Most commonly, abortion involves elective surgery. As with all forms of
surgery, there are risks associated with the procedure. For abortion, these
risks increase dramatically the later in the pregnancy the procedure is
performed. Approximately 10% of women undergoing elective abortion will suffer
immediate complications, of which approximately one-fifth (2%) are considered
life threatening. Possible physical risks of abortion are listed below.
Immediate health risks
- Death - Women who abort are approximately four times more likely
to die in the following year than women who carry their pregnancies to term,
according to a 1997 government funded study in Finland.
- Uterine perforation - About 2% of all abortion patients may
suffer perforation of their uterus, yet most of these injuries will remain
undiagnosed and untreated unless laparoscopic visualization is performed.1
- Cervical lacerations - Significant cervical lacerations requiring
sutures occur in at least one percent of first trimester abortions. Lesser
lacerations, or micro fractures, which would normally not be treated may
also result in long term reproductive damage.2
- Pelvic Inflammatory Disease (PID) - 23% of patients who have a
chlamydia infection at the time of the abortion will develop PID within 4
weeks. About 20 to 27% of patients seeking abortion have a chlamydia
infection. Approximately 5% of patients who are not infected by chlamydia
develop PID within 4 weeks after a first trimester abortion.3
- Endometritis (Infection) - Occurrence of genital tract infection
following elective abortion is up to 5% for first trimester abortions and up
to 18% in midtrimester. Endometritis is a post-abortion risk for all women,
but especially for teenagers, who are 2.5 times more likely than women 20-29
to acquire endometritis following abortion.4
Long-term health risks
- Breast Cancer - The risk of breast cancer almost doubles
after one abortion, and rises even further with two or more abortions.
- Cervical, ovarian, and liver cancer - Women with one abortion
face a 2.3 relative risk of cervical cancer, compared to non-aborted
women, and women with two or more abortions face a 4.92 relative risk.
Similar elevated risks of ovarian and liver cancer have also been linked
to single and multiple abortions.5
Risks to future pregnancies
- Pre-term delivery - Women who had one, two, or more
previous induced abortions are, respectively, 1.89, 2.66, or 2.03
times more likely to have a subsequent pre-term delivery, compared
to women who carry to term.6
- Placenta previa - Abortion increases the risk of placenta
previa in later pregnancies (a life threatening condition for both
the mother and her baby) by seven to fifteen fold. Abnormal
development of the placenta due to uterine damage increases the risk
of fetal malformation, perinatal death, and excessive bleeding
- Ectopic pregnancy - Abortion is significantly related to
an increased risk of subsequent ectopic pregnancies. Ectopic
pregnancies, in turn, are life threatening and may result in reduced
- Kaali, S. et al. 1989. The
Frequency and Management of Uterine Perforations During
First-Trimester Abortions. Am. J. Obstetrics and
White, M. 1977. A Case-Control Study of Uterine
Perforations documented at Laparoscopy. Am. J.
Obstetrics and Gynecology 129:623.
- Schulz, K. et al. 1983. Measures to
Prevent Cervical Injuries During Suction Curettage
Abortion. The Lancet May 28, 1983, pp 1182-1184.
Cates, W. 1986. The Risks Associated with Teenage
Abortion. New England Journal of Medicine
Castadot, R. 1986. Pregnancy Termination: Techniques,
Risks, and Complications and Their Management.
Fertility and Sterility 45(1):5-16.
- Frank, et.al. 1985. Induced
Abortion Operations and Their Early Sequelae. Journal
of the Royal College of General Practitioners 35
Grimes and Cates. 1986. Abortion: Methods and
Complications. Human Reproduction, 2nd ed., pp.
Freedman, M.A. 1986. Comparison of complication rates in
first trimester abortions performed by physician
assistants and physicians. Am. J. Public Health
76 (5):550- 554.
- Burkman et al. 1977. Culture and
Treatment Results in Endometritis Following Elective
Abortion. Amer. Jour. OB/GYN 128 (5) 556-559.
Burkman, et al. 1986. Morbidity Risk Among Young
Adolescents Undergoing Elective Abortion.
Post-Abortal Endometritis and Isolation of Chlamydia
Trachomatis. Obstetrics and Gynecology 68
- M-G, Le, et al. 1984. Oral
Contraceptive Use and Breast or Cervical Cancer:
Preliminary Results of a French Case- Control Study,
Hormones and Sexual Factors in Human Cancer Etiology,
ed. J.P. Wolff, et al., Excerpta Medica New York
Parazzini, F. et al. 1989. Reproductive Factors and the
Risk of Invasive and Intraepithelial Cervical Neoplasia.
British Journal of Cancer 59:805-809.
Stewart, H.L. et al. Epidemiology of Cancers of the
Uterine Cervix and Corpus, Breast and Ovary in Israel
and New York City. Journal of the National Cancer
Fujimoto, I. et al. 1985. Epidemiologic Study of
Carcinoma in Situ of the Cervix. Journal of
Reproductive Medicine 30 (7):535.
Weiss, N. 1983. Events of Reproductive Life and the
Incidence of Epithelial Ovarian Cancer Am. J. of
Epidemiology 117 (2):128-139.
Beral, V. et al. 1978. Does Pregnancy Protect Against
Ovarian Cancer. The Lancet May 20, 1978, pp.
LaVecchia, C. et al. 1992. Reproductive Factors and the
Risk of Hepatocellular Carcinoma in Women.
International Journal of Cancer 52:351.
- Zhou, W., et. al. 1999. Induced
Abortion and Subsequent Pregnancy Duration.
Obstetrics & Gynecology 94 (6):948-953.
- Barrett, et al. 1981 Induced
Abortion: A Risk Factor for Placenta Previa. American
Journal of Ob. & Gyn. 141:7.
- Daling,et.al. 1985. Ectopic
Pregnancy in Relation to Previous Induced Abortion.
JAMA 253 (7):1005-1008
Levin, et.al. 1982 Ectopic Pregnancy and Prior Induced
Abortion. American Journal of Public Health
Chung, C.S. 1982. Induced Abortion and Ectopic Pregnancy
in Subsequent Pregnancies. American Journal of