This myth dates back to when abortion was illegal and therefore dangerous. Safe, legal abortion performed by qualified practitioners is very rarely associated with any future risk to fertility.  Illegal abortions performed by unskilled practitioners in unhygienic conditions may increase the risk of future infertility if infection or uterine scarring occurs.

A pregnancy confirms a woman’s fertility, and most women return to their pre-pregnancy fertility immediately following the abortion. A small number of women experience a delay in the return of normal menstrual cycles. But many women can become pregnant again almost immediately after the termination, since the next ovulation takes place 10 – 14 days later.

Long-term risks of one abortion on infertility (as well as second-trimester miscarriage, premature birth, and low birth weight) were comprehensively reviewed in 1982 and updated in 1990. These reviews formed the basis for American Surgeon General Everett Koop’s conclusion that “the physical sequelae of abortion were no different than those found in women who carried pregnancy to term or who had never been pregnant.” Specifically, there are no significant risks for secondary infertility, either with surgical or medical abortion. However, if a surgical abortion is infected or complicated by pre-existing and non-treated STDs, the risks of secondary infertility, ectopic pregnancy, and fetal loss increase. This can be prevented with antibiotics given at the time of the abortion.

Expert David G. Grimes adds: “Early surgical abortions tended to be performed using a dilation and curettage (D&C) method, with an inherent but small risk of scarring that could potentially lead to complication. However, this technique is obsolete, replaced with a much safer and effective suction method in the early 1970s. In the 21st century, the WHO recommend a suction-based technique for surgical abortion, rendering the risk to future fertility negligible.”

Abortion does not increase the chance of being diagnosed with breast cancer. In 2003, the National Cancer Institute (NCI) convened a workshop with over 100 scientists, who evaluated the current strength of studies addressing the association between reproductive events and the risk of breast cancer. The participants concluded that induced abortion is not associated with an increase in breast cancer risk. Studies published since 2003 continue to support this conclusion. Further, major health organizations around the world agree with this conclusion, including the World Health Organization, the American Cancer Society, the American Congress of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynaecologists, the German Cancer Research Center, and the Canadian Cancer Society.

Many studies of the relationship between prior induced abortion and breast cancer risk have been found to be methodologically flawed, especially studies that depended on small samples, or “case control” studies that use control groups of women without breast cancer – who tend to under-report their abortions compared to case groups of cancer-stricken women looking for possible causes. This skews the results of case control studies, making it appear that women with breast cancer had more abortions and creating an apparent association.

More rigorous recent studies (the best ones are called “prospective” or “cohort” studies) demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk, because they don’t depend on women self-reporting their abortions.
Nevertheless, anti-choice groups continue to attempt to dissuade women from choosing abortion by promoting the discredited link and exploiting their fear of breast cancer.

Sources:

American College of Obstetrics & Gynecology, ACOG Committee Opinion: Induced Abortion and Breast Cancer Risk (2009)

Planned Parenthood Federation of America, Myths About Abortion and Breast Cancer (2003)

Dr. David A. Grimes, Abortion and Breast Cancer: How Abortion Foes Got It Wrong (2015)

Rewire, How Deeply Flawed Studies on Abortion and Breast Cancer Become Anti-choice Fodder, by Joyce Arthur (2014)

The Guardian, A scientist weighs up the five main anti-abortion arguments, by David Robert Grimes (2015)

The myth of “post-abortion syndrome” was invented by the anti-choice movement to scare women out of having abortions. The best scientific evidence indicates that among adult women with an unplanned pregnancy, the relative risk of mental health problems is no greater after an early abortion than after childbirth.

A July 2015 study from the United States found that 99% of women don’t regret their abortions. Women in the study experienced decreasing emotional intensity over time, and the overwhelming majority felt that termination was the right decision for them over three years. An earlier study in 2000 found that 80% of women were not depressed after having an abortion, nearly 70% reported being satisfied with the decision, and 72% reported more benefit than harm from the abortion. When women are denied abortion, they are more likely to live in poverty and in abusive situations at home, and unwanted children also suffer.

The most commonly reported feeling after an abortion is relief.  Grief and sadness are also common emotions after an abortion, as for any serious life event, but negative emotions generally subside within a few weeks. Often, such feelings are related to the unwanted pregnancy or other life factors, not to the abortion itself, which tends to resolve anxiety and stress.

Across studies, prior mental health is the strongest predictor of post-abortion mental health. Certain subsets of women may also have more difficulty coping after an abortion, such as teenagers, women with wanted pregnancies gone wrong, women who were ambivalent, and very religious women. Ironically, negative emotions like guilt and shame are often the result of stigma imposed by the anti-choice movement.

Sources:

American Psychological Association, Mental Health and Abortion, 2008

PLOS One, Decision Rightness and Emotional Responses to Abortion in the United States: A Longitudinal Study, Rocca et al., July 2015

ANSIRH – The Turnaway Study (2015)

HP David – Born Unwanted: mental health costs and consequences (2011)

JAMA Psychiatry, Psychological Responses of Women After First-Trimester Abortion, Major et al., 2000

American Psychologist, Abortion and Mental Health: Evaluating the Evidence, Major et al., 2009

Guttmacher Institute, Abortion and Mental Health, 2011

Guttmacher Institute, Susan A. Cohen, Still True: Abortion Does Not Increase Women’s Risk of Mental Health Problems (2013)

No one can detect if a woman has had one or more abortions, because it does not leave any traces. Pregnancy itself does leave traces, however. The pregnancy hormone Beta-HCG dissipates slowly from the body, and a pregnancy test can still be positive up to 4-6 weeks after.

If you have a medical abortion using the drugs mifepristone and misoprostol (or misoprostol alone), the effect is like a natural miscarriage, and it is impossible for a doctor to tell the difference. The drugs are metabolized within 24 – 48 hours and would not be detected in any conventional blood test.

Even if you have complications such as infection or retained tissue, these can occur just as commonly in a miscarriage.

The only time a doctor may suspect that you’ve had a previous abortion, is if you had an unsafe abortion in which you suffered serious complications that left scarring or other signs of permanent injury to your uterus or cervix.

Sources:

Women on Waves, Misoprostol, abortion pill, cytotec

Dr. Aarti Abraham (Health Care Magic), Can mifepristone and misoprostol be detected by blood test? (2013)

Childbirth is at least 14 times more dangerous than abortion, as shown by data from the U.S.  A 2012 study found that the pregnancy-associated mortality rate among women who delivered live babies was 8.8 deaths per 100,000 live births (average per year, between 1998 and 2005). The mortality rate for induced abortion over the same period was 0.6 deaths per 100,000 abortions. However, maternal mortality rates in the U.S. have gotten far worse – 26.4 deaths per 100,000 live births were recorded in 2015 (some but not all of the increase may be attributable to improved reporting), even while rates continue to decline in other developed countries. There is no evidence of increased abortion-related deaths in the U.S.

Out of 4.2 million pregnancies (2008 data) that end in live births in the U.S. each year, 700 women die (2017 data) and over 2 million women suffer pregnancy complications, 20,000 of them life-threatening (2008 data). In comparison, only 5 or 6 American women die from abortion each year, even though at least 1 in 5 pregnancies end in abortion.

The huge difference between the safety of childbirth and abortion is repeated in all other countries where abortion is legal.  The reason why the “abortion is dangerous” myth exists is because the anti-choice movement misinterprets studies that seem to show that women who have abortions are more likely to die afterwards, compared to women who give birth. A key example is a 2004 Finnish study often cited by anti-choice activists, which found that women who have abortions are more likely to die from any cause up to one year later, compared to those who give birth – in particular, a risk of death by suicide is usually cited, even though another study did not find this correlation.

The key point is that correlation does not equal causation – which means it could be other factors that lead to an increased risk of death, not the abortion itself.  Women who have abortions should never be compared to women with wanted pregnancies who give birth, as they are two quite different groups. The latter tend to be in more stable and healthy life situations, while women who choose abortions are often doing so because of challenging life circumstances, such as poor health, age (too young, too old) poverty, partner abuse, drug or alcohol abuse, psychological issues, or other problems.  It is these factors that lead to an increased risk of death for women who have abortions, not the abortion itself. (Also, the increased risk of death is quite small).

Sources:

Obstetrics & Gynecology, The comparative safety of legal induced abortion and childbirth in the United States. Raymond & Grimes (2012)

National Public Radio – U.S. Has The Worst Rate Of Maternal Deaths In The Developed World (2017)

British Journal of Psychiatry, AC Gilchrist et al, Termination of pregnancy and psychiatric morbidity (1995)

Centers for Disease Control, Pregnancy Related Deaths (2017)

CDC’s Abortion Surveillance System FAQs (2013)

Guttmacher Institute, Induced Abortion in the United States (2017)

American Journal of Obstetrics & Gynecology, Pregnancy-associated mortality after birth, spontaneous abortion, or induced abortion in Finland, 1987-2000 (Gissler et al., 2004)

Pro-Choice Action Network, Beware of meaningless studies by anti-choice researchers (2003)

Safe, legal abortion performed by qualified practitioners is not linked with any risks to future pregnancy, including both surgical and medical abortion. There is little to no evidence of any impact on a woman’s ability to conceive and carry a pregnancy to term based upon her therapeutic abortion history. The inability to conceive or carry a pregnancy to term is based on many factors (e.g., sexually transmitted infections, genetics, environmental and social factors, etc.).

Women who have not had an abortion experience subsequent miscarriage, ectopic pregnancy, or placenta previa at rates similar to women who have had an abortion. Overall findings from many studies do not support a causal association between induced abortion and ectopic pregnancy. The risk of placenta previa (where the placenta partially or totally covers the cervix, often leading to severe bleeding during pregnancy and delivery) increases with the number of previous deliveries, as well as from uterine scarring from previous surgeries, including caesarean sections and complications from unsafe abortion or D&C treatment for miscarriage.

Long-term risks of one abortion in regards to second-trimester miscarriage, premature birth, low birthweight, and infertility were comprehensively reviewed in 1982 and updated in 1990. These reviews formed the basis for American Surgeon General Everett Koop’s conclusion that “the physical sequelae of abortion were no different than those found in women who carried pregnancy to term or who had never been pregnant.”

Options for Sexual Health, Common Abortion Myths and Facts

New England Journal of Medicine, Medical Abortion and the Risk of Subsequent Adverse Pregnancy Outcomes (2007)

A 2001 symposium at Geneva University Hospital examined the couple relationships and sex lives of 103 women for 6 months before and after an abortion. They noted that the quality of the couple relationship remained the same before and after the abortion. If the relationship was previously well, it remained so afterwards. If the couple had previous difficulties, they were not solved by the abortion. The stability of a couple played a role in the decision to abort.

Partner-related problems are a frequently stated reason for abortion. A 2004 U.S. study found that 48% of women who chose abortion cited relationship problems or a desire to avoid single motherhood as one of their main reasons, with 8.2% citing partner-related problems as the leading reason. Between 2008 and 2010, 31% of U.S. women cited partner-related issues as one of their main reasons. Sometimes a woman may have an abortion to try and save a failing relationship, which usually doesn’t work. These factors help explain the apparent association of abortion with relationship breakup (which is often cited by anti-abortionists), but correlation does not equal causation. The causes of relationship breakups are often varied and generally precede the abortion.

Sources:

Psychische Folgen – Mythen und Fakten, 2001 (in German)

Contraception, Reasons why women have induced abortions: a synthesis of findings from 14 countries (2017)

Guttmacher Institute, Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives (2005)