Do abortions affect future pregnancies?
If you have had an abortion and are hoping to have children at a later time it is natural to be thinking ‘do abortions affect future pregnancies?’. Though the answer to it cannot be in the form of an absolute ‘no’ or ‘yes’, we will try to bring to you as much clarity on the matter as possible.
We are a premier and probably among the very few government recognized abortion centers in Chennai.
An abortion is not what is expected to affect your ovaries or its ability to produce healthy eggs. So when done in a safe setting by a qualified and well-trained practitioner, having an abortion should not interfere with your ability to get pregnant again in the future.
Procedures done as part of surgical abortion may sometimes have lasting effects on your reproductive organs such as the uterus and its various parts. Such effects on the uterus may be much more severe in case of complications arising from surgical procedures done for abortion. Complications arising from surgical abortion are usually rare and chances of such complications arising are minimal in the hands of experts.
Whatever be the reason for which you have undergone an abortion and whether it was years ago or recently, the chances of you having difficulty getting pregnant in the future are very rare. Do abortions affect future pregnancies?. We will try to clarify that in this article
A medical abortion only involves taking oral medicine. So they should have minimal effects on your reproductive organs. Whereas a surgical abortion involves inserting instruments into the cervix and the uterine cavity. The instruments have the potential to cause damage to the cervix and the uterus.
The damage may lead to scarring of the uterus, more when done multiple times. But the possibility of scarring also exists in pregnancies that end in cesarean delivery. We will hereby describe the various effects on future pregnancies caused by such injury or scarring of the uterus.
- Retained placenta
Retained placenta is when the placenta fails to separate spontaneously after delivery of the baby.
The possibility of retained placenta in future pregnancies is higher in women who have undergone a surgical abortion in the past.
It is probably due to the injury caused to the uterine lining. In case of retained placenta, the manual removal of the placenta may be needed. The manual removal of the placenta is generally performed under sedation or general anesthesia.
- Placenta previa
Placenta previa is when the placenta gets attached inside the uterus but near or over the opening of the uterine cervix.
This may lead to spontaneous vaginal bleeding during pregnancy from the placental blood vessels. The placenta may get attached at the site of the uterine scar caused by surgical abortion procedure done in the past leading to placenta previa.
The woman will be at risk of bleeding during the second half of pregnancy. Profuse bleeding may warrant early termination of pregnancy by cesarean section in view of saving lives of mother and baby.
If placenta previa is of low grade and of lesser severity, vaginal delivery may be attempted with all the arrangements for an emergency cesarean section on standby.
- Intrauterine adhesions
Formations of adhesions between the lining wall of the uterus occur rarely following procedures such as dilatation and evacuation.
The intrauterine adhesions will distort the uterine cavity.
A distorted uterine cavity may lead to failed implantation of an embryo following fertilization leading to difficulty in getting pregnant. Though very rare such intrauterine adhesions generally develop following multiple abortions. The risk of such intrauterine adhesions developing following a single abortion is near zero.
- Cervical incompetence
Cervical incompetence is a condition where there is cervical weakness and the mouth of the cervix begins to open up before the pregnancy reaches term.
Cervical weakness ensues in women who sustain an injury to the cervix during the surgical abortion.
The instruments used to dilate the cervix during surgical abortion procedures may cause tearing or laceration of the cervix. Such injuries are minimal in the hands of experts.
If such injuries occur, they should be recognized early and repaired promptly so as to avoid cervical incompetence in future pregnancies. The treatment for a cervical tear or laceration is immediate surgical repair.
- Perforation of the uterus
The wall of the uterus may get perforated through and through by the instruments used in surgical abortion. Such perforation of the uterus needs to be identified early.
Complications such as perforation of the uterus are minimal when surgical abortion is done in a safe setting by experienced practitioners.
If the perforation is small it must be surgically repaired at the earliest to avoid further complications. If the perforation is too large, the woman may lose her womb as the uterus may have to be removed so as to save her life. Such serious complication may take away from the woman her ability to bear a child in future.
Now you are aware of all the possible injuries that can be caused to your reproductive organs during a surgical abortion procedure and the effects those injuries may have on your future pregnancies. It may have made you realize the importance of approaching a recognized and well-equipped abortion center with well-trained practitioners for the purpose of an abortion.
Whatever may be the method of abortion – medical or surgical, it has been shown that abortion has some effects on future pregnancies which you may want to be aware of.
Ectopic pregnancy:-
Ectopic pregnancy is a pregnancy that occurs anywhere outside the uterus and it most commonly occurs within the fallopian tubes. After abortion women are found to be about 8 times more likely to have an ectopic pregnancy in the future.
If pregnancy is suspected in a woman, an ultrasound scan should be done to rule out an ectopic pregnancy. If an ectopic pregnancy is detected treatment should be initiated promptly. Allowing an ectopic pregnancy to continue may cost a woman her life if the ectopic pregnancy ruptures.
The treatment of ectopic pregnancy may be medical or may involve surgically removing the fallopian tube containing the pregnancy, depending on the individual woman’s clinical condition.
Rh incompatibility:-
If the woman undergoing abortion has Rh-negative blood group, it is important to identify the blood group of the baby being aborted. If the aborted baby has Rh-positive blood group, the woman needs to be immunized with anti-D immunoglobulins to avoid antibody response by the woman’s immune system.
An antibody response may be triggered by mixing of maternal and fetal blood as a result of which the woman’s immune system gets exposed to fetal blood.
Even in very early abortions done before 8 weeks, feto-maternal hemorrhage can occur leading to mixing of maternal and fetal blood. Such Rh antibodies if formed may result in Rh incompatibilities in future pregnancies. These Rh incompatibilities can :
- Require that future baby, if Rh-positive may need blood transfusions soon after birth
- Cause future Rh positive babies to be born dead because of incompatibility
- Cause future Rh positive babies to die soon after birth due to incompatibility.
Low birth weight:-
It is likely that women who have had an abortion in the past may have low birth weight babies in the future. Though the exact reason has not been ascertained, studies show that women who have had an abortion are more likely to deliver low birth weight babies in the future
To minimize the chances of delivering a low birth weight baby and for improved maternal health status, it is advised to avoid getting pregnant within 3 months from the time of having had an abortion. The woman’s reproductive organs need at least 3 months to recuperate following an abortion process. Even the blood lost during an abortion has to be replenished so as to avoid maternal anemia during future pregnancies.
Preterm delivery:-
Preterm delivery is more likely in women who have had at least one abortion in the past when compared to those who have not had abortions. Preterm delivery comes with a lot of complications to the baby.
The preterm baby may suffer problems such as respiratory distress due to inadequate lung maturity. A preterm baby may need prolonged neonatal ICU care which may also add to the costs. Caregivers of a preterm infant also need to be extra cautious.
Spontaneous abortions:-
The risk of spontaneous abortions in the future is higher in women who have had abortions. The reason for this increased risk of spontaneous abortions in women who have had an abortion is not clearly known.
Pelvic inflammatory disease:-
Abortions are sometimes associated with incomplete clearance of the uterine cavity leading to retained products of conception. Such retained products of conception, if left undetected or untreated may lead to serious infections of the uterus and fallopian tubes.
Retained products of conception must be identified early and treated by dilatation and curettage. Infections may also be introduced into the uterus by unsterile instruments used for surgical abortion procedures.
The infection of the uterus and fallopian tubes may present in the form of abdominal pain and foul-smelling vaginal discharge. The infected fallopian tubes may get blocked in the future due to scarring.
A blocked fallopian tube may lead to infertility problems in the woman. The fallopian tube blockage prevents the ovum released by the ovaries, from reaching the sperm for fertilization.
A follow-up post-abortion is important to rule out retained products of conception. So it is evident how important it is to choose a recognized abortion clinic where abortion happens in a safe setting.
Secondary infertility:-
About 1 out of 50 women become sterile after an abortion. If a woman who has previously conceived spontaneously has difficulty in conceiving a baby, it is referred to as secondary infertility. Sometimes the reason for infertility in women who have previously had an abortion is not evident. Such infertility issues after an abortion are extremely rare though.
Psychological impact:-
Psychological stress surrounding abortion may sometimes affect the woman’s future pregnancy if not identified and treated promptly. Psychological issues such as depression associated with an abortion may go unnoticed for a prolonged period.
Emotional disturbances may range from sleeplessness to suicidal thoughts and may take anywhere between few days to years to become evident. Depression associated with an abortion experience in the past may worsen with pregnancy.
Women may also face attachment and relationship problems with the spouse or partner following an abortion which may also affect her chances of getting pregnant in the future. So it is important to extend emotional support to the woman suffering from psychological stress following an abortion.
How to get pregnant after an abortion?
It is very important to know that a woman may be fertile even before her next period following an abortion. A woman may get pregnant even as early as 2 weeks following an abortion.
Most women do not face problems conceiving a baby even if she has had an abortion in the past.
It is better to wait for at least a month following an abortion before trying to get pregnant again. The lining of the uterus needs at least a month to heal before it is completely ready to implant an embryo. The ideal thing is to wait for at least 3 months following an abortion before you get pregnant again. The 3 months of time helps the woman’s body recuperate well from the stress of abortion.
Overall, having an abortion, whatever be the reason she chooses to have it, doesn’t leave a woman unable to get pregnant later in life if or when she is prepared to have a baby.
All that matters is that you do not adopt unsafe methods of abortion with or without non-medical assistance. Unsafe abortions can cause permanent damage to your reproductive organs and narrow your chances of having a baby in the future. It may even cost a woman her life. So it is important you seek abortion assistance at a recognized abortion clinic
Hope this article helped get rid of your worries about the safety of abortions such as ‘do abortions affect future pregnancies?’.
References:-
- The effect of pregnancy termination on future reproduction
- Manual vacuum aspiration and future pregnancies