Usually, no treatment is needed for a miscarriage. However, sometimes some pregnancy tissue remains in the womb after the miscarriage and must be removed. Sometimes doctors do a surgical abortion. This is the same kind of surgery that is done for induced abortions. Doctors can also prescribe women medicines that can help the miscarriage finish without needing surgery.
An induced abortion is when things are done to end the pregnancy on purpose. These things are normally done by doctors. In countries where abortion can be done legally, it is often done by specialists who know a lot about women's bodies (gynecologists). Abortions done illegally are often performed by people without this special knowledge. This makes them more dangerous. Such abortions are usually called unsafe abortions, back-alley abortions or DIY abortions, mainly because the risk to the health of the mother is much higher than with abortions carried out by skilled doctors.
There can be medical reasons, why an abortion is performed. These include:
There are two different kinds of induced abortions. The type of abortion that is done depends on a few different things, like what the woman wants, what her doctor thinks is best, and how far along a woman is in her pregnancy (how long she has been pregnant).
One type of induced abortion is called a "medical abortion" or a "medication abortion". In this type of abortion, a doctor gives the woman one or two medications that will end her pregnancy. A medication abortion can only be done early on in the pregnancy. This is because the medications that are used work best when they are started as early as possible, and after a woman has been pregnant for about two months, the medications usually do not work very well. Because of this, medication abortion usually is not used after a woman has been pregnant for 9 weeks. Some of the benefits (or reasons why some women choose this type of abortion) are that it can be started as soon as a woman realizes she is pregnant; it does not require anesthesia; and the woman does not have to have a procedure in a hospital or clinic to have the fetus removed, like with the other kind of abortion that is done. After a woman is given the medication or medications that end her pregnancy, the abortion happens like a "spontaneous" abortion or a miscarriage. (The woman passes the fetus, along with the blood and tissue that have built up in the uterus, from her vagina.)
The most common medications that are used for medication abortions are mifepristone and misoprostol. First, a doctor gives the woman mifepristone, which is sometimes also called "RU-468" or "the abortion pill". This drug blocks the hormone progesterone in the body. Without progesterone, the embryo cannot survive. The lining of the uterus becomes thinner, and the embryo cannot grow or stay attached to the lining of the uterus. After a few days, a doctor gives the woman misoprostol. This makes the uterus contract (or get smaller) and the embryo is expelled from (or pushed out of) the uterus through the woman's vagina. Sometimes, another medication, called methotrexate, is used along with misoprostol in medication abortions. A woman is given methotrexate, usually as a shot in a doctor's office, and the drug stops the embryo from staying attached to the lining of the uterus. Then misoprostol is given a few days later.
With the second type of abortion - called "surgical abortion" or "in-office abortion" - a doctor does a procedure that removes an embryo or fetus from the woman's uterus. This kind of abortion can be done in different ways, depending on how long the woman has been pregnant. Surgical abortion is simpler, and there are fewer problems that can happen, if it is done earlier on in the pregnancy. The most common form is called an "aspiration abortion" or a "suction curettage." This can be done in a doctor's office or clinic. First the woman's cervix (the top part of the uterus) is dilated (or made bigger). A medical tool is used to suction out everything inside the woman's uterus, including the fetus. If the woman has been pregnant for more than 12 weeks, the doctor first has to dilate the cervix (or make the cervix bigger), usually by putting small sticks into the cervix to help it open up. If another tool, called a curette, has to be used to scrape out tissue that is still inside the uterus, then this form of abortion is sometimes called a "dilation and curettage" (or "D&C").
A pregnancy that ends without a child being born also may cause some problems to the woman this happens to. There are two broad groups of things that can happen:
Abortion is safer than childbirth if it is done before the 16th week of pregnancy and it is done by a professional. Certain methods of abortion are pretty safe, and complications are rare. Generally, stopping a pregnancy that has gone on longer is riskier.
Women usually feel a small amount of pain during first-trimester abortion. In a 1979 study of 2,299 patients, 97% reported having some amount of pain. Patients rated the pain as being less than earache or toothache, but more than headache or backache.
Local and general anesthesias are used during the abortion.
Few studies have been done to see if an abortion affects the woman psychologically, or mentally. Those that have been done give contradictory results. One study looked at 13.000 women who had become pregnant even though they did not want to. The study found that having an induced abortion does not increase the risk of getting mental health problems; the group that was compared were women who also did not want to have a baby, but who did not have an abortion. Other studies showed similar results: women who had an abortion did better in school or at work after the abortion. Another study showed that women who had an abortion had a higher self-esteem and felt better than those who did not.
Many women who had an abortion felt better afterwards, they also felt relieved. They would do it again in a similar situation.
A study done in New Zealand in 2006 showed that many women who had an abortion developed severe depression up to 4 years after they had the abortion. They were also more likely to have problems with alcohol and illegal drugs than those women who did not have an abortion. The person who oversaw the study later told media that given these results it would be very hard to say that having an abortion has no psychological effects on the woman who has it. He called the abortion "a traumatic experience".
Both spontaneous and induced abortions have some risk for the woman.
If a bad thing happens because of a surgery or medicine that a doctor gives, or because of a miscarriage, it is called a "complication". Complications of abortions can be infection, bleeding, pain. There may or may not be problems getting pregnant again; this is still being researched. In places where induced abortions are legal less than 1% of induced abortions have a bad complication. If doctors do induced abortions, the risk to the woman is less than the risk of complications of childbirth (giving birth to a baby). In places where induced abortions are legal, less women have complications of induced abortion than in places where induced abortion is illegal. This is because induced abortions that are not done by doctors have much more risks. For example, after induced abortions became legal in the United States in 1973, less women died from having abortions. In the United States in 2000, 11 women died from the complications of legal abortion. The risk of death from a legal abortion is 1/100 of the risk of an appendectomy. The risk of death from an injection (shot) of penicillin (an antibiotic) is bigger than the risk of death from a legal abortion.