Women who have terminated a previous pregnancy often worry about the possibility of conception after abortion. But, for most women, conceiving again shouldn't be a problem.
Types of Abortions
In the United States, there are two types of abortion procedures available to most women.
- Medication-based abortions: These abortions are available up to about nine-weeks gestation. After meeting with a physician and having medical tests, a woman is given a tablet of mifepristone, which changes the hormones needed to continue a pregnancy. After taking this pill, the fetus stops growing and the uterus is no longer able to support a pregnancy. Because a woman's body may not expel the pregnancy tissue on its own right away, the medication misoprostol is taken a few days after the mifepristone. This pill causes the uterus to begin contracting and is similar to a very heavy period.
- Surgical abortion: The two main types of surgical abortions are aspiration, which uses a vacuum to empty the uterus, and a dilation and evacuation (D&E) procedure, which uses surgical instruments to remove the fetus and surrounding tissue. Medications are also given to control pain and to reduce infection rates. The type of surgical abortion that is performed depends on how far along a pregnancy is and other health concerns.
One of the most important aspects of any abortion is having proper follow-up care in the days and weeks following the procedure. Infection, excess bleeding, and fevers all need to be addressed and treated quickly to minimize the long-term effects on the patients.
Conception After Abortion
Most women who have a medication-based abortion will not have problems conceiving in the future as long as there are no untreated infections or remaining tissue. Conception after abortion should also not be a problem for women who have the surgical procedure, assuming that the abortion is performed in a sterile environment with proper medical supervision and equipment.
There are, however, some instances when a woman may have difficulty with conception after abortion, including:
- Multiple abortions: Procedures that occur inside the uterus, whether abortions or other surgeries, may produce scar tissue that can make it difficult to conceive, especially if the scarring occurs near the fallopian tubes.
- Cervix weakening: Any procedure that forces the cervix to dilate and open may weaken it, especially if it has happened more than once. Doctors may be able to do a simple procedure to help it stay closed during pregnancy, so it's important that the OB/GYN knows the full history of the patient.
Trouble Conceiving After Abortion
Most studies do not find any relationship between properly performed abortions and infertility. The average couple will conceive within a year of actively trying, but there are some methods that couples can try to increase their chances:
- Ovulation monitoring: Knowing exactly when ovulation occurs can dramatically increase the possibility of conception. Most women with regular cycles will ovulate 14 days before their period is due, but this can vary by a few days. Using an over-the-counter ovulation predictor can help pinpoint ovulation day.
- Lifestyle modifications: Smoking, drug use, obesity, and poor nutrition can all affect a woman's fertility. Changing unhealthy habits may help improve the likelihood of conceiving.
- Fertility testing: After several months of trying unsuccessfully, a couple may want to be tested to see if there is a medical reason for not conceiving. The Fertell Fertility Test is an inexpensive, over-the-counter kit that can give couples preliminary information on both partners.
- Seeing a specialist: If a couple has been unable to conceive for 12 months, or 6 months if the woman is 40 or above, they should consider seeing a fertility specialist for guidance. Possible treatment options include fertility medications or assisted reproductive techniques such as intrauterine insemination or in vitro fertilization.
A woman who has had a past abortion is not at a higher risk for fertility problems as long as her body has properly healed from the procedure and she has not had any complications from the abortion.