. 

And unfortunately, there are many websites that may appear to be educational but are actually providing incorrect, biased, or incomplete information.

In this article, I'll give you an accurate, judgment-free overview of everything you need to know about abortions, including:

  • The history of abortions
  • The various procedure options that are available for women
  • Physical and emotional effects of abortions
  • How an abortion may affect your hormones
  • And more.

Let’s dive in.

What to Know About Abortions

An abortion is defined as the deliberate termination of a pregnancy. It’s a safe, common medical procedure that nearly a quarter of all women today may get in their lifetimes. 

It's important to know that not only is it 100% normal to consider getting an abortion, it's also nothing new. Let's take a quick look at the history of abortions to help normalize this subject further.

The History of Abortions

Abortions have been performed since ancient times in various ways, although early abortions were primarily non-surgical methods (meaning people were given a variety of remedies they took orally or used as salves or poultices to bring an end to being pregnant).

While we know that some ancient cultures were permissive of abortions, such as the Greeks and Romans, others, like the Persians, were not. Views on this issue have always been influenced by cultural norms and the differing eras in which women lived — which isn't to say that “illegal” abortions didn't still occur anyway in societies that weren't permissive, because they certainly must have.

Most people aren't aware that in the colonies and later the United States from about 1600 to the early 1900s, abortions were quite common among both settlers and indigenous people, and actually weren't such a a religious or politically charged issue as they are today.

But in the mid-1800s, the newly formed American Medical Association (AMA) changed a lot about abortion care — and women's care in general. Suddenly midwives and female doctors were highly regulated and controlled by the primarily male AMA There was a crusade to give doctors the legal power to make decisions about women's pregnancies , and as a result, it became more stigmatized. 

Sadly, since midwives were the primary care providers for women’s reproductive health up to this point, most doctors didn’t actually have much experience in caring for women during pregnancy during this time.

After increasing controversy and politicalization, abortion was eventually made illegal in every state by 1910. Although there were exceptions, such as to save a patient’s life, the decision was up to the (again, mostly male) doctors. 

This situation continued until the late 1960s when abortion reform became a focus throughout the U.S.

Roe v. Wade and Abortion in America Today

Roe v. Wade was the precedent-setting landmark U.S. Supreme Court decision that made abortion legal across the U.S, but abortion is still a controversial right for women. As a result, it's still being challenged legislatively as well as judicially in the US. 

For example, not long after Roe v. Wade,, Congress also passed a policy called the Hyde Amendment that limits federal insurance providers like Medicaid from covering abortions, which disproportionately affected access to abortion care for those living below the poverty line and women of color.

 And thousands of abortion restrictions have been passed in various states that limit abortions after a certain gestational age or use specific methods. There are also movements to make it more difficult for someone to seek an abortion by requiring counseling — or even punishing abortion providers.

Since laws vary, you can use this link to see where your state falls in terms of regulations and abortion policy.

How Common are Abortions?

Abortions are fairly common. The CDC reported that in the year 2019, about 630,000 legal abortions were reported in the U.S. And from 2010 to 2019, the annual abortion rate was 11.4 abortions per 1000 women aged 15-44.

But keep in mind that annual rates don't tell us the whole picture, either. Lifetime rates of abortion may be as high as 30% for all women, but are harder to calculate because the annual rate varies over time.

Reasons People Get Abortions

The choice to have an abortion is rarely an easy decision for anyone, regardless of the reason. 

Some of the more common medical reasons can include:

  • Preexisting health conditions like heart or kidney issues that make pregnancy life-threatening or dangerous for the mother.
  • Fetal genetic abnormalities that are non-survivable for the fetus.

There are other non-medical reasons someone may have an abortion, all of which are deeply personal.

The full list would be too extensive for a blog post, but it's worth considering some of the private and personal reasons that people decide to terminate pregnancies, including rape, incest, abusive relationships, trauma, and personal values regarding bringing a life into the world.

Are Abortions Safe?

Research tells us that when abortion is legal, it’s a very safe medical procedure with few complications. 

The mortality rate where women have safe and legal access to abortions is about 0.7 per 100,000 abortions performed, or one death per 142,847 abortions. When it comes to risk, statistics show this is comparable to:

  • Driving a car or motor vehicle 758 miles,
  • Receiving a cosmetic surgery procedure, 
  • Having a dental surgery, or
  • Running a marathon. 

I encourage women to think carefully about any big decision of this nature, but let's be clear: legal abortions are extremely safe when it comes to the risk of dying.

On the other hand, abortions become far less safe in areas where they are illegal. Unsafe abortions can lead to severe complications not associated with abortions conducted in a safe, sterile environment with appropriate care.

According to the World Health Organization, in developed regions, 30 women die for every 100,000 unsafe abortions performed, which is more than a four-fold increase. In developing regions, the number rises to 220 deaths per 100,000 unsafe abortions — 314 times higher than the rate safe abortions . 

Other Potential Abortion Risks

First of all, abortion is not risk-free — but then, neither is pregnancy! The good news is that your provider can help you navigate these challenging decisions. 

To get a better understanding of your options and risk levels, you and your doctor will need to discuss factors including gestational age (the length of the pregnancy), any possible health conditions you may have, and sometimes lab tests to help date the pregnancy and learn if you may be anemic (low in iron). 

In the meantime, here's a list to help you understand the potential complications that may sometimes result from abortion:

  • Hemorrhage or other injury during abortion
  • Infection 
  • Ongoing pregnancy (an unsuccessful abortion) 

The risk of infertility or future pregnancy complications that's associated with having an abortion is low. Different studies show different results, but generally around 1% higher absolute risk (meaning your actual risk of complications may be increased by about 1% following an abortion). Some studies also show no elevated risk of these outcomes resulting from a prior abortion. 

Also, pregnancy termination doesn't appear to be associated with ongoing health issues in the mother according to current evidence. 

What Are the Different Abortion Procedures?

There are two primary types of abortion procedures: in-clinic and medication abortions.

In-Clinic Abortions

In-clinic abortions are procedures at the doctor’s office and are performed by a medical professional. There are two options:

  • Suction abortion (vacuum aspiration): This procedure takes five to ten minutes and uses gentle suction to empty the uterus. Sedation is given, and it’s usually offered until about 14 to 16 weeks after the last menstrual period.
  • Dilation and evacuation (D&E): This procedure is used later in pregnancy, usually after 14-16 weeks. It’s a bit more involved and requires cervical dilation (usually overnight). The actual procedure only takes 10 to 15 minutes as a combo of suction and medical tools to remove the pregnancy.

Medication Abortions

Medication abortions use a set of two different pills to end a pregnancy. This option is usually offered during early pregnancy. The experience of this type of abortion is often described as being similar to a miscarriage or a very heavy period

Many women prefer medications because they’re done at home, so they’re more private and less invasive. They now account for the majority of all abortions.

The two abortion pills are:

  • Mifepristone: Stops the pregnancy from developing by blocking hormones. 
  • Misoprostol: Leads to uterine contractions to empty the uterus.

They may be administered simultaneously or 48 hours apart. 

This form of medication abortion is only FDA-approved for up to 10 weeks gestational age, but is used safely off-label later in pregnancies. Talk to your doctor or provider to get more insight if you're considering it.

Is Plan B an Abortion Drug?

Short answer: no! Plan B is not an abortion pill. 

It works to prevent pregnancy from occurring in the first place by blocking ovulation and has to be taken within 72 hours of unprotected sex. Also, unlike abortion medication, it's usually available over-the-counter.

If you find this confusing, you aren't alone. There’s a lot of confusion about Plan B, AKA the morning after pill — so much so that I wrote an entire article about it. 

How Will I Feel After an Abortion?

There’s no way to predict just how you feel after having an abortion, as everyone has a different experience.

Pregnancy hormones can impact emotions in a way that could lead to intense feelings and emotions. It can take time for hormones to balance out as you start a new menstrual cycle.

There are so many different emotions surrounding abortions, and all are normal. 

Some women may feel relief, others may feel sadness, and many feel a combo of both. There’s no right or wrong way to feel, but it's a good idea to seek nonjudgmental support or even counseling if you're struggling.

What to Expect Physically After an Abortion

It’s normal to experience some bleeding and cramping after having an abortion, but many people can go back to everyday activities the next day. Discomfort also depends on timing and the type of procedure you have.

Your health care provider will give you pain medication instructions if you need them. 

Pads, tampons, or menstrual cups can be used just as with your period for bleeding, whatever is most comfortable for you (or per your doctor’s recommendations). 

If you experience heavy bleeding, you’ll want to check in with your doctor, but you’ll also be given instructions on this before you leave the office.

How Will Having an Abortion Affect My Period?

An abortion will temporarily affect the menstrual cycle and period, but hormones should regulate in a month or two. 

An abortion is like resetting the menstrual cycle, so a period should resume about 4 to 8 weeks later. 

If it doesn’t, and you aren’t on any birth control, make sure to check in with your provider.  

When Can I Have Sex After an Abortion?

Although there is no medical consensus for when you can resume sex, it is often recommended that you wait one to two weeks in order to decrease infection. Many providers advise resuming sexual activity when you feel comfortable.

When Can I Take Birth Control After My Abortion?

If you plan to take birth control after an abortion, you can start immediately, although keep in mind you can still get pregnant through the first cycle.

Hormones After Abortion

Hormone shifts after having an abortion can look a lot like someone going through the postpartum experience, a topic that isn't discussed enough in my opinion. 

If you think about it, it makes sense that the hormones that accompany pregnancy will need to rebalance after having an abortion. The placenta, which has been providing the pregnancy hormones, is removed from the body, which leads to hormone shifts.

With pregnancy, progesterone and estrogen rise dramatically. The level of hormones and accompanying shift depends on how far along the pregnancy is, but when the placenta is removed, it will lead to a sudden drop in hormones just as the placenta is removed from the body after labor and delivery.

However, remember, all it takes is time for your hormones to get back to normal. As your body adjusts and regains balance after an abortion, it can take 4 to 8 weeks for a cycle to normalize.

Breast Tissue Development

Tender breasts are often the first sign of pregnancy, so it’s normal for this to last for a week or two after having an abortion. Again, this is related to pregnancy hormones, but firmness and tenderness should subside.

It’s also worth mentioning that you may have come across headlines suggesting a link between abortions and a higher risk of breast cancer., but there’s evidence this actually isn't true. According to the American Cancer Society, there’s a small increased risk of breast cancer following a full-term pregnancy, but abortions are not linked to the same risk.

Lactation

It is possible to have milk come in following an abortion, but this usually occurs for people who have late-term abortions. Like lactation following a full-term pregnancy, milk could come in about three days following an abortion as hormones are released. There are medications a doctor can prescribe to minimize production if needed.

How to Support Your Hormones Post-abortion

You can help your hormones get back on track post-abortion:

  • Eat a nutrient-dense, blood sugar-balancing diet. High fiber foods like fruits, vegetables, and whole grains help keep blood sugar stable and balance sex hormones. Keep processed foods to a minimum, and really work on nourishing your body. I’ve created a free hormone-balancing kit that includes a seven-day meal plan to make it easy to take care of yourself.
  • Rest. Prioritize sleep as best you can, as deep sleep is critical for our hormones and healing. Keep your bedroom cool, quiet, and screen-free at night. I’ve created a product that contains a gentle blend of botanicals and nutrients to help you get a better night’s sleep.
  • Get outside. If possible, spend time outdoors in the sunshine. Whether walking in nature or just sitting on your front steps and taking deep breaths, sunlight regulates your body's natural 24-hour rhythms to help sleep and hormone balance.
  • Be kind to yourself. Even if we don’t speak out loud, the words we say to ourselves can impact stress levels and how we feel. It’s okay to feel any range of emotions and seek out support if you need it.

Will Having an Abortion Affect My Health?

Abortion is a reasonably safe procedure, and while it's not risk-free, neither is carrying a pregnancy to term.

The side effects of cramping and bleeding are short-term, and your body and hormones will go back to normal. Having an abortion also doesn’t mean you will necessarily struggle to become pregnant in the future if that’s what you want. 

Making the decision to have an abortion is a personal choice, and there’s no right or wrong answer, but my hope is that all of this information can support you in whatever choice you make.

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References

  1. Jones RK and Jerman J. Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008–2014. American Journal of Public Health. 2017. 107. 1904-1909.
  2. Moore B, et al.. History and scientific background on the economics of abortion. PLOS ONE. 2021.
  3. Shimabukuro JO and Lewis KJ. Abortion Law Development: A Brief Overview. UNT Libraries Government Documents Department.
  4. The Hyde Amendment: A Discriminatory Ban on Insurance Coverage of Abortion. Guttmacher Institute Federal Policy Snapshots.
  5. Abortion Surveillance—Findings and Reports. CDC Reproductive Health Data Statistics.
  6. Raymond EG, Grossman D, Weaver MA, Toti S, Winikoff B.. Mortality of induced abortion, other outpatient surgical procedures and common activities in the United States.. Contraception. 2014 Nov. 90(5). 476-9.
  7. Napso T, et al.. The Role of Placental Hormones in Mediating Maternal Adaptations to Support Pregnancy and Lactation. Front. Physiol.. 2018 Aug.
  8. FAQ: Post-Abortion Care and Recovery. UCSF Health.
  9. Abortion and Breast Cancer Risk. American Cancer Society: Cancer A-Z.
  10. Blume C, Garbazza C, Spitschan M.. Effects of light on human circadian rhythms, sleep and mood. Somnologie (Berl.). 2019. 23(3). 147-156.
About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is a women’s hormone expert and prominent leader in women’s medicine. As a licensed naturopathic physician who is board certified in naturopathic endocrinology, she takes an integrative approach in her clinical practice. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones. She is the best selling author of Beyond the Pill and Healing Your Body Naturally After Childbirth. Dr. Brighten is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on women’s health. She is a member of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, Sports Illustrated, Elle, and ABC News. Read more about me here.