Disclaimer: Abortion laws and medical practices vary according to where you live. Always check the status of abortion in your area.
Whether you had an abortion 10 years or 10 months ago, it’s understandable that you might be wondering how that could affect your future chances of having a baby. After all, abortion can bring up lots of questions, including how the process works, what to expect afterward, and whether a termination can affect your future fertility.
Know that you’re not alone. There are 73 million induced abortions globally every year, according to the World Health Organization (WHO). That means that 61% of unintended pregnancies end in termination, as do 29% of all pregnancies.
We asked Flo board members Dr. Jenna Flanagan, an OB-GYN (obstetrician and gynecologist), and Dr. Tiffanny Jones, a fertility specialist, to answer the most common questions around abortion and fertility.
The answer is yes; you can get pregnant after an abortion and relatively quickly. “A woman can ovulate [release an egg for fertilization] and become pregnant before her next menstrual cycle following an abortion,” says Dr. Jones. American College of Obstetricians and Gynecologists’ research backs this up. They found 83% of women ovulate within a month of abortion. That means you can get pregnant before your next period.
That’s why it’s so important to use effective birth control if you’re planning on having sex that could result in pregnancy. We’ll go into more detail on the different contraception options below.
Often infertility is one of the biggest concerns after an abortion, but study results are reassuring.
“Research doesn’t indicate that there’s an impact on future fertility for those who have a [medically supervised] abortion,” Dr. Flanagan tells Flo. And that’s the case whether you’ve had a medical or surgical abortion, regardless of which trimester you were in, as long as the termination was performed safely.
She explains what this means. “Overall, there’s no increased risk in future fertility after an abortion regardless of how far along the pregnancy is, as long as the abortion is done with a licensed professional following guidelines that help ensure the safety and health of the patient,” Dr. Flanagan says. Those guidelines come from the WHO; you can read them here.
There can be a very small risk of scarring on your uterus if you have a surgical abortion because of microtrauma to the uterine lining from using medical instruments — especially if you get an infection — which can potentially make it harder to get pregnant down the line. That’s why it is important to report any increase in pain or abnormal discharge to your healthcare team right away.
"However, this is very rare, and it can often be diagnosed and treated with a simple outpatient procedure after the abortion to optimize fertility for the future,” Dr. Flanagan says. And this risk isn’t unique to surgical abortion — scarring can also crop up when medical instruments are used on your uterus for other procedures such as “surgical management of a miscarriage or [having] a camera inserted (hysteroscope).” Always talk to your health care provider if you have concerns.
“Typically not,” says Dr. Jones. “However, future pregnancies can have higher risks if there are complications [after an abortion]. If multiple surgeries have been performed in the uterus, a future pregnancy may be at a higher risk for abnormal growth of the placenta into the muscle of the uterus.”
Meanwhile, the science isn’t clear-cut when it comes to abortion and the risk for premature labor in a later pregnancy. A 2015 joint Italian-American review of scientific evidence found that removal of the pregnancy tissue after an abortion or miscarriage (also known as “uterine evacuation”) is a risk factor for premature labor and birth. But in a large Scottish study of more than 120,000 women who’d had abortions, the risk of premature labor was lower than for those who had experienced a miscarriage.
Ultimately, Dr. Flanagan offers reassurance here: “Preterm [early] birth after abortion is not typically a risk that we discuss as it is so modest — if it exists — and many studies show conflicting data,” she says.
You can use most contraceptives after a medical or surgical abortion, but there’s one exception.
“An intrauterine device (IUD) can be placed only in a follow-up appointment after a medical abortion as it’s important to ensure the abortion process is complete and it’s safe to insert an IUD into the uterus,” says Dr. Flanagan. “If you have a surgical abortion, the medical professional can insert an IUD on completion of the abortion as part of the procedure.”
“We recommend that contraception starts immediately after, or at the time of, an abortion to prevent a subsequent pregnancy — if pregnancy isn’t what you want — as ovulation can happen 2 to 4 weeks after the abortion, before the first menstrual cycle after the abortion.”
Other options include “birth control pills, patch, or ring, as well as the implant, [which] can be started immediately or shortly after the medications are taken for the abortion,” Dr. Flanagan explains. They’re also effective after a surgical abortion.
Pregnancy tests work by detecting the pregnancy hormone, human chorionic gonadotropin (hCG), in your urine. A positive result means there is hCG in your system. Dr. Jones offers a word of caution here if you’re planning to take a pregnancy test following an abortion.
“It can take weeks for a pregnancy test to turn negative even after a complete abortion because hCG is still present, and it can take a while for those levels to return to zero,” she says. But if you’re worried that your abortion isn’t complete, or if you’re worried about any complications, talk to a health care professional. Your health care professional can use blood tests to measure the precise amount of hCG in your system and follow whether they are increasing or decreasing to give a clearer picture of whether you are still pregnant or not.
An incomplete medical abortion means that some of the pregnancy tissue remains in the uterus. Often, someone experiencing this will have symptoms, such as continued signs of pregnancy like nausea and fatigue. Prolonged and irregular bleeding (usually accompanied by clots and cramps) that last longer than expected (1-2 days) may also be a sign that something isn’t right. Ongoing symptoms or pregnancy or pain should prompt a visit with your health care professional.
Having an abortion can bring up all sorts of emotions — from relief to anger and sadness and everything in between — sometimes all at once.
Dr. Flanagan offers some reassurance about those boomerang feelings that might crop up. “Any emotion you experience is normal,” she says. “And at different times throughout the process, you may experience widely different emotions. Again, that’s normal.”
Some women and people who menstruate benefit from talking to someone. “Getting support is a personal choice, but it’s likely better for your emotional and physical recovery to have the support of someone you trust. This can come from family, friends, therapy, or your health care provider,” says Dr. Flanagan. You could also look online for forums and support groups where people who’ve had an abortion can share their experiences in a safe space.
Flo board member and clinical psychologist Lorna Hobbs has shared some things you can do to take care of you after an abortion here.