Expert: Pat G - 4/18/2010

Question
I had an abortion in sept. I was 13 weeks. I found out I am pregnant again about a month ago. I now am in a position to have a child and was very happy to hear this news. I have done everything I can to keep my self healthy but unfortunatly think I am having a miscarriage now. My question is: Did having an abortion at 13wks make miscarriage more of a risk for me? I have read that abortion in early pregnancy doesn't effect future pregnancies but what about 2nd trimester abortions?

Answer
Hello, Bridget,

Yes, having an abortion during the first trimester does increase the chances of a miscarriage later, by about 400%. The literature is not telling you the truth. But in your case, since you had an abortion so late, it would be even higher. When they force open the cervix in order to do an abortion, they damage it. There will be many tiny tears in the flesh, and this weakens it so that it can't hold the weight of a full term baby. And yes, this damage also happens in abortions done during the first trimester. Scarring on the surface of the uterus can also be a problem, because if the placenta is trying to grow over scars, it won't be able to grow there, so this could restrict the size and effectiveness of the placenta. Placenta previa is also a risk. This is due to scarring as well. When they do a surgical abortion, they have to cut away the placenta, and they scrape the surface. This is why scars form. Also, you may need to be checked for tubal pregnancy. This is also caused by scarring; the Fallopian tube is partly covered by scar tissue so the ovum can't get into the uterus. This is a medical emergency; you will need immediate surgery to save your life. A woman who has a tubal pregnancy will experience pain. If the pain abruptly ends, the tube has ruptured, and this is a huge emergency.

If you are experiencing a possible miscarriage after six weeks, you need to go to a doctor right away and ask him to see if it will help to fasten your cervix shut. Whether or not miscarriage is inevitable, I can't say. If you are bleeding, the placenta is apparently turning loose. If you are feeling cramping or labor, then fastening your cervix may help. You should stay off your feet as much as possible, and get as much bed rest as you can. Don't do any lifting. Right now, you need a doctor who can undertake emergency measures for you, so possibly you should go to the emergency room. However, before you do that, contact the local organization in your area that helps pregnant women. You can find the closest one by going to this web site:

http://www.pregnancycenters.org/

If they can give you a referral right away, hopefully this doctor will be able to meet you in the emergency room. Have someone take you.

I am keeping this message short so that you can go ahead and get some help. I hope and pray your baby will be fine. Please let me know how you do.