Hesperian Health Guides

What makes an abortion safe or unsafe?

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HealthWiki > Health Actions for Women > Chapter 9: Preventing Deaths from Unsafe Abortion > What makes an abortion safe or unsafe?

In places where abortion is illegal, almost all abortions are unsafe. Even where abortion is legal, women may not be able to find a clinic that provides safe abortions. Or safe abortions may cost more than women can afford to pay. Many women who are unable to get a safe abortion will use harmful methods to end an unintended pregnancy. Unsafe methods can kill women or leave them unable to get pregnant again. Helping women learn the difference between safe and unsafe abortion saves lives and also helps women protect their reproductive health.

Safe abortion

A safe abortion is usually much safer than giving birth, especially for a girl who has not grown enough to give birth safely, or for a woman with serious health problems such as high blood pressure or diabetes. Safe abortions do not make women infertile (unable to have a baby later) and they do not cause cancer. These are myths, not facts.

To use either of the following 2 abortion methods safely, the woman and a trained health worker need to know how long she has been pregnant. To do this, start counting after the first day of your last regular monthly bleeding.

instruments used for vacuum aspiration.

Vacuum aspiration or suction. When vacuum aspiration is done by hand (manual vacuum aspiration or MVA), the contents of the womb are removed with a special syringe. Otherwise, a small electric machine is used.

MVA is simple and safe up to 12 weeks after day 1 of the last regular bleeding, when done by a person with training and experience using proper instruments under very clean conditions. Anything put inside the womb must be sterilized to remove any germs on it. A trained health worker should know how to watch for problems and be able to respond quickly and appropriately with medicines and care.

Abortion using medicine. Misoprostol and mifepristone are medicines that can be taken by a woman herself, if she understands when to take them, how much to take, and what to expect after she takes them. She also needs to know how to watch for danger signs, such as an incomplete abortion. If possible, she should talk with a health worker before taking these medicines.

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Abortion using medicine is safe up to 9 weeks (63 days) after day 1 of the last regular monthly bleeding.

See Where Women Have No Doctor for more information about medicines for abortion and sterilizing tools and equipment.

Unsafe abortion

Abortions are unsafe when they are done in unclean conditions by someone who has not been properly trained. Abortions are especially dangerous when unsterilized instruments are put inside a woman’s womb. The following methods are all unsafe and should never be used.

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  • Do not put sharp objects such as sticks, wire, or hard plastic tubing into the vagina or womb. These can tear the womb and cause dangerous bleeding and infection.
  • Do not put herbs, plants or toxic chemicals in the vagina or womb. These can burn or irritate badly, causing damage, infection, and bleeding.
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  • Do not put substances such as bleach, lye, ashes, soaps, kerosene, or solvents into the womb. Also do not drink them.
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  • Do not take the medicines chloroquine (for malaria) or ergometrine (to stop bleeding after childbirth). They can kill before they cause an abortion. Use only the medicines misoprostol and mifepristone, see Abortion using medicine.
  • Do not hit the abdomen (belly) or throw the woman down stairs. This can cause injury and bleeding outside her body, but may not cause abortion.

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These unsafe methods can kill a woman or cause serious injury or illness before they cause abortion. If the woman survives these traumas, she may have long-term or permanent damage to her body, including injured genitals, infertility, and urinary and bowel problems.