Induced abortion

Last updated: November 20, 2023

CME information and disclosurestoggle arrow icon

To see contributor disclosures related to this article, hover over this reference: [1]

Physicians may earn CME/MOC credit by searching for an answer to a clinical question on our platform, reading content in this article that addresses that question, and completing an evaluation in which they report the question and the impact of what has been learned on clinical practice.

AMBOSS designates this Internet point-of-care activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

For answers to questions about AMBOSS CME, including how to redeem CME/MOC credit, see "Tips and Links" at the bottom of this article.

Summarytoggle arrow icon

Induced abortion is the use of interventions (e.g., medication, procedures) to end a pregnancy. Common indications include patient choice, anticipated harm to the pregnant individual, and fetal genetic or anatomical abnormalities. Abortion may be performed via medical or surgical procedure. When performed under clinical guidance, induced abortion is highly effective and safe.

Epidemiologytoggle arrow icon

In 2017 in the US: [2]

  • Approx. 18% of pregnancies ended in abortion
  • Approx. 60% of abortions occurred at ≤ 10 weeks' gestation

Indicationstoggle arrow icon

Common indications include: [3][4]

  • Patient choice to end the pregnancy
  • Anticipated harm to the pregnant individual
  • Genetic or anatomical abnormalities in the fetus

Preparationtoggle arrow icon

Prior to induced abortion, the following steps should be considered: [3][4]

Procedure/applicationtoggle arrow icon

Methods of induced abortion [3][6]
Medical abortion Surgical abortion
  • The administration of medications to end a pregnancy

First trimester (≤ 12 weeks' gestation)

Second trimester (between 13 and 24 weeks' gestation)

  • Noninvasive
  • No anesthesia
  • May be performed at home during the first trimester
  • Preferred for certain medical conditions [3]
  • Usually requires follow-up
  • More perceived bleeding than abortion procedures
  • Takes longer to complete than abortion procedure [3]
  • Contraindicated in patients with: [3]
  • Invasive
  • Requires anesthesia
  • Always performed in a clinical setting

Postabortion [10]

  • For confirmation of abortion or evaluation of abortion complications, obtain: [3]
  • Treat any complications.
  • If a gestational sac is present, consider expectant management or repeat induced abortion. [3]
  • Counsel patients on recommended follow-up:
    • A routine follow-up visit is not required for uncomplicated induced abortion. [3][8][11]
    • Perform a pregnancy test 4 weeks after abortion. [3]
    • Seek medical attention for symptoms of incomplete abortion or complications (e.g., prolonged or excessive pain or bleeding). [3]

Patients with uncomplicated induced abortions do not need a follow-up office visit, but one should be offered to all patients. [3]

Management options for an incomplete abortion after an induced abortion include watchful waiting, medication abortion, or procedural abortion. [3]

Complicationstoggle arrow icon

Compared to unsupervised self-managed abortion, complications from medically supervised abortions are exceedingly rare, but may include: [4][6]

We list the most important complications. The selection is not exhaustive.

Unsupervised or unsafe self-managed abortiontoggle arrow icon

In the US, as of June 2022, medical practitioners are not required to report individuals who have performed an unsupervised self-managed abortion. [10]

Legal implicationstoggle arrow icon

Related One-Minute Telegramtoggle arrow icon

Interested in the newest medical research, distilled down to just one minute? Sign up for the One-Minute Telegram in “Tips and links” below.

Referencestoggle arrow icon

  1. $Abortion Incidence and Service Availability in the United States, 2017.
  2. Harris LH, Grossman D. Complications of Unsafe and Self-Managed Abortion. N Engl J Med. 2020; 382 (11): p.1029-1040.doi: 10.1056/nejmra1908412 . | Open in Read by QxMD
  3. Grossman D, Perritt J, Grady D. The Impending Crisis of Access to Safe Abortion Care in the US. JAMA Intern Med .. 2022.doi: 10.1001/jamainternmed.2022.2893 . | Open in Read by QxMD
  4. Moss DA, Snyder MJ, Lu L. Options for women with unintended pregnancy.. Am Fam Physician. 2015; 91 (8): p.544-9.
  5. ACOG, no authors listed. Second-trimester abortion. Obstetrics and Gynecology. 2013.doi: 10.1097/ . | Open in Read by QxMD
  6. Orlowski MH, Soares WE, Kerrigan KA, Zerden ML. Management of Postabortion Complications for the Emergency Medicine Clinician. Ann Emerg Med. 2021; 77 (2): p.221-232.doi: 10.1016/j.annemergmed.2020.09.008 . | Open in Read by QxMD
  7. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Gynecology, Society of Family Planning. Medication Abortion Up to 70 Days of Gestation: ACOG Practice Bulletin. Obstet Gynecol. 2020; 136 (4): p.e31-e47.doi: 10.1097/aog.0000000000004082 . | Open in Read by QxMD
  8. $Medical management of abortion.
  9. Abortion care guideline. Updated: March 9, 2022. Accessed: June 29, 2022.
  10. Borgatta L, Kapp N. Labor induction abortion in the second trimester. Contraception. 2011; 84 (1): p.4-18.doi: 10.1016/j.contraception.2011.02.005 . | Open in Read by QxMD
  11. Lyus RJ, Gianutsos P, Gold M. First Trimester Procedural Abortion in Family Medicine. J Am Board Fam Med. 2009; 22 (2): p.169-174.doi: 10.3122/jabfm.2009.02.070204 . | Open in Read by QxMD
  12. $Contributor Disclosures - Induced abortion. All of the relevant financial relationships listed for the following individuals have been mitigated: Jan Schlebes (medical editor, is a shareholder in Fresenius SE & Co KGaA). None of the other individuals in control of the content for this article reported relevant financial relationships with ineligible companies. For details, please review our full conflict of interest (COI) policy.

Icon of a lockAccess full content

Sign up and get unlimited access.
 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer