What to Know About Abortion for Medical Reasons

Abortion, sometimes called the termination of a pregnancy, is a medical procedure that can be done for a variety of reasons. When an abortion is performed for medical reasons, it is sometimes referred to as a "therapeutic abortion." Therapeutic abortion is most often discussed in cases where the fetus has a condition that is incompatible with life or when the health or life of the pregnant person is at risk. Other cases where abortion may be considered for medical reasons are less straightforward.

Anyone who has ended a pregnancy has their own reasons for choosing abortion—and they are all valid—but if you're curious about what medical reasons for an abortion might look like, here is more information.

Medical Reasons for Abortion

Abortion is a common procedure. According to the Guttmacher Institute, over 862,000 abortions were performed in the US in 2017.

A study from the same year reveals that the reasons for abortion vary widely. The study polled pregnant people from 14 different countries and found that socioeconomic concerns and personal reasons like not wanting any more children or not wanting children at that point in time were some of the most common reasons for abortion. In most cases, the survey showed that people often have more than one reason for having an abortion. Risks to maternal and fetal health were also among the top reasons people chose abortion.

Fetal anomalies and congenital disorders

Prenatal care providers may do screening or diagnostic tests in the first and second trimesters of pregnancy, which can include ultrasound, noninvasive prenatal testing (NIPT), chorionic villus sampling (CVS), or amniocentesis. Occasionally, these tests uncover a condition that could negatively impact the baby's quality of life, or that could result in fetal death before or shortly after birth. In some cases, severe congenital disorders are considered medical reasons for abortion.

These conditions may include:

• Genetic abnormalities that can affect the child's well-being, like trisomy 13, trisomy 18, Down syndrome, Turner syndrome, Tay-Sachs disease, and DiGeorge syndrome
• Birth defects including severe neural tube defects such as anencephaly (lack of development of the brain or skull), kidney abnormalities resulting in a lack of amniotic fluid, and heart defects with poor post-birth prognosis
• Severe twin-to-twin transfusion syndrome

Maternal health conditions

The American College of Obstetricians and Gynecologists (ACOG) explains that there are "situations where pregnancy termination in the form of an abortion is the only medical intervention that can preserve a patient’s health or save their life."

That is to say that there are times when abortion is medically indicated, either because of a severe pregnancy complication or a medical condition that makes pregnancy dangerous or has limited treatment options that aren't safe for pregnancy.

U.S. News & World Reports explains that exact statistics about abortions for maternal health reasons are hard to pinpoint because medical issues can arise at any point in a pregnancy and the decision-making process between the pregnant person and their doctor is complex and personal. Some possible health conditions that may result in therapeutic abortion include:

• Ectopic pregnancy or complete molar pregnancy
• Preterm premature rupture of membranes (PPROM) before fetal viability
• Severe preeclampsia before fetal viability
• Certain chronic health conditions such as cancer, lupus, cystic fibrosis, pulmonary hypertension, cardiac disease, or kidney disease
• Infection, hemorrhage, or sepsis
  

An abortion can also be performed for mental health.

Methods for Terminating a Pregnancy

Doctors end pregnancy using safe and evidence-based techniques. The exact technique used will depend on several factors, including how far along the pregnancy is and the reason for termination.

The ACOG explains that there are two main types of abortion: medication abortion and procedural abortion.

Medication abortion

Medication abortions typically use two medications to end the pregnancy. Medication abortion is most often used in the first 10 weeks of gestation. A person will take two separate pills—mifepristone and misoprostol—to thin the uterine lining and release the pregnancy.

Most people experience heavy bleeding, clots, and cramping with a medication abortion. Other side effects like nausea, diarrhea, fatigue, and mild fever may also occur.

Procedural abortion

In a procedural abortion, a doctor manually dilates the cervix and uses tools to remove the pregnancy. Before 10 weeks gestation, this can be done outpatient using a suction device called a manual vacuum aspirator. Alternatively, the procedure can be performed in an operating room, where it's more commonly referred to as dilation and curettage (D&C).

After 14 weeks, doctors may use specialized tools in a technique called dilation and extraction (D&E). These minimally invasive procedures are more than 99% effective and are very safe. Side effects of procedural abortion include bleeding and cramping.

Finding Support After Abortion

No matter the reason for choosing an abortion, a health care provider can serve as a guide through the entire process, including connecting you to appropriate specialists, such as high-risk obstetricians, genetic counselors, therapists, pediatric surgeons, and developmental pediatricians for more information.

Perinatal social workers or therapists may also help prepare you for the emotions that may accompany an abortion. It is normal to feel a wide range of emotions after ending a pregnancy. No one person will react the same way to needing or having an abortion, so it is important to work with a professional who can help support you along your own personal journey.