A therapeutic abortion is performed out of medical necessity. Your clinician may recommend a therapeutic abortion if continuing the pregnancy poses a significant risk to your health.
Your clinician may also recommend a therapeutic abortion if the pregnancy isn’t viable, or if the fetus is unlikely to survive without long-term complications.
This rationale is the only thing that differentiates an “elective” or “voluntary” abortion from a “therapeutic” abortion.
The protocol for terminating a pregnancy or treating a miscarriage is often the same, regardless of the reason for receiving care.
Terms like “elective abortion,” “therapeutic abortion,” and “spontaneous abortion” are more-so used by legislators to define “acceptable” and “unacceptable” medical services.
Insurance providers also use these terms to describe the services they do and do not cover.
It’s worth noting that what constitutes “medically necessity” is highly subjective.
To learn more about your legal rights, message the Repro Legal Helpline via a secure online form or call 844-868-2812.
Your clinician may present the option for termination if continuing the pregnancy presents a
This could be related to a preexisting medical condition, such as:
Or it could be related to a condition that develops during pregnancy, such as:
- premature rupture of membranes (PROM), which can increase the risk of infection
- placental abruption, which can increase the risk of hemorrhagic shock
- preeclampsia, which can increase the risk of organ damage
They may also present the option if prenatal screening suggests a fetal anomaly. Some anomalies can
These may include:
- anencephaly, where the brain, skull, and scalp do not fully develop before birth
- hydrocephalus, where fluid builds up in the skull and the brain swells
- Meckel-Gruber syndrome, where abnormalities develop in multiple organs
- Potters syndrome, where there are low levels of amniotic fluid
- thanatophoric dysplasia, where the limbs are shortened and the lungs are underdeveloped
If the pregnancy is considered high risk for you but not the fetus, you might consider continuing the pregnancy. Your clinician might recommend inducing labor as soon as the fetus has developed enough to live outside the uterus.
You might also consider carrying a pregnancy with a suspected fetal anomaly to term. Some, but not all, fetal anomalies are considered fatal. Talk with your clinician about what this might mean for your pregnancy.
Moving forward with a pregnancy that risks your life or health could result in serious complications.
It’s important to be informed about the risks and all potential outcomes so you can make the best decision for your circumstances.
If you decide against termination, talk with your clinician about your options for managing symptoms, mitigating risks, and delivery. You might also consider creating or updating your advance directives for medical care.
In some cases, continuing a pregnancy could result in death for you or the fetus. Identifying potential resources for support may be helpful.
Thinking about your end-of-life wishes may be difficult, but it can alleviate some of the stress for your loved ones if this information becomes necessary.
More than half of all abortions performed at a medical facility in the United States are medication abortions. Some are completed with two medications — mifepristone and misoprostol — and some only use misoprostol.
Suction (vacuum) aspiration can also empty the uterus during the first trimester. This is a minor surgical procedure that typically
It may be necessary to dilate your cervix beforehand. Your surgeon may also use an instrument called a curette to scrape the uterine lining and confirm that it’s empty. This is called a dilation and curettage (D and C).
Surgical abortion during the second and third trimesters is known as dilation and evacuation (D and E). It involves dilation and aspiration. Additional instruments, like forceps, are used to help remove the pregnancy.
First-trimester prenatal screening is performed during weeks 10–13 of pregnancy. Second-trimester screening is performed during weeks 15–22 of pregnancy.
Because of this, many fetal anomalies aren’t suspected or diagnosed until the second trimester.
Although medical abortion may be used until
week 15, healthcare professionals typically recommend surgical abortion.
Medical or medication termination may be started in a clinic and completed at home. Many people experience some combination of the following symptoms after taking misoprostol:
Sedation can be used to increase your comfort during surgical termination. You may experience bleeding or cramping afterward, but it’s usually
You’ll likely return home the same day as your procedure. Many people feel physically capable of returning to their usual activities the following day.
You might experience a variety of emotions afterward. These feelings may change over time. Remember that there’s no “right” or “wrong” way to feel, and give yourself grace as you move forward.
Researchers conducted a 30-year longitudinal study, published in 2008, with over 500 women studied to the age of 30 to examine the relationship between pregnancy and mental health outcomes.
They suggest that termination for medical reasons may have a greater mental health impact than other reasons for termination or miscarriage, perhaps in part because the latter typically occurs early in pregnancy.
Researchers found that people usually experienced a
Negative mental health impacts were less common — research from 1992 states approximately
Researchers found that negative outcomes were more frequent among people with preexisting mental health conditions. Termination for medical reasons
Researchers also highlighted other demographic factors, like age at time of pregnancy and number of previous pregnancies, alongside a wide array of social, cultural, and economic factors that can influence a person’s outcome.
The decision to continue or terminate a pregnancy is complex. Your unique circumstances often shape the decision process.
If you don’t have a therapist or counselor, your primary care doctor or gynecologist may be able to make a referral. Your healthcare professional can also provide information about your options and answer any questions you may have.
Your care team may make recommendations, but the choice is ultimately yours. You deserve support, dignity, and respect no matter what comes next.
Tess Catlett is a sex and relationships editor at Healthline, covering all things sticky, scary, and sweet. Find her unpacking her inherited trauma and crying over Harry Styles on Twitter.