Having an abortion is certainly not an easy decision. No one should judge a woman’s decision of having an abortion as reasons and life conditions can vary in one or another. Aside from the arising legal and morality issues, it certainly raises health concerns to the woman planning for one. One of the health concerns that has been lingering around on most woman’s mind is “does an abortion affect fertility?”.
First thing first, we will talk a bit more about the abortion and the process itself. Abortion is a procedure to end a pregnancy or in other words, termination of pregnancy. 1 out of 4 pregnancies around the world end with abortion. Abortion is certainly a common medical procedure and relatively safe, provided in a safe environment equipped with standard medical facility and skilled healthcare personnel. There are 2 main ways of having an abortion which are medically and surgically. The decision of choosing either medical abortion by using drugs such as mifepristone and misoprostol or surgical abortion such as suction (vacuum) aspiration, will be based on the woman health condition and current pregnancy status. It is important to note that in Malaysia, termination of pregnancy is legal if the continuation of the pregnancy might risk the life of the pregnant woman or injury to the mental or health of the pregnant woman (according to Section 312 of the Penal Code).
Back to the main question of does abortion affect fertility? In short, it does not affect the chance of getting pregnant and healthy pregnancy. In fact, after having an abortion, it is likely that you can get pregnant almost immediately. This is especially true for those with a regular menstrual cycle as ovulation can happen in 2 weeks and pregnancy occurs in the coming weeks. It is advisable to use contraception if a woman intends to avoid pregnancy.
Although abortion in general does not pose risks of infertility, there is still very small risks if a woman experiences untreated infection to the womb caused by the procedure. This infection can cause a disease known as pelvic inflammatory disease (PID). In PIC, the bacteria travel from vagina and cervix, up to the womb and along the fallopian tube. This infection may cause abscess or pus in the fallopian tube or ovary, causing scars to the tube which then block and prevent egg from fertilisation process. PID may also increase infertility by causing pregnancy outside of the womb called ectopic pregnancy. However, it is unlikely patients will reach severe infection stage as prompt treatment and early administration of antibiotic before abortion procedure helps minimizing risks of infection. Patients are reminded to get medical opinion as soon as possible if there is sign of infections, i.e. high temperature fever, severe pain especially at the lower part of abdomen or foul smell vaginal discharge, after the procedure.
It is safe to say that having an abortion does not cause infertility as long as it is performed by a qualified medical provider. There is no concrete evidence that an abortion increases ectopic pregnancy, low birth weight baby or infant death. Risks of facing complications are greatly reduced as infections are treatable, incomplete procedures are corrected immediately and procedure costs minimal injuries. Woman must understand that the final decision of an abortion is entirely up to themselves because it is them who know their body better since their body is their right and the life circumstances affecting them. Thus, women must be knowledgeable on options available for them as doctors can only guide and give medical advice.