Pregnancy Termination: What are the risks of pregnancy termination?

The general risks of surgical procedures are described insurgery risks. A number of specific complications of pregnancy termination are quoted, but research has shown that the risks are low and not as worrying as the anti-abortion lobby tends to suggest. The risks increase as the pregnancy becomes more advanced. The concerns include the risk of reduced fertility, future miscarriage and depressive illness. There are a number of difficulties in evaluating the incidence of these complications. For example, a significant number of those seeking pregnancy termination are at increased risk of pelvic infection (Q 20.2).

The uterus is soft during pregnancy and it can be perforated either during dilation of the cervix or during suction with the possibility of damaging other structures in the pelvis including the bowel and the bladder.

The cervix may tear during dilatation. As instruments are introduced through the lower genital tract into the uterus there is a risk of pelvic infection (Q 20.2) which is increased if some pregnancy products are inadvertently retained. There is evidence that prophylactic (preventative) antibiotics reduce the risk. Some clinicians advocate taking swab tests from the neck of the womb and administering antibiotics only if bacteria are cultured. This protocol allows identification of sexually transmitted disease and facilitates contact tracing, thus reducing the incidence of sexually transmitted disease.

The commonest cause of pregnancy related deaths worldwide remains pregnancy termination. The number of women dying each day from termination complications is about 500 (1 in 300 of all pregnancy terminations, including those undertaken without medical supervision). My generation of British gynaecologists has been spared the tragic sight of women dying due to illegal termination. It is pertinent to point out that in the three years before the Abortion Act of 1967, ninety-eight women died as a result of back-street abortions.

During my first weekend on call as a senior house officer in gynaecology, we were looking after a woman who had a surgical termination of pregnancy carefully performed by an accomplished consultant. The patient was married and the couple had no child. They had wished to delay parenthood for social reasons. During the operation there was bleeding and despite the team's best efforts, a life-saving hysterectomy was necessary. 

There has been a suggestion that pregnancy termination may be associated with an increased risk of breast cancer later in life.¹⁹⁹⁶

Pregnancy termination does not appear to increase the risk of miscarriage in a subsequent pregnancy.

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