Expert: Pat G - 12/10/2009

Question
okay, i had an abortion my junior year of high school which was nov. 1 2007. i had the surgical procedure done which cost me somewhere around $500.00 because my first ultrasound at the clinic was 12w5d. after the abortion i was an emotional wreck having to go to school and keep it hid from others. it was the hardest things i've ever went through. but when i went to my check ups everything was normal or healed. my period is back to normal but shorty after the drs. said everything was alright i started what i thought was my period, but instead i was bleeding for 4-5 weeks straight. do you know why that was? i also wanted to know if it is possible for me to still have kids? will it be hard for me in the future to become pregnant?  

Answer
Hello, kaila,

My heart goes out to you. This is something most people don't understand: the emotional impact. When a woman gets an abortion to conceal her pregnancy, she's not thinking about how she will react. As for the bleeding, it sounds like they injured you when they did the abortion. It's not that common for a woman to bleed for that long. But this is not at all surprising, because when they do a surgical abortion, they have to scrape the surface of the uterus with a sharp knife and cut away the placenta. All of this leaves an open wound that will bleed, or it will cause scars. If it does leave an open wound that does bleed, there will also be scars there eventually.

About 10% of the women who get a surgical abortion will never become pregnant again. We can hope and pray you are not one of them. Because you were so far along, the likelihood may be somewhat larger.

There are several things you need to know about so that you can try to protect yourself, and protect your baby if you should become pregnant in the future. First, you probably had an abortion of your first pregnancy. Your chances of getting breast cancer when you are still young is greatly increased. If you have breast cancer in your immediate family, the chances are very, very high. I do not recommend regular mammograms, because they can actually cause or aggravate breast cancer. Instead, you should get a regular thermogram. These are totally non-invasive and safe. You should also make sure that you supplement with Vitamin D3. Your skin can make this if you are in the sun enough (and yes, it is safe to do it that way). You can't use sunscreen (which will have the opposite effect). You have to be in the sun for a minimum of 20 minutes a day with significant skin exposed, and you can't bathe for a couple of days afterward while the Vitamin D absorbs into your skin. If you have darker skin or live in a more northern latitude, the amount you will have to get will be greater. The other alternative is to take supplements. You will need to get your blood checked periodically to make sure that you don't overdose. You can get more information about this on the internet, or I can give you some links.

The next thing to be concerned about is tubal pregnancy. If you become pregnant, and develop pain at about 4 to 6 weeks, especially if the pain abruptly stops, you have an emergency situation that will require surgery. The baby cannot survive. If the pain stops, you need the surgery immediately. This happens because of partial scarring over the entrance to the Fallopian tube. It has a hole big enough to admit sperm, but not big enough for the zygote to pass into your uterus.

You will also need to be concerned about the possibility you could have a miscarriage or a very premature birth. Because you were so far along, this risk is greater than average. This is due to weakening the cervix with many tiny tears because it was forced open. Even if they used laminaria, this is a problem. A very premature birth can harm your baby and cause certain problems, most notably cerebral palsy, epilepsy, and autism, or any other damage to the baby's brain. The remedy is for the doctor to fasten your cervix shut until time for birth. Be sure your doctor knows about your abortion.

Also, there can be complications at the time of birth. Because of the scarring, the baby may not implant in a good place in your uterus. If so, the baby may implant too close to the cervix. This is called placenta previa, and the problem is that the placenta can tear loose from the uterus during labor. This causes hemorrhage, and it could kill you both. The remedy is Caesarian section. The doctor should be able to tell with a late ultrasound where the placenta is. But you won't be able to have a homebirth safely, for example. The other problem is prolonged labor, and this is also a threat to you both. Again, the remedy is Caesarian section.

These problems don't happen to everybody, but this is part of the consequences of having a surgical abortion, and I'm really sorry you are facing all of this.

Some women try to become pregnant through artificial insemination because of these problems. However, this also can cause complications, and there are certain birth defects that are far more common in children conceived through artificial insemination. Ideally, the better solution is to re-open the Fallopian tubes so that conception can take place naturally.

Finally, you have been vulnerable to sexually transmitted diseases and things like pelvic inflammatory disease (which can cause infertility and other problems). You should get tested.

I can't tell you what the consequences will be in your particular case, unfortunately, and neither can anyone else. But you could have the doctor take a look around in your uterus with a tiny camera to see how bad the scarring is, and this may help you to understand what you are up against. I hope and pray that you and your future children will be fine. If for some reason, you are one of those who cannot conceive, please consider adoption. It is an excellent way to form a family (I speak from experience) and if you want, you can breastfeed an adopted child if you get custody soon after birth. I can tell you more about that as well.

Feel free to come back and ask questions any time, and let me know how things go, even if you don't find out for awhile. Also, because of the emotional impact your abortion had on you, I am here for you, and I do work with women who have suffered emotionally after abortion. There are also organizations that provide post-abortion counseling and programs. To find one near you, go here:

http://www.pregnancycenters.org/

Please take care.