Abortion is a safe and legal procedure that women choose for various reasons, including medical, financial, and personal. However, like any medical procedure, there is a risk of complications, and in some cases, the abortion may fail, leading to potential health risks and emotional distress. In this article, we will discuss the causes, risks, and treatments of a failed abortion.
What is a failed abortion?
A failed abortion is when the pregnancy continues after the abortion procedure. It can occur in both medical and surgical abortions. In a medical abortion, a woman takes medication like the MTP kit or RU-486 to end the pregnancy, while in a surgical abortion, a healthcare provider removes the fetus and placenta from the uterus. A failed abortion means the pregnancy continues to develop even after the procedure.
Causes of a failed abortion
Several factors can cause a failed abortion, including:
- Incorrect administration of medication: In a medical abortion, a woman must take medication at the correct time and dosage for the procedure to be successful. Incorrect administration can lead to a failed medical abortion, where the pregnancy continues to develop.
- An undetected ectopic pregnancy: An ectopic pregnancy is a condition where the fertilized egg implants outside the uterus, most commonly in the fallopian tubes. Abortion pills are ineffective for ectopic pregnancies, and attempting to terminate them with medication can be dangerous.
- Structural issues with the cervix: A cervix that is too narrow or has scar tissue from previous procedures can make it difficult to complete a surgical abortion.
- Preexisting medical conditions: Certain medical conditions, such as diabetes and hypertension, can affect the success of the abortion procedure.
Signs of failed abortion
Medical and surgical abortions are highly effective, but there exists a chance of less than 1% for the pregnancy to persist after the termination. Indicators of continuing pregnancy following an abortion are
- the persistence of pregnancy symptoms,
- a missed menstrual cycle,
- a positive pregnancy test (after 3-4 weeks when hormone levels should have normalized), and
- confirmation through ultrasound scanning.
In case you suspect a continuing pregnancy post-abortion, you should seek guidance from the abortion clinic immediately. To terminate the pregnancy, you may have to repeat the abortion procedure. The medical practitioner may suggest repeating the same medical termination procedure or opt for a different one, such as surgical abortion or manual vacuum aspiration.
Incomplete abortion: Can abortion fail?
Sometimes, even after the end of a pregnancy, some material may still be left in the uterus. This typically consists of the womb lining that formed a large clot and became trapped in the cervix or uterus before it could be expelled. This situation is referred to as an incomplete abortion and occurs in approximately 5% of all abortions. If you experience the following symptoms following the termination, you may be affected:
- More severe than anticipated cramping or bleeding
- Bleeding lasting longer than three weeks
- Heavy bleeding, particularly if it occurs suddenly
If you notice these signs, it is essential to contact the abortion clinic and see a doctor immediately to avoid further complications or blood loss. The medical practitioner may suggest one of the following treatments:
- Medications to stimulate uterine contractions
- Manual vacuum aspiration or dilation and curettage to eliminate the material from your womb.
While these procedures use the same techniques as an abortion, they are not considered a second termination since the pregnancy is already terminated.
What to expect after a failed abortion?
It is crucial to have a follow-up appointment with your healthcare provider approximately one week after the abortion procedure. During this visit, your doctor will examine your cervix and uterus to ensure that your body is healing correctly, and they will ask you questions about any post-abortion symptoms you may be experiencing, such as bleeding or discomfort. They will also conduct a lab test to measure your pregnancy hormones and check for any signs of infection. It is recommended that you postpone taking a pregnancy test for a few weeks.
What is the effectiveness of the abortion pill?
Medical professionals consider the abortion pill a highly effective solution for terminating a pregnancy, with only a 1% chance of causing adverse effects. Compared to surgical abortion, the abortion pill is equally effective in ending a pregnancy. However, certain factors may reduce the effectiveness of the abortion pill, such as incorrect administration or having an ectopic pregnancy. In such cases, surgical abortion is the only viable option.
Additionally, low-quality medication may be a possible reason for the failure of the abortion pill, and it is crucial to never purchase these drugs from an online or black market source. Only doctors can prescribe these medications, and ordering them without medical supervision can harm your health. By skipping the post-abortion support and care, you increase the likelihood of complications and side effects. It is essential to receive proper medical attention throughout the process.
Reasons why medical abortion failed to terminate a pregnancy
- Obtaining and using abortion pills without consulting a doctor or pharmacist.
- Incorrect dosage or inadequate use of medication.
- Experiencing vomiting or diarrhea after taking abortion pills.
- Presence of pre-existing pelvic infections.
- Pregnancy is more than three weeks past the expected menstrual cycle date.
- Undiagnosed ectopic pregnancy (dangerous when using abortion pills).
- Performing abortions without locating the gestational sac through sonography.
- Cervical abnormalities, such as stenosis, which prevent the cervix from opening up.
- Use of counterfeit medication or advice from unqualified medical professionals.
- Failure to properly follow up and detect incomplete abortions and prolonged bleeding.
Risks of failed abortion
An unsuccessful abortion can lead to dangerous complications for pregnant women, such as
- Infection: The remaining tissue in the uterus can cause infection, leading to severe health problems if left untreated.
- Blood clots: Blood clots can form in the uterus, leading to prolonged bleeding and pain.
- Emotional distress: A failed abortion can be emotionally distressing for women, leading to anxiety, depression, and other mental health issues.
These complications can cause infertility or fetal malformations, impacting a woman’s daily life. Even with a safe abortion, complications may still occur, affecting a woman’s physical and mental well-being. To avoid these unwanted complications, women need to choose an appropriate and effective method of contraception if they don’t want to become pregnant.
Treatment for a failed abortion
The treatment for a failed abortion depends on the severity of the situation. In some cases, additional medication can be prescribed to complete the abortion. In other cases, a surgical procedure may be necessary to remove the remaining tissue from the uterus.
If the failed abortion leads to an infection, antibiotics may be prescribed to treat it. Medication can be given to reduce bleeding and prevent further clots from forming if a blood clot has formed.
Women must seek medical attention immediately if they suspect a failed abortion. Delaying treatment can increase the risk of complications and make it more challenging to complete the abortion procedure.
Takeaway
A failed abortion is a serious medical condition that requires prompt medical attention. Women who experience prolonged bleeding, pain, or suspect that the abortion was unsuccessful should seek medical attention immediately. Seeking proper medical care and attention can reduce the risk of complications and ensure a safe and successful abortion procedure.
References
- Redinger A, Nguyen H. Incomplete Abortions. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559071/
- Kim C, Barnard S, Neilson JP, Hickey M, Vazquez JC, Dou L. Medical treatments for incomplete miscarriage. Cochrane Database Syst Rev. 2017 Jan 31;1(1):CD007223. [PMC free article] [PubMed]
