IMPACT
ABORTION
Short-Term Health Risks
Abortion procedures, like other medical interventions, carry potential risks that may affect both immediate and longer-term health outcomes. While serious complications are generally uncommon in modern clinical settings, they are documented in medical literature and require prompt recognition and treatment when they occur (World Health Organization 2022; ACOG 2020).
Hemorrhage is a recognized complication associated with abortion procedures. Although most patients experience only light to moderate bleeding, excessive bleeding can occur and may require medical management such as uterotonic medications, repeat uterine evacuation, or, in rare cases, surgical intervention. Clinical guidance emphasizes the importance of identifying abnormal bleeding and seeking urgent medical evaluation when heavy bleeding is present (World Health Organization 2022; National Health Service 2023).
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Infection is another documented risk. Post-procedural infections may occur if bacteria enter the uterus, particularly in cases involving retained tissue or compromised sterile technique. Clinical symptoms may include fever, abdominal pain, and abnormal or foul-smelling vaginal discharge. Early diagnosis and treatment with antibiotics are critical to prevent progression to more severe illness (ACOG 2020; World Health Organization 2022).
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Damage to reproductive organs is a recognized but uncommon complication, particularly in surgical abortion procedures that involve cervical dilation and intrauterine instrumentation. Cervical lacerations or uterine injury can lead to bleeding, infection, or scar formation, and in some cases may affect future pregnancy outcomes. Medical guidelines emphasize careful procedural technique and follow-up monitoring to reduce these risks (Kapp and Lohr 2020; ACOG 2020).​
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Uterine perforation is a rare but serious complication associated with instrumented uterine procedures. Perforation can lead to internal bleeding or injury to adjacent organs such as the bowel or bladder, sometimes requiring surgical repair. Although uncommon, it is a well-documented risk in gynecologic procedural literature (Kapp and Lohr 2020).
In rare cases, infection can progress to sepsis, a life-threatening systemic inflammatory response to infection. Sepsis requires immediate treatment, typically including intravenous antibiotics, fluid resuscitation, and supportive care due to the risk of septic shock and organ failure (Merck Manual Professional Edition 2023).
Long-Term Health Effects
Medical research has examined whether prior uterine or cervical procedures may influence outcomes in later pregnancies. Some large studies have found that women with a history of induced abortion have modestly higher odds of preterm birth in later pregnancies. For example, one large meta-analysis found about a 36% increase in statistical odds of preterm birth after one prior induced abortion and about a 93% increase in statistical odds after multiple prior abortions (Shah and Zao 2009).
Researchers have proposed several possible biological explanations, including cervical injury or changes to the uterine lining after procedures involving dilation or uterine instrumentation. Studies examining dilation and curettage (used in miscarriage management and some abortion procedures) have also found an association with increased likelihood of later preterm birth (Lemmers et al. 2016). However, most evidence is observational, and clinical guidelines note that these findings do not establish direct causation (Royal College of Obstetricians and Gynaecologists 2011).
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Research also shows that abnormal placental attachment—such as placenta previa or placenta accreta spectrum—can increase risks including preterm birth and maternal hemorrhage. Prior uterine surgery or procedures are considered part of the overall risk profile for these conditions, along with factors such as prior cesarean delivery (Jauniaux et al. 2018).
Abortion Pill Risks
Medication abortion, most commonly involving the drugs mifepristone followed by misoprostol, is widely used in early pregnancy and has been extensively studied in peer-reviewed medical literature. Like all medical interventions, however, it carries potential risks. The most commonly reported significant complication is heavy or prolonged bleeding. While bleeding is an expected part of the medication abortion process, a small percentage of patients experience hemorrhage requiring medical treatment, including intravenous fluids, blood transfusion, or surgical intervention. Large cohort studies and systematic reviews consistently report that serious hemorrhage is uncommon but documented in clinical settings, typically occurring in well under 1% of cases (Cleland et al. 2013; Upadhyay et al. 2015).
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Another recognized risk is incomplete abortion or ongoing pregnancy, in which the medications do not fully end the pregnancy. In these cases, additional doses of medication or a surgical procedure may be required. Reported rates vary depending on gestational age and treatment protocol, with effectiveness generally slightly decreasing as pregnancy progresses. Follow-up care is therefore considered an important part of medication abortion protocols to ensure completion and to monitor for complications (Raymond et al. 2013; Kapp et al. 2018).
Infection is also documented in the medical literature, though serious infections are rare. Symptoms may include fever, severe abdominal pain, or abnormal discharge, and most infections respond well to antibiotics when identified early. Another important medical concern is undiagnosed ectopic pregnancy, which medication abortion does not treat. If an ectopic pregnancy is missed, rupture can occur and become life-threatening, which is why screening and evaluation before treatment are emphasized in clinical guidelines (Chen and Creinin 2015; Cleland et al. 2013).
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In addition to these complications, many patients experience temporary side effects such as nausea, vomiting, fever, chills, diarrhea, and significant cramping. These symptoms are common and typically resolve without long-term harm. Overall, peer-reviewed research generally concludes that serious complications from medication abortion are uncommon, but they remain medically important and require access to follow-up care and emergency treatment when necessary (Kapp et al. 2018; Raymond et al. 2013).
Psychological & Emotional Impact
Research in psychology and psychiatry shows that women experience a wide range of emotional responses after abortion. While many report relief or neutral emotions, some experience grief, sadness, regret, guilt, or a sense of loss. These responses appear more likely among women who felt conflicted about the decision, lacked social support, or held moral or religious beliefs that emphasize the value of unborn life.
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Some longitudinal studies have found statistical associations between abortion and later reports of certain mental health challenges. Researchers emphasize that these outcomes are influenced by multiple factors, including prior mental health history, socioeconomic stressors, relationship stability, and life circumstances. In this context, abortion may be one factor among many associated with later emotional distress for some women (Fergusson, Horwood, and Ridder 2006).
​Clinical and psychological literature also notes that some women report grief responses similar to other forms of pregnancy loss, including persistent sadness, intrusive thoughts, or emotional conflict. However, estimates of how often this occurs vary significantly depending on study design, population, and methodology (Major et al. 2009; Coleman 2011).
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Major medical and psychological organizations state that most women do not develop diagnosable long-term mental health disorders directly attributable to abortion. However, this does not mean abortion is emotionally neutral for all women. Some women report lasting feelings of grief, regret, or emotional pain, highlighting the importance of honest risk discussion and access to emotional and psychological support.
Findings from the Turnaway Study add additional context to understanding emotional outcomes related to abortion decisions. Long-term follow-up data show that women who obtained abortions often reported, even years later, that the decision was right for them (Rocca et al. 2020). At the same time, extended analyses of women denied abortions show that emotional responses can change substantially over time. In long-term reporting, the proportion of women who indicated they no longer wished they had obtained an abortion increased from about 35% one week after denial to approximately 88% by the time of birth, 93% by one year postpartum, and about 96% five years later (Foster 2020). These findings suggest that women denied abortions often adapt to their circumstances over time, while women who obtain abortions may also remain confident in their decision. Together, these results illustrate that different groups of women may follow different emotional trajectories over time.​