Version July 2025
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ABORTION OVERVIEW —
Abortion, also known as pregnancy termination, is a way to end a pregnancy. This can be done by taking medications or having a procedure.
People choose to have an abortion for many different reasons. For example, they may have become pregnant but decided it is not a good time to have a baby; they might have a health problem that makes pregnancy unsafe; or they might have learned that their fetus has an unexpected diagnosis.
Deciding to have an abortion is a personal and medical decision. This article provides information about the different types of abortion, the benefits and risks of each approach, as well as the alternative of continuing the pregnancy. It also explains what to expect during and after an abortion. If you have other questions or concerns, talk with your health care provider if possible, or seek information from a clinic that provides abortion. (See 'Where to get more information' below.)
IS ABORTION RIGHT FOR ME? —
If you are pregnant and considering abortion, only you can know if the decision is right for you. You may or may not want to talk to a friend or family member, your partner, or someone else you trust. You can also talk to a supportive health care provider; clinics that provide abortion services usually have counselors who can help you understand your options.
It can be helpful to share your thoughts and feelings about your decision with people who will support you no matter what you choose. Asking others for their input may be helpful, but if you feel someone is not letting you make your own decision or is trying to force you to make a particular decision, you may want to seek additional help from a clinic or counselor.
Is abortion legal? — Abortion laws depend on where you live. In the United States, each state has its own laws about abortion. For example:
●Some states have banned abortion completely. Others ban abortion with exceptions, such as pregnancies that threaten the health or life of the pregnant person or in which the fetus has a lethal problem or condition.
●In states where abortion is legal, rules vary about how far along in pregnancy you can get an abortion. Some allow it until "viability" (the point at which a fetus can live outside the uterus) while others have limited it to earlier stages of pregnancy.
●Some states require people younger than 18 years old to get permission from parent or guardian. (See 'What if I am a minor?' below.)
If you are not sure whether you can have an abortion because of how far along you are in your pregnancy, you can ask a clinic that provides abortion or knowledgeable health care providers to help you figure this out. You can also use an online calculator to get an idea of how far along you are in your pregnancy based on the date of your last period (calculator 1). If your periods are not regular (that is, you do not have a period approximately every month), these calculators may not be accurate. To be sure about how far along you are, it is best to see a health care provider.
To learn more about the laws where you live, you can get information from a clinic like Planned Parenthood or from Abortion Finder (www.abortionfinder.org). A summary of United States abortion laws can also be found through the Guttmacher Institute (www.guttmacher.org/global/abortion).
What if I am a minor? — If you are a minor, you may have to get permission from a parent or guardian to get an abortion. In the United States, more than half of states require anyone younger than 16 to 18 years old to get permission from a parent or guardian. However, if you are not able to get a parent's permission, most states have set up systems so you can get a judge to grant you permission without involving your parents (this is called "judicial bypass"). Clinics that provide abortion and other health care providers (in states where abortion is legal) can help you with this process.
Resources — More information about abortion, including legal information, is available online (see 'Where to get more information' below). While some places call themselves "pregnancy crisis centers," most of these do not provide accurate abortion information or provide medical care.
TYPES OF ABORTION —
There are two basic ways an abortion can be performed:
●Medication abortion – This is when you take medication to end a pregnancy. It is also sometimes called a "medical abortion" or "abortion with pills."
●Procedural abortion – This is when a trained health care provider does a procedure to remove the pregnancy from your uterus. It is also called "surgical abortion," although it is done through the vagina and does not involve making incisions like in some types of surgery. Other names for procedural abortion include "uterine aspiration," "suction aspiration," "vacuum aspiration," and "dilation and evacuation" ("D&E"). The terms used typically depend on how many weeks pregnant you are.
Which type of abortion is right for me? — The type of abortion you can have depends on a few factors, including where you live, how far you are in your pregnancy, and your personal preferences. In some cases, certain health conditions may affect your options. The type of abortion and setting also varies at different points in pregnancy; this is discussed below.
Your health care provider can usually talk with you about the options to help you make an informed decision. However, some states have laws that make it illegal to "aid and abet" people accessing abortion, and some hospitals and institutions have interpreted these laws to include referral for abortion care. If you live in a state where your provider cannot discuss options with you, a clinic that provides abortion can help.
If you are deciding which type of abortion to have, there are different things to consider. These include where to have the abortion (which will depend in part on how many weeks pregnant you are), how long it will take, and what the experience will be like. These issues are discussed more below. (See 'Medication abortion' below and 'Procedural abortion' below.)
Different people have different preferences. Depending on where you live, your abortion options might be limited. Some people may be able to travel to a different area or state to have an abortion, but this is not always possible.
Initial evaluation and discussion — If you go to a health care provider or clinic for an abortion, you will meet with a trained health care professional who can answer any questions you may have and about what to expect during the abortion. While this may occur in a clinic setting, it can sometimes be done during a "telemedicine" visit (by phone or video) or through other online communication (eg, chat, email). (See 'Setting' below.)
During this appointment, the provider may do the following:
●Confirm you are pregnant and determine how many weeks pregnant you are. This may include reviewing your menstrual history (date of last menstrual period), and doing a pregnancy test and/or a pelvic exam. Sometimes, the provider might recommend an ultrasound to determine exactly how far along in pregnancy you are. Some states also have laws that require a person seeking an abortion to have an ultrasound; however, this is not for medical reasons. Sometimes an ultrasound is done to confirm that you have not had a pregnancy loss (miscarriage) or do not have an "ectopic" pregnancy (when a pregnancy implants outside of the uterus). An ectopic pregnancy occurs in approximately 1 out of 100 (1 percent) pregnancies and may require emergency treatment. (See "Patient education: Ectopic (tubal) pregnancy (Beyond the Basics)".)
●Discuss the types of abortion that are options for you. This includes a thorough discussion of the available options, the risks and benefits of each, and what to expect during and after the abortion. The provider can also discuss alternatives to abortion (ie, continuing the pregnancy and choosing to either parent or make an adoption plan) if you have not already considered these options.
●Order a blood test to determine your blood type. If you have a blood type that is Rh group negative (for example, "A negative"), and depending on how far along you are in pregnancy, you may need an injection of a medication called Rh immune globulin (RhoGAM) after your abortion. This medication helps prevent complications in future pregnancies (if you get pregnant again).
●Offer testing for sexually transmitted infections. Depending on your situation, you might be offered testing for gonorrhea, chlamydia, HIV, or other infections.
●Review contraceptive (birth control) options. If you are interested in discussing ways to prevent pregnancy, your health care provider can discuss birth control options with you. (See 'Birth control after abortion' below.)
In some states, a person is required to wait for a certain amount of time (usually 24 hours) between the counseling described above and the abortion. In other states, an abortion can be done on the same day as the counseling. (See 'Is abortion legal?' above.)
MEDICATION ABORTION —
This involves taking medications that cause your body to end the pregnancy. The exact steps depend on how far along you are in pregnancy. This is determined by the date of your last period (if known); if necessary, ultrasound can be used to confirm this. (See 'Initial evaluation and discussion' above.)
Setting — Where to have a medication abortion depends on how far along you are in pregnancy. If you are less than 11 to 12 weeks pregnant (ie, 11 to 12 weeks after your last period), you can often have a medication abortion at home. Later in pregnancy, medication abortion is typically managed in a clinic or hospital setting.
Many people go to a clinic to be seen in person for a medication abortion. But before 11 to 12 weeks of pregnancy, other options may include:
●"Telemedicine" – This means talking to a doctor or nurse on the phone or online, instead of in person. They will ask questions to make sure that you can have a medication abortion at home. Then, they will arrange a way for you to get the medicines, and explain how to take them. You might pick up the medicines from a pharmacy or get them through the mail.
●"Self-managed" abortion – This involves getting mifepristone and misoprostol, often through the internet, without any direct contact with a doctor, nurse, or clinic. Information about how to get a prescription is available online (table 1).
Never use herbs, chemicals, or objects in the vagina to try to end a pregnancy. These things are unsafe and could cause serious harm or even death.
Process — Below are the general steps for medication abortion:
●You will usually get a medication called mifepristone (brand name: Mifeprex). This comes as a pill. Often, mifepristone is taken in a clinic or doctor's office, but if you got it from a pharmacy or through the mail, you can take it at home. Sometimes, this medication is not available, and it will not be part of your abortion plan.
●One or two days after taking mifepristone, you take another medication called misoprostol (brand name: Cytotec). This is usually taken at home, but depending on how far along your pregnancy is, it might be taken in a clinic or hospital.
Misoprostol can come as pills that you swallow or as tablets that you put in your vagina, inside your cheek, or under your tongue. Your doctor or nurse will tell you exactly how to take it. You might need to take more than one dose.
●The medications cause your body to end the pregnancy. When this happens, you will bleed from your vagina and have cramping.
If you are early in pregnancy, you might bleed and cramp as quickly as 4 to 6 hours after taking the second medication. Later in pregnancy, it can take longer, around 24 hours.
What to expect — During a medication abortion, you can expect to have symptoms as your body ends the pregnancy. These include:
●Vaginal bleeding – It is normal to experience vaginal bleeding during an early medication abortion; this means the medication is working. Your bleeding may be heavy, especially in the first few hours after you take the misoprostol. You might see large blood clots or pieces of tissue. If you are later in pregnancy, the process can feel similar to labor. You might see a lot of pregnancy tissue or the fetus itself. Bleeding usually decreases after the pregnancy tissue passes out of your uterus. It may continue for several weeks but should be lighter than a menstrual period after the first few days.
If you soak through two full menstrual pads in an hour for two hours in a row and are still bleeding, you should contact your health care provider, clinic, or online pharmacy. If you do not have any bleeding at all after you take the medications, you should also contact them because this could mean the medications did not work.
●Pain and cramps – It is normal to have abdominal pain and cramps after taking the second medication (misoprostol). These may be mild or strong. If you are later in pregnancy, the process can be like labor. The pain should decrease once the pregnancy tissue has passed out of your uterus. For most people, this happens within 2 to 24 hours after taking the misoprostol.
Most people can take ibuprofen (sample brand names: Advil, Motrin) for pain if needed. You can also use a heating pad on your abdomen, but make sure it is not hot enough to burn you. If you are in a hospital or clinic, the staff will talk to you about your options for pain relief. If you have severe pain that is not relieved by these treatments, call your health care provider or clinic immediately.
●Other side effects – Some people experience a mild fever, nausea, vomiting, or diarrhea after taking the second medication (misoprostol). These side effects usually go away quickly on their own without treatment. If you get a fever higher than 100.4°F (38°C) or if you have chills, vomiting, or diarrhea that does not go away within several hours, contact your health care provider or clinic.
Depending on how far along the pregnancy was, you might also notice that your breasts feel full or leak milk. It can help to wear a supportive bra and use ice on your breasts until this goes away. Your doctor might also have other suggestions.
How effective is medication abortion? — Medication abortion is very effective, however, in a small number of cases it may not work.
If early medication abortion does not work in ending your pregnancy, you will need to have a procedural abortion. Continuing a pregnancy after an attempted medication abortion is not recommended because there is an increased risk of problems in the fetus from the misoprostol. It is possible that your medication abortion was not successful if:
●You do not have vaginal bleeding after taking the medications.
●You still have pregnancy symptoms (breast tenderness, nausea) more than a week after your abortion.
●You continue to bleed for more than two weeks after your abortion.
●You have a positive pregnancy test four weeks after the abortion.
●You do not have a menstrual period within eight weeks after your abortion (unless you are on hormonal birth control).
If you have any of these signs, or if you have a positive pregnancy test four weeks or more after your abortion, contact your health care provider or clinic. They may want to see you or speak with you on the phone. They may suggest taking a home pregnancy test (if you have not already); the results, along with your symptoms, can help them figure out if the medication abortion worked. However, it is important to be aware that home pregnancy tests will continue to be positive for at least several weeks after an abortion. Also, if your home pregnancy test is negative but you feel unwell or that something may be wrong, contact your provider.
PROCEDURAL ABORTION —
Procedural abortion is also called "surgical abortion" or "aspiration abortion," but it does not involve any incisions in your skin or organs, and you will not have any scars afterwards. Instruments are passed through the vagina and cervix into the uterus to remove the pregnancy.
Setting — A procedural abortion takes place in a clinic, medical office, or hospital.
Process — During a procedural abortion:
●You will get medications to help with pain and anxiety. Examples include:
•Medications like ibuprofen (sample brand names: Advil, Motrin)
•A shot of numbing medication in your cervix (figure 1)
•Medications to help you relax
Having a support person talk with you during the procedure can also help with pain and anxiety. This could be a family member or friend, or it might be a nurse or other staff member.
●In some cases, you might have the option to receive intravenous (IV) pain and/or sedating medication during the procedure.
●Depending on how far along you are in pregnancy, you might need to get medicines to open or "dilate" your cervix (figure 1). Or the health care provider might use devices called "dilators" instead. You might need to visit the clinic or hospital to have dilators placed a day or two before your abortion. Your health care provider will tell you if you need to have your cervix dilated.
●The health care provider will use suction to remove the pregnancy tissue from your uterus. If you are farther along in pregnancy, they may also use instruments to remove pregnancy tissue.
A procedural abortion usually takes less than 30 minutes and is generally shorter the earlier it is in the pregnancy. After the procedure, you will be monitored by health care staff until you are ready to leave; the time for this varies but typically ranges from half an hour to one and a half hours. If you got medicines to help you relax, you will need to have someone else drive you home after the procedure.
What to expect — After a procedural abortion, it's normal to have vaginal bleeding, abdominal pain, and cramping.
●Abdominal pain and cramping – Most people have some abdominal pain and cramping after a procedural abortion. You can take ibuprofen (sample brand names: Advil, Motrin) for pain unless you have a medical reason to avoid this medication. Some clinicians also give a prescription for a stronger pain medication you can take if needed.
Cramping usually lasts several hours after a procedural abortion. If you have severe pain that does not get better with treatment, or if your pain continues for more than a few days after the procedure, call the clinic where you had the abortion or your health care provider.
●Vaginal bleeding – It is normal to have some vaginal bleeding after a procedural abortion; it is usually less than with a menstrual period and lasts only a few days, but can last up to several weeks. The bleeding should get lighter after the first few days. You may also pass some tissue or blood clots.
If you are bleeding so heavily that you soak through two menstrual pads in an hour for two or more hours in a row and you are still bleeding, you should call the clinic where you had the abortion or your health care provider.
Depending on how far along the pregnancy was, you might also notice that your breasts feel full or leak milk. It can help to wear a supportive bra and use ice on your breasts until this goes away. Your doctor might also have other suggestions.
How effective is procedural abortion? — Procedural abortion is very effective, but rarely, it does not work.
If procedural abortion does not work completely to get rid of all the pregnancy tissue, you may need to take medicines or have another procedure to remove any leftover tissue. It is possible that your abortion was not complete if:
●You still have pregnancy symptoms (breast tenderness, nausea) more than a week after your abortion.
●You have vaginal bleeding that is heavy or not decreasing
●You do not have a menstrual period within eight weeks after your abortion (unless you are on hormonal birth control)
If you have any of these signs, or if you have a positive pregnancy test four weeks or more after your abortion, contact your health care provider or clinic. They may want to see you or speak with you on the phone. They may suggest taking a home pregnancy test (if you have not already); the results, along with your symptoms, can help them figure out if the abortion was complete. However, it is important to be aware that home pregnancy tests will continue to be positive for at least several weeks after an abortion. Also, if your home pregnancy test is negative but you feel unwell or that something may be wrong, contact your provider.
WHEN TO SEEK HELP AFTER ABORTION —
Call a health care provider or seek care immediately if:
●You are bleeding so heavily that you soak through two menstrual pads per hour for two hours in a row and you are still bleeding.
●You have severe abdominal or pelvic pain that is not relieved by pain medications.
●You have shaking chills or develop a temperature higher than 100.4°F or 38°C (use a thermometer to measure your temperature).
●You have foul-smelling or pus-like discharge from your vagina.
FOLLOW-UP CARE —
Specific instructions for follow-up depend on which type of abortion you had (medication or procedural) and where you received care. These may include the following:
●After a medication abortion, you will be instructed about a plan for follow-up. The main purpose of this follow-up is to confirm that you are no longer pregnant. It may involve a return visit to the provider (or another health care provider closer to where you live) or some other form of communication with your provider (telehealth).
●After a procedural abortion, some abortion providers recommend a follow-up visit two to three weeks later, while others do not. Sometimes, the provider may need to do a pelvic exam or ultrasound at that visit. If you have any symptoms that worry you, or if you would like to talk to someone about your feelings after your abortion, do not wait for this visit; contact your provider.
Birth control after abortion — If you do not want to get pregnant again soon after an abortion, you should talk to your provider about contraception (birth control) options. After an abortion, you can get pregnant again quickly, even before your next menstrual period.
●If you had a procedural abortion, you can start using most birth control methods (pill, patch, vaginal ring, injection, intrauterine device [IUD], implant) on the same day.
●If you had a medication abortion, you can start some kinds of birth control (pill, patch, vaginal ring, injection) on the same day you take the first medication. Other methods, like the IUD, can be inserted soon after the abortion, usually within a few days after you take the medicine.
More detailed information about birth control and emergency contraception are available separately. (See "Patient education: Birth control; which method is right for me? (Beyond the Basics)" and "Patient education: Emergency contraception (Beyond the Basics)".)
ABORTION COMPLICATIONS —
Legal abortions are safe and rarely cause serious complications. However, as with any medical procedure, complications sometimes occur. These can include excessive bleeding (hemorrhage), infection, injury to the cervix or uterus (in the case of procedural abortion), or pregnancy tissue that remains in the uterus. These problems are very rare, and serious complications occur in less than 1 out of 100 (1 percent) of cases.
MYTHS AND FACTS ABOUT ABORTION —
Many people have questions about what is true or not true that they have heard about abortion:
●MYTH: Abortion is dangerous.
FACT: While abortion does have some small risk, carrying a pregnancy and giving birth are riskier than having an abortion. It is important to know that an abortion performed by someone who is not trained is not safe and can lead to serious complications, including bleeding, infection, infertility, and even death.
●MYTH: Abortion will make me infertile.
FACT: When an abortion is performed safely, it does not affect your ability to get pregnant in the future.
●MYTH: Abortion increases the risk of breast cancer.
FACT: Having an abortion does not increase the risk of developing breast cancer.
●MYTH: Abortion increases my chance of pregnancy loss (miscarriage) in the future.
FACT: Abortion does not increase the risk of pregnancy loss, preterm birth, or other complications with future pregnancies.
WHERE TO GET MORE INFORMATION —
Your health care provider is the best source of information for questions and concerns related to your medical problem. Several reliable sources of information are also listed below.
This article will be updated as needed on our web site (www.uptodate.com/patients). Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below.
Patient level information — UpToDate offers two types of patient education materials.
The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.
Patient education: Deciding to have an abortion (The Basics)
Patient education: Medication abortion (The Basics)
Patient education: Procedural abortion (The Basics)
Patient education: Pregnancy in Rh-negative people (The Basics)
Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.
Patient education: Birth control; which method is right for me? (Beyond the Basics)
Patient education: Emergency contraception (Beyond the Basics)
Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.
Overview of pregnancy termination
First-trimester pregnancy termination: Medication abortion
Misoprostol as a single agent for medical termination of pregnancy
First-trimester pregnancy termination: Uterine aspiration
Second-trimester pregnancy termination: Choosing medication abortion or dilation and evacuation
Counseling in abortion care
Unsafe abortion
Contraception: Postpartum counseling and methods
The following organizations also provide reliable health information.
●National Library of Medicine
(www.nlm.nih.gov/medlineplus/abortion.html)
●Guttmacher Institute
●Planned Parenthood
●National Abortion Federation
●Reproductive Health Access Project
●Abortion Finder
