In Australia, abortion is a common type of surgery and is thought to be a physically safe procedure. But every medical procedure carries some level of risk. Your doctor will explain the abortion procedure to you and ask you to consent to the procedure.
As with all surgery the risks must be clear to the person agreeing to the medical procedure. RCOG (Royal College of Obstetricians and Gynaecologists) provide information for doctors to describe risk in a way that helps people understand the level of risk in an abortion procedure.
The College recommends that doctors use the following list of descriptions for explaining risk –
‘Very common’ means 1 patient in 1 to 1 patient in 10 will experience a certain symptom
‘Common’ means 1 patient in 10 to 1 patient in 100
‘Uncommon’ means 1 patient in 100 to 1 patient in 1000
‘Rare’ means 1 patient in 1000 to 1 in 10 000
‘Very rare’ means less than 1 patient in 10 000
RCOG guidelines for abortion recommend that women are informed about the kinds of risks they may face from having an abortion.
The list below shows many of the possible risks of abortion and the level of risk to indicate how common each one is. The information is followed by the RCOG recommendations to medical providers –
Very Common – Pain, gastrointestinal upset, bleeding.
The most common physical symptoms are pain and bleeding.
Gastrointestinal symptoms are frequent, particularly after medical abortion.
Women who choose medical abortion at less than 14 weeks report more pain and gastrointestinal symptoms than those choosing surgical abortion. More bleeding is reported by women choosing medical abortion than surgical because of the different types of procedure.
RCOG Recommendation – Women should be advised of these symptoms and when to seek further advice if they experience a symptom.
Common – Failed abortion, continued pregnancy, post-abortion infection
Failed abortion and continued pregnancy – surgical and medical methods of abortion carry a small risk of failure to end the pregnancy (less than 1 in 100), necessitating another procedure.
RCOG Recommendation – Women should be informed that there is a small risk (usually much less than 5%) of the need for further intervention, such as surgical intervention following medical abortion or re-evacuation following surgical abortion.
Infection of varying degrees of severity may occur after medical or surgical abortion and is usually caused by pre-existing infection.
RCOG Suggestion – Prophylactic (preventative) antibiotic use and bacterial screening for lower genital tract infection reduces this risk.
Uncommon – Heavy bleeding, uterine perforation, damage to the cervix
Severe bleeding requiring transfusion; the risk is lower for early abortions, occurring in less than 1 in 1000, rising to around 4 in 1000 at gestations beyond 20 weeks.
Uterine perforation (surgical abortion only); the risk is in the order of 1–4 in 1000 and is lower for early abortions and those performed by experienced clinicians.
Damage to the cervix – (surgical abortion only)
Damage to the vagina – (surgical abortion only) is lower for early abortions and those performed by experienced clinicians.
RCOG Guideline – Women must be informed that, should one of these complications occur, further treatment in the form of blood transfusion, laparoscopy or laparotomy may be required.
RCOG Recommendation – Women should be informed of the uncommon complications that may occur and of their possible clinical consequences.
Rare – Uterine Rupture
Uterine rupture has been reported in association with medical abortion at late gestations. The risk is less than 1 in 1000.
RCOG Recommendation – Women should be informed of this rare but serious complication that may occur.
Unrelated to abortion – Breast cancer, ectopic pregnancy, infertility, placenta previa
Induced abortion is not associated with an increase in breast cancer risk
There are no proven associations between induced abortion and subsequent ectopic pregnancy, placenta praevia or infertility
RCOG Recommendation – Women should be informed that induced abortion is associated with a small increase in the risk of subsequent preterm birth, which increases with the number of abortions. However, there is insufficient evidence to imply causality.
You can read more about the risks and RCOG guidelines here.