OVERVIEW

What is abortion?

Termination of pregnancy within 12 weeks of gestation through surgical or medical methods is called early pregnancy termination, also known as induced abortion. Abortion is used as a remedy for unintended pregnancy due to contraceptive failure, as well as for those who need to terminate pregnancy due to medical conditions that make continuing pregnancy unsuitable or to prevent congenital malformations or genetic diseases.

Abortion can be divided into surgical abortion and medical abortion. In a narrow sense, "induced abortion" refers to surgical abortion, with the commonly used methods being vacuum aspiration abortion and dilation and curettage abortion.

Before and after the abortion procedure, patients may not only endure physical pain but also experience significant negative emotions. If your family or friends have undergone an abortion, please provide them with sufficient emotional support and encourage them to actively undergo rehabilitation.

What is painless abortion?

Painless abortion refers to an abortion procedure performed under anesthesia or analgesia, where pain-relieving drugs are administered during the surgery to prevent the patient from experiencing painful stimuli.

Compared to conventional procedures performed under local anesthesia, painless abortion is indeed pain-free. However, "painless" does not mean "harmless." The surgical procedure remains the same, with the only difference being the addition of anesthesia, which carries its own risks.

What are visual abortion and minimally invasive abortion?

Visual abortion is a surgical abortion performed under ultrasound guidance to avoid blind operations and minimize damage, residual tissue, and other issues. In most hospitals, this is standard practice and no longer specifically referred to as "visual."

Minimally invasive abortion is performed using hysteroscopy. However, in China, hysteroscopy is prohibited for routine abortion procedures and is only used to manage potential complications arising from abortion.

Therefore, marketing claims about "visual abortion" or "minimally invasive abortion" are mostly just gimmicks.

SYMPTOMS

Is abortion dangerous?

Abortion is generally very safe. However, as it is a medical procedure, there are still some minor risks. Never choose illegal medical facilities out of embarrassment—ensure the abortion is performed at a compliant clinic or hospital.

Some individuals are at higher risk when undergoing abortion, including those with underlying conditions like cardiovascular diseases, uterine abnormalities, or those who have had multiple abortions or undergo the procedure shortly after childbirth.

Are abortion and induced labor the same thing?

Induced labor can be considered a method of abortion. However, it is typically used after 12 weeks of pregnancy, primarily involving mid-term methods like Rivanol induction or balloon catheter induction.

CAUSES

What is abortion suitable for? What to do after an unplanned pregnancy?

After an unplanned pregnancy, the first decision is whether to continue or terminate the pregnancy. If continuing, after 8 weeks, prenatal care should be established in obstetrics. If terminating, a legal abortion should be performed at a正规医院. Everyone has the right to abortion.

Abortion can also be performed after 14 weeks of pregnancy, but according to current regulations, a local health department-approved induction certificate is required for hospitalization.

DIAGNOSIS

When is the best time to have an abortion?

If an unintended pregnancy occurs (with normal menstruation but a missed period, confirmed by a positive home pregnancy test) and the decision is made not to keep the baby, the abortion should be performed as early as possible.

During early pregnancy, the embryo's basic structure has not yet formed, and it is only a gestational sac. The small embryonic bud inside the sac makes the procedure relatively simpler and lower in risk compared to terminating a more developed fetus.

First, an ultrasound is needed to confirm the presence of a gestational sac. If only about 30 days have passed since the last menstrual period and no sac is visible, with only slightly thickened endometrium, abortion is not recommended.

Can an abortion be incomplete?

Incomplete abortion is possible but rare. The risk depends on several factors, such as:

• Multiple abortions;

• Therapeutic abortion (e.g., early detection of abnormal embryo development or low progesterone levels, where progesterone is used to sustain the pregnancy), which may lead to adhesion of the gestational sac;

• Abnormal uterine shape or cavity structure, where the embryo may be located in a corner, increasing the risk of adhesion and potential retention of fetal membranes, decidua, or even chorionic villi.

TREATMENT

How to Choose Between Medical Abortion and Surgical Abortion?

Pros and Cons of Surgical Abortion:

• Advantages include a short procedure time, usually completed in 5–10 minutes, with a relatively high success rate. The chances of incomplete abortion or missed abortion are low, and most people succeed in one attempt.

• Disadvantages include the risks and potential complications associated with surgery. The physical damage is generally greater compared to medical abortion.

Pros and Cons of Medical Abortion:

• Advantages include minimal physical damage. Although vaginal bleeding may last longer, increasing the risk of infection, the long-term complications related to abortion are generally lower compared to surgical abortion. In other words, medical abortion causes less damage.

• Disadvantages include a longer process, typically requiring medication for three days, and a lower success rate of about 90%. If it fails, a follow-up surgical procedure (dilation and curettage) may be required.

What Are the Common Drugs Used in Medical Abortion?

The commonly used drugs are mifepristone and prostaglandins. Medical abortion can be performed on an outpatient basis within 7 weeks of pregnancy. If it exceeds 7 weeks, hospitalization is recommended.

Mifepristone blocks the effect of progesterone on the embryo, causing it to deteriorate. Exogenous prostaglandins then induce uterine contractions, expelling the embryo from the uterus, similar to the process of a natural miscarriage. In natural miscarriages, poor embryo development stimulates the production of endogenous prostaglandins, leading to uterine contractions and the expulsion of the deteriorated embryo.

Can Medical Abortion Be Performed Without a Doctor's Guidance?

All types of abortion carry risks, including medical abortion. First, it must be determined whether medical abortion is suitable. The following conditions are not suitable:

• Contraindications to mifepristone or prostaglandins, such as drug allergies;

• Health conditions such as tumors, adrenal-related diseases, severe liver or kidney diseases, bronchial asthma, glaucoma, etc.;

• Prolonged bleeding after self-administration, which may lead to severe infection or anemia;

• If it is an ectopic pregnancy, medical abortion could cause rupture and severe bleeding, leading to shock and loss of treatment opportunity.

Therefore, medical abortion must be performed under a doctor's supervision.

What Should Be Noted After Medical Abortion?

After medical abortion, seek immediate medical attention if bleeding increases beyond normal menstrual flow. While bleeding may last longer, medical evaluation is necessary if it persists for more than two weeks.

What Are the Methods of Surgical Abortion?

• Vacuum Aspiration: For pregnancies within 10 weeks, a tube is inserted into the uterus to suction out the gestational sac.
• Dilation and Curettage (D&C): For pregnancies beyond 10 weeks, instruments are used to remove the gestational sac, followed by suction to clear remaining tissue.

What Should Be Noted Before and After Surgical Abortion?

• Before Surgery: Avoid sexual intercourse; clean the genital area the night before and fast after 8 PM; bring sanitary products on the day of surgery.

• After Surgery: Patients under anesthesia require accompaniment due to residual effects for up to 24 hours. Avoid driving or working at heights. Clean the genital area daily without using baths. Avoid sexual intercourse until bleeding stops to prevent infection. Rest adequately and avoid strenuous activities initially, gradually resuming normal life.

When Does Menstruation Return After Surgical Abortion?

Recovery varies depending on ovarian function and cervical adhesions. Without adhesions, ovulation resumes quickly, leading to earlier menstruation. Most people menstruate within about 30 days, while some may require medical intervention.

What Indicates an Incomplete Abortion?

• No bleeding after medical abortion;

• Persistent pregnancy symptoms (e.g., nausea, breast tenderness) a week or more after abortion;

• Bleeding lasting over two weeks after abortion;

• No menstruation within six weeks post-abortion.

If incomplete, a follow-up surgical procedure (dilation and curettage) is usually required.

What Are the Risks of Abortion to Women's Health?

Short-Term Risks:

• Retained tissue requiring a second procedure;

• Bleeding during or after the procedure, sometimes prolonged;

• Repeated abortions may cause cervical adhesions, leading to missed periods and cyclical pain;

• Improper procedures may cause infections, such as pelvic inflammatory disease.

Long-Term Risks: Mainly affect ovarian function and, in severe cases, reproductive health.

• Repeated abortions thin the uterine lining, increasing the risk of ectopic pregnancy in future pregnancies;

• Repeated procedures may cause pelvic inflammation and adhesions, affecting fallopian tube function and increasing the risk of ectopic pregnancy;

• Changes in implantation sites may lead to placenta previa, placenta accreta, or placenta increta.

However, it is important to note that these risks are minimal and usually occur only with repeated procedures. Generally, having an abortion does not increase difficulty in future pregnancies, harm your health, or affect the health of future babies.

DIET & LIFESTYLE

How long after an abortion can sexual activity resume?

Absolutely avoid sexual intercourse within 2 weeks after an abortion, and do not insert any objects into the vagina. This could lead to serious infections.

How long after an abortion can an IUD be inserted?

If you do not wish to conceive again in the near future after the abortion, an IUD can be inserted during the procedure. Many people now opt for painless abortions, which allow two issues to be addressed in one surgery: terminating the current pregnancy and providing a long-term contraceptive method, eliminating the need for another procedure after menstruation resumes. This is a highly effective approach.

Is follow-up examination necessary after an abortion?

Compared to other surgeries, abortion is considered a minor procedure with mature techniques. However, factors such as an unusual uterine position, pelvic abnormalities, embryonic maceration (where the embryo dies but is not expelled, requiring surgical removal), or limited experience of the surgeon may affect the outcome, leading to incomplete removal of pregnancy tissue.

Retained pregnancy tissue may present as persistent bleeding after the abortion or lower abdominal pain, with ultrasound confirming the residue. In such cases, a urine hCG test should be performed after 2 weeks. A negative result rules out retained tissue, while a positive result requires further evaluation.

Therefore, routine follow-up (including ultrasound if necessary) is recommended 2–4 weeks after an abortion to confirm complete termination and diagnose or treat any complications.

What lifestyle precautions should be taken after an abortion? When should medical attention be sought?

Although an abortion does not have as significant an impact as childbirth, proper rest is still essential. Avoid overexertion, maintain a hygienic and balanced diet, ensure a comfortable indoor temperature, and minimize the risk of other illnesses. Additionally, watch for warning signs such as:

• Fever;
• Worsening abdominal pain unrelieved by ibuprofen or with unclear location;
• Increased vaginal bleeding severe enough to soak a sanitary pad within an hour;
• Drop in blood pressure;
• Purulent vaginal discharge.

PREVENTION

What is the best preventive measure in induced abortion?

Of course, it's effective contraception!

Do not treat abortion as contraception. Regardless of the abortion method, it is always a last-resort solution. Even the least damaging abortion is more harmful than contraception. Therefore, choosing reliable contraceptive methods is the best approach.