What Is an Abortion?

An abortion involves using surgery or taking medicines to end a pregnancy. It’s also sometimes referred to as termination of pregnancy, per MedlinePlus.

According to Planned Parenthood, about 1 in every 4 people who can get pregnant in the United States will have an abortion by the time they’re 45 years old.

The reasons for having an abortion vary, but according to the Mayo Clinic, someone might choose this option if:

• They didn’t intend to get pregnant (Research shows half of people seeking abortion report using birth control in the month before they became pregnant.)
• They no longer want to be pregnant
• They have a medical condition that makes pregnancy life-threatening
• The fetus has a serious medical condition
• They require medical assistance to induce delivery of nonviable fetal tissue after miscarriage or stillbirth (While medical providers would not use the term “abortion” in these scenarios because the pregnancy has already ended, the medications and procedures are the same. However, ongoing abortion restrictions at the state level could prevent women from obtaining this medically necessary care.)

In a study published in the medical journal BMC Women’s Health, researchers analyzed a sample of 954 women from 30 abortion facilities across the United States. They found that women cited many reasons for choosing an abortion, including the following:

• Not being financially prepared
• Bad timing
• Partner-related issues
• The desire to focus on the children they already had
• Concern that the pregnancy would interfere with future opportunities
• Not being emotionally prepared
• Health-related reasons
• Believing the child deserved a better life
• Not being independent or mature enough
• Influences from family or friends

Most of the women studied reported multiple reasons for choosing to terminate their pregnancy. The authors of the paper concluded that a woman’s decision to seek an abortion is influenced by various factors, such as age, health, socioeconomic status, parity, and marital status.

Abortion Legal Barriers

On Jun 24, 2022, the U.S. Supreme Court overturned the decision Roe v. Wade (PDF), which had protected the federal right to abortion for nearly 50 years. As a result, the ability to access abortion is now determined at the state level. State laws can change frequently, but the Guttmacher Institute, a nonprofit organization that supports abortion rights, maintains a database where you can confirm the legal status of abortion in your state.

RELATED: How to Find Trustworthy Abortion, Emergency Contraception, and Birth Control Resources

There are different ways to perform an abortion. Your healthcare provider might recommend a type based on your personal choices, how far along you are in your pregnancy, or other circumstances, notes UCSF Health.

Medication Abortion

A medication abortion, sometimes referred to as a medical abortion, involves taking medications to end your pregnancy.

This type of abortion is typically only an option up until 11 weeks from your last menstrual period, per Planned Parenthood. However, some insurance companies won’t cover a medication abortion after seven weeks of pregnancy, notes UCSF.

A medication abortion is about 95 percent effective at helping someone completely pass a pregnancy without surgery.

The most common medications given for a medication abortion are mifepristone (Mifeprex, RU-486) and misoprostol (Cytotec). Mifepristone blocks the action of the hormone progesterone, which is important for pregnancy. Misoprostol prompts the uterus to contract and empty.

A healthcare provider will give you these medicines at a health clinic. You may take them at the facility or at home, depending on your state laws and your provider’s policies.

You will need to see your provider at least two times: once before taking the medicines and once after you’ve completed the treatment to confirm that the abortion worked.

Medication abortions can take up to 24 hours to complete.

A medication abortion is different than emergency contraception, of which the most common is known as the “morning after pill.” Emergency contraception is used to prevent pregnancy, while a medication abortion is used to terminate a pregnancy.

Surgical Abortion

A surgical abortion, or an “in-clinic abortion,” is a procedure that’s done to remove the pregnancy tissue from a person’s womb (uterus), per MedlinePlus.

According to Planned Parenthood, the two types of surgical abortions are:

• Suction Abortion (Vacuum Aspiration) With this technique, gentle suction is used to empty the uterus. A suction abortion can be performed until about 14 to 16 weeks after your last period. This is the most common type of in-clinic abortion.
• Dilation and Evacuation (D&E) Abortion A D&E involves using suction and surgical instruments to empty a woman’s uterus. Doctors may recommend this type of procedure if it’s been 16 weeks or longer since your last period.

Most in-clinic abortion procedures take about 5 to 10 minutes.

Surgical abortions are usually very successful. According to Planned Parenthood, they work more than 99 out of every 100 times.

Abortion Later in Pregnancy

Abortions occurring at or after 21 weeks of pregnancy are extremely uncommon, per the Kaiser Family Foundation, accounting for only about 1 percent of abortions in the United States. Abortions at this stage of pregnancy are sometimes called “late-term abortions,” although this is a nonmedical term that many healthcare providers take issue with.

A landmark report called “The Turnaway Study” conducted interviews with almost 1,000 women who were seeking abortions. Some were able to get an abortion, while the rest were turned away because they had surpassed their state’s gestational limit. By following up with these individuals multiple times over five years, the study authors were able to compare the physical, emotional, and social outcomes of receiving a wanted abortion versus being denied one.

For people who were able to receive an abortion, the benefits they experienced compared with those who were forced to carry their pregnancy to term included:

• Better Health and Less Chronic Pain Women who were denied an abortion and gave birth experienced more life-threatening complications like eclampsia and postpartum hemorrhage. They also reported more chronic headaches or migraine, joint pain, and gestational hypertension compared with people who were able to get a wanted abortion.
• Better Short-Term Mental Health Those who were denied an abortion reported increased anxiety and stress and decreased self-esteem soon after the procedure was denied. About six months to a year after receiving or being denied an abortion, all women reported similar levels of mental health and well-being.
• Better Economic Security People who were denied an abortion were 4 times more likely to fall below the federal poverty level than those who were able to get an abortion. Women forced to carry a pregnancy to term were also 3 times as likely to be unemployed, and also reported more debt, lower credit scores, and more financial insecurity for multiple years after giving birth.
• More Likely to Graduate With an Advanced Degree Women denied abortion had similar odds of graduating or dropping out of school compared with those who did get an abortion, but those who got one were more likely to graduate with an advanced degree.
• Better Outcomes for Their Existing Children The already existing children of women forced to carry a pregnancy to term were over 3 times as likely to live in poverty, and less likely to achieve developmental milestones compared with the existing children of people who were able to get an abortion.

Legal abortions are considered safe, with very few lasting risks. According to the National Academy of Sciences, pregnant people are nearly 13 times more likely to die in childbirth than to die from receiving an abortion. Between 1988 and 2010, only 0.7 deaths occurred for every 100,000 abortions, versus 8.8 deaths out of every 100,000 births.

Childbirth is riskier for minorities as well. Black women are 3 times more likely to die in childbirth than white women in the United States, according to the Centers for Disease Control and Prevention (CDC), and elevated risks for Native Americans and Alaska Natives follow close behind.

Studies show that early abortions without complications do not affect a woman’s future fertility. Additionally, having an abortion won’t cause pregnancy issues such as birth defects, miscarriage, premature birth, ectopic pregnancy, or infant death down the road, notes Planned Parenthood.

The short-term complications you might experience will depend on the type of abortion you have.

Medication Abortion Risks

According to Mayo Clinic, some short-term physical complications of a medication abortion include:

• Infection
• Heavy or prolonged bleeding
• An incomplete or unsuccessful abortion (which means you may need to have a surgical abortion)

Between 3 and 5 percent of women will need to have a surgical abortion because of persistent or excessive bleeding, continued pregnancy, or their own preferences.

If abortion is illegal in your state, you could face prosecution for completing a medication abortion. Although so far instances of such prosecution have been rare, experts predict they will increase in a post-Roe environment, according to NPR.

In the unlikely case that you have complications from medication abortion that require medical attention, you do not have to tell your healthcare provider you took abortion pills — there is no way for them to tell the difference between a spontaneous miscarraige and one induced with medication, according to the abortion nonprofit Women Help Women.

Surgical Abortion Risks

Rare complications of a surgical abortion may include:

• Very heavy bleeding
• Infection
• Pregnancy tissue left in your uterus
• Injury to your cervix, uterus, or other organs
• An allergic reaction to medications

Additionally, there’s a small chance the abortion won’t work, and your pregnancy doesn’t end. You might need another procedure if this happens, notes Planned Parenthood.

Before a medical or surgical abortion, your provider may perform a urine test, a physical exam, or a blood test. Additionally, you may need to have an ultrasound to confirm how far along you are in your pregnancy and to rule out ectopic pregnancy.

Your healthcare provider will explain how the medicines or procedure will work, the side effects, and the risks.

If you’re having a surgical abortion, you might need the following before your procedure, according to UCSF Health:

• Oral pain medicines, such as Vicodin, Valium, and ibuprofen
• Medicines to soften your cervix, such as misoprostol
• Dilating sticks that are placed in your cervix, such as laminaria or Dilapan
• Antibiotics to help prevent infections
• Sedation drugs

The medicines you require and when you receive them will depend on how far along you are in your pregnancy and the type of abortion you’re having, notes UCSF Health.

If you take Vicodin, Valium, or other sedation medicines, you’ll need to arrange for someone to take you home from the clinic.

Finding a Provider and Clinic

You should know that healthcare providers aren’t required to perform elective abortions, and different states have certain legal requirements, waiting periods, or age restrictions when it comes to abortions, if they’re legal at all. These laws might make it challenging to find a provider or clinic.

Planned Parenthood offers resources for finding clinics and health centers in your area.

Costs and Insurance Coverage

Planning for the cost of an abortion can be challenging for some people. While prices vary, an abortion in the first trimester can run up to $1,500, notes Planned Parenthood. A second trimester abortion usually costs more.

Some insurance plans cover abortions, but others don’t. Check your policy before scheduling your appointment. If your procedure is not covered, you might be able to work out a self-payment option with the clinic.

Community health clinics are often a good option for low-cost care. The centers are funded by the federal government and are usually located in areas with fewer doctors. According to the Health Resources and Services Administration (HRSA), these federally qualified health centers in underserved areas must provide care on a sliding scale based on your ability to pay.

Additionally, your local Planned Parenthood health center may be able to provide you with other options or resources for financial assistance.

How Is an Abortion Performed?

The process will depend on the type of abortion you have.

An abortion feels different for everyone. Some women report intense pain, while others describe it as slight discomfort. Your doctors and nurses will try to make your abortion as comfortable as possible, notes Planned Parenthood.

Medication Abortion

For a medication abortion, your provider will give you one tablet of mifepristone that you usually take in the clinic, according to Mayo Clinic, although some states allow telehealth for first trimester medication abortions

Then, hours or days later, you’ll be instructed to take misoprostol, usually at home. Your provider may also give you antibiotics to prevent an infection.

About a week later, you’ll meet with your provider to make sure the abortion is complete.

Suction Abortion

If you’re having a suction abortion, according to Planned Parenthood, a healthcare professional will first examine your uterus and use a speculum to see inside your vagina. Then, they will:

• Inject numbing medication into your cervix
• Stretch the opening of your cervix with dilating rods
• Insert a thin tube into your uterus
• Use a small suction device or machine to remove the pregnancy tissue out of your uterus

Additionally, the doctor may use a tool to remove any tissue that’s still left in your uterus or to confirm that your uterus is completely empty.

After the suction abortion is over, you’ll stay in a recovery area for about an hour or until you feel well enough to go home.

While the procedure itself only takes about 10 minutes, your appointment will be longer due to prep and recovery time.

D&E Abortion

You’ll probably be sedated for a D&E procedure.

First, your doctor will prepare your cervix with medicines that help open it. Dilator sticks (laminaria) are often given a few hours or a day before a D&E.

To begin the procedure, a healthcare provider will look at your uterus and examine inside your vagina with a speculum. Then, they will:

• Inject a numbing medication into your cervix
• Stretch the opening of your cervix with dilating rods
• Insert a thin tube into your uterus
• Use surgical instruments along with a suction device to remove the pregnancy tissue from your uterus

The procedure typically takes about 10 to 20 minutes, but your appointment will be longer due to the prep and recovery time.

You’ll wait in a recovery room for up to an hour or until you feel well enough to leave.

Most people heal quickly after an abortion, but your recovery might depend on the type of abortion you had and how far along you were in your pregnancy.

Recovery After Medication Abortion

If you have a medication abortion, you should plan to rest on the day you take your second medicine. You might feel tired for a couple of days after this dose, notes Planned Parenthood.

You can usually resume most normal tasks, such as going to work or driving, the next day. However, don’t perform any strenuous activities, such as heavy exercise, for several days.

You might bleed or spot sporadically for several weeks after your medication abortion.

Follow your provider’s instructions carefully. Let them know if you experience nausea, vomiting, diarrhea, or a fever for more than 24 hours after taking misoprostol.

You can have sex as soon as you feel ready (but again, it's important to use contraception if you want to avoid pregnancy).

Your normal periods should resume four to eight weeks after the abortion, but this will depend on your birth control method.

Recovery After Surgical Abortion

The day after a surgical abortion, you can usually resume regular activities, such as driving and working, if you feel up to it. You can also have sex as soon as you feel well enough, though be sure to use reliable contraception if you wish to prevent pregnancy, notes Planned Parenthood.

You’ll probably experience some cramping or bleeding. Pain medicines, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), can help with the discomfort.

You might bleed or spot for several weeks, but some people don’t bleed at all. Your healthcare provider may recommend that you use pads, so you can keep track of how much you bleed.

You should get a normal period about four to eight weeks after your procedure, but this might vary if you use certain birth control methods.

Be sure to follow all your doctor’s instructions after your procedure. Call your provider right away if you:

• Soak through two pads per hour for two hours
• Have pain or cramps that don’t get better with medicine
• Have a fever of 100.4 degrees F or higher

If you’re considering an abortion, you’re not alone. Many resources are available to help you through the process. Here are some of Everyday Health’s favorites:

Abortion Finder

AbortionFinder.org features more than 750 health centers and offers a comprehensive directory of trusted and verified abortion service providers in the United States. You can also find information about how the laws in your state may affect your ability to get an abortion.

The Guttmacher Institute

The Guttmacher Institute is a nonprofit organization supporting abortion rights. It maintains an up-to-date database of the legality of abortion in all 50 states and the District of Columbia, in addition to other abortion information resources.

Planned Parenthood

Planned Parenthood is a nonprofit organization that delivers vital reproductive healthcare, sex education, and information to millions of people around the world. On their site, you can search for clinics in your area and even chat with a health educator who can answer any questions or concerns you have about your pregnancy options.

National Abortion Federation (NAF)

The mission of the NAF is to unite, represent, serve, and support abortion providers in delivering patient-centered, evidence-based care. Their toll-free hotline provides callers with abortion referrals and financial assistance services. You can also locate a provider in your area right on their website.

National Network of Abortion Funds (NNAF)

The NNAF aims to remove financial and logistical barriers to abortion access. They help connect people seeking an abortion with organizations that can assist with the costs of having one.

Resources to Avoid: Crisis Pregnancy Centers

In every state there are clinics sometimes called “crisis pregnancy centers” or “pregnancy resource centers” that present themselves as abortion clinics or healthcare facilities, and that specifically target people looking for information on abortion, according to Planned Parenthood.

These clinics do not present the full range of options when it comes to making a decision about an unwanted pregnancy. Oftentimes, they even intentionally mislead people seeking information, for example by telling them the lie that abortion can cause infertility. Resources like the Crisis Pregnancy Center Map and Expose Fake Clinics have searchable lists of predatory crisis pregnancy centers that you can use to make sure the clinic you select is reputable.

Next Steps and Recommendations

Most women can start on hormonal or nonhormonal birth control immediately after having an abortion.

Some options include:

• The pill (available in a variety of formulations)
• A progesterone implant (Nexplanon)
• Intrauterine devices (IUDs), with or without hormones
• A progesterone shot (Depo-Provera)

In cases of surgical abortion, providers can insert an IUD in your uterus at the same time you undergo the procedure.

If you’re interested in a birth control method, your provider can walk you through your options.