An induced abortion is a medical procedure used to end a pregnancy intentionally. This distinguishes it from a spontaneous abortion, which is the unplanned loss of a pregnancy before 20 weeks, more commonly called a miscarriage. Around 73 million induced abortions take place worldwide each year, according to the World Health Organization. The term covers a range of methods depending on how far along the pregnancy is and the reason for ending it.
Elective vs. Therapeutic Abortion
Induced abortions fall into two broad categories. An elective abortion is performed at the pregnant person’s request, without a specific medical diagnosis driving the decision. A therapeutic abortion is performed after a physician determines there is a medical necessity, such as a serious risk to the pregnant person’s health or a diagnosis that the fetus cannot survive outside the womb.
Therapeutic abortions sometimes occur later in pregnancy, after the first trimester, when a fetal condition is detected or when the pregnancy begins to pose a physical danger or severe psychological harm to the mother. Unlike elective terminations, therapeutic abortions require a clinical evaluation by a physician confirming the medical indication.
Medication Abortion
Medication abortion uses a two-drug regimen to end an early pregnancy. It is FDA-approved for use through 10 weeks of gestation, counted from the first day of the last menstrual period.
The first medication works by blocking progesterone, the hormone that maintains the uterine lining and supports the pregnancy. Without progesterone, the lining begins to break down. The drug also triggers the body to produce natural compounds called prostaglandins, which cause the uterus to contract. A second medication, taken 24 to 48 hours later, intensifies those contractions and helps the uterus expel the pregnancy tissue. The experience is similar to a heavy, crampy period, and most of the process happens at home.
Surgical Abortion: First Trimester
When a pregnancy is under 14 weeks, a suction aspiration procedure can be completed in a single clinic visit. During the procedure, a clinician opens the cervix gradually using thin rods, then inserts a narrow flexible tube into the uterus. Gentle suction through the tube removes the pregnancy tissue. The cervix is numbed beforehand, and the procedure itself typically takes only a few minutes.
Surgical Abortion: Second Trimester
For pregnancies beyond the first trimester, a procedure called dilation and evacuation (D&E) is used. It combines suction with additional instruments when needed to remove pregnancy tissue completely. An ultrasound is performed before and sometimes during the procedure to confirm the gestational age and verify that all tissue has been removed. Medications to manage pain and help with relaxation are given beforehand. D&E is the most common method for second-trimester abortions and is performed in a clinic or hospital setting.
How Safe Is Induced Abortion?
Major complications from induced abortion are rare. A large study published in the New England Journal of Medicine found an overall major complication rate of 0.23%, meaning fewer than 3 in every 1,000 procedures resulted in a serious problem. First-trimester surgical abortions had the lowest rate at 0.16%. Medication abortions came in at 0.31%, and second-trimester surgical abortions at 0.41%.
When major complications did occur, the most common were heavy bleeding (31% of complications), infection (28%), and incomplete removal of pregnancy tissue (23%). Uterine perforation, where an instrument creates a small hole in the uterine wall, accounted for just 2% of major complications.
What Recovery Looks Like
Most people can return to normal activities the day after a procedure. Bleeding can last up to a week continuously, or come and go for up to four weeks. The flow varies from light to fairly heavy and tends to increase with physical activity and decrease with rest. Small blood clots, ranging from red to dark purple, are normal.
Cramping typically lasts a few days. Some people experience a second wave of heavier bleeding and cramps around four to six days after the procedure. Pregnancy symptoms like nausea, vomiting, and fatigue usually resolve within three days. Breast tenderness and swelling take about seven to 10 days to fully subside.
A normal menstrual period returns within four to seven weeks, though the first few cycles may be irregular. If you start a hormonal birth control method like the pill, patch, or ring on the same day as the procedure, your next period will follow the schedule of that contraceptive cycle.