Do abortions make you less fertile?
— Grace, Santa Cruz, Calif.
No, there is no link between safe abortion and the ability to get pregnant in the future.
Only abortions that are associated with complications could potentially impact future fertility. Medical complications that might lead to difficulties getting pregnant in the future include uterine injury from the procedure, infection and serious bleeding that requires surgery.
The risk of a major complication with a legal abortion in the United States — meaning a complication that could theoretically lead to infertility — is 0.23 percent. Even with second trimester and later procedures that risk is only 0.41 percent. For perspective, the risk of these complications and other major complications that could lead to infertility is much higher with a pregnancy that goes to term and ends in either a vaginal delivery or a C-section. In fact, the risk of dying from giving birth in the U.S. is 14 times greater than the risk of dying from an early abortion.
Complication rates with abortion are very high in areas of the world without access to safe, legal procedures. Accurate data on complications after an illegal procedure is difficult to obtain because many women do not seek care, of those who are hospitalized for complications, 7.2 percent have severe trauma. Serious uterine injury, bowel injury and severe infections are common complications of illegal abortion that could affect future fertility by scarring the uterus and/or fallopian tubes. Women who need a hysterectomy to treat the complications of an unsafe abortion will also lose their fertility. It is estimated that 8 percent to 11 percent of maternal deaths worldwide are caused by unsafe abortions. Maternal mortality is obviously also an impediment to future fertility.
Dr. Jen Gunter, often called Twitter’s resident gynecologist, is teaming up with our editors to answer your questions about all things women’s health. From what’s normal for your anatomy to healthy sex and clearing up the truth behind strange wellness claims, Dr. Gunter, who also writes a column called The Cycle, promises to handle your questions with respect, forthrightness and honesty.