Surgical abortions in medical settings rarely damage the uterus. But, as with other surgeries, there is a low chance of complications, including uterus injuries and scar tissue formation, during or after an abortion.

Healthcare professionals use the term “perforation” to describe one type of injury to the uterus. A perforation can cause heavy bleeding and is a medical emergency. However, it is also treatable.

Scar tissue can form as a result of Asherman syndrome, a rare condition that is not a medical emergency. Symptoms can include abdominal pain and decreased menstrual flow.

Data suggest that only 1.3–1.5% of surgical abortions lead to any kind of complication. Most complications are minor and treatable, and serious complications are uncommon.

Read on to learn about the signs of uterus damage after abortion.

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Surgical abortion can damage the uterus, but in medical settings, this is rare.

Estimates from older research suggest that 0.1–3 of every 1,000 abortions result in a uterine perforation. It is more common during unsafe or illegal abortions.

Other factors that increase the risk of perforation include:

  • older age
  • multiple or twin pregnancy
  • some uterus shapes or positions
  • uterine growths, such as fibroids
  • previous surgeries, such as cesarean delivery
  • infections
  • surgeons’ lack of experience
  • a lack of cervical dilation before the procedure

Asherman syndrome is also rare. It can develop after dilation and curettage, a type of surgery that doctors can use to end a pregnancy.

In a 2021 study of people who had a surgical abortion before the 20th week of pregnancy, the incidence of Asherman syndrome was 1.6%. The risk of developing Asherman syndrome is higher if a person has had three or more abortions.

Abortion is not the only potential cause of Asherman syndrome — infections and other factors can also contribute.

After an abortion, people may experience bleeding or cramping. This may cause them to worry that the procedure has damaged the uterus. However, in the vast majority of safe abortions, this is not the case.

Typical side effects people can experience include:

  • cramping
  • bleeding that is similar to a period
  • passing of blood clots

These symptoms usually go away within several weeks. People can use sanitary pads to cope with any bleeding. This also allows them to monitor the amount of blood.

Excessive bleeding or severe pain may indicate perforation of the uterus. The symptoms of uterine perforation can include:

  • bleeding that soaks through more than two pads per hour for more than 2 hours
  • increasingly worse abdominal pain or cramping
  • pain or cramping that does not respond to pain medication
  • fever of 100.4°F (38°C) or more
  • nausea or vomiting
  • diarrhea

The symptoms of Asherman syndrome take time to develop. They will vary depending on the amount of scar tissue that grows.

People with milder symptoms may experience cramping or pain and a lighter menstrual flow than usual. Moderate to severe symptoms can include:

  • irregular or no periods
  • abdominal pain
  • fertility problems in some people

It is typical for periods to take some time to resume after a surgical abortion. If a person is not taking hormonal birth control, periods should begin after 4–8 weeks.

Not having a period during this time does not necessarily indicate that a person has Asherman syndrome.

A person should contact the clinic or the doctor who performed their abortion if they experience any unusual symptoms after the procedure.

If the clinic is closed or the symptoms are severe, call 911 or go to the emergency department of the nearest hospital. Signs of a potential emergency include:

  • excessive bleeding that soaks through more than two pads per hour for more than 2 hours
  • severe abdominal pain or cramping that does not respond to pain medication
  • symptoms of infection, such as a high fever, nausea, or vomiting
  • weakness, dizziness, or fainting

Asherman syndrome and some other abortion complications are not a medical emergency. If people develop any of the following symptoms, they should consult a doctor:

  • persistent, but not severe, pain
  • low grade fever
  • bad-smelling discharge
  • persistent changes to periods or fertility

The most common emotion people report after an abortion is relief. However, an abortion can be challenging for some people. A person should seek help from an unbiased, understanding doctor as soon as they can if they have depression or thoughts of self-harm after an abortion.

Learn more about depression after abortion.

To help with recovery, a person may need to avoid certain activities immediately after an abortion. To reduce the chance of infection, a person should avoid the following for 2 weeks after the procedure:

  • using tampons
  • having sexual intercourse
  • going swimming

If a person received anesthesia or pain medication, they should avoid driving or operating machinery until the following day.

Most people can return to their usual activities the next day. However, people who have undergone dilation and evacuation, which is a type of later abortion, may need longer to recover. The same is true for people who experienced complications.

It is important to note that a person can get pregnant immediately after an abortion. If a person wants to prevent future pregnancies, they can discuss birth control methods with a healthcare professional.

Learn more about self-care after an abortion.

Surgical abortions are safe medical procedures, and the rate of complications is low. In fact, it is much lower than the pregnancy complication rate. However, complications can happen in rare cases or if a person undergoes an unsafe abortion.

Some bleeding and cramping are typical for several weeks after an abortion, but heavy or persistent bleeding and severe pain are not. Seek medical help if these symptoms develop or if a person has symptoms of infection.