Surgical Abortion

Induced abortion and early pregnancy loss in the United States are common. One in four pregnant people will have an induced abortion in their lifetime and roughly one tenth of clinically recognized pregnancies end in miscarriage [1, 2]. Though not all cases are managed surgically, induced abortion remains the second most common procedure for people of reproductive age after cesarean section [1, 3]. Surgical uterine evacuation for induced abortion or pregnancy loss in the United States is safe, and complications are infrequent. Abortion by any method is safer than childbirth; major complication (transfusion, unplanned hospitalization, further surgical procedures) rates for surgical uterine evacuation are less than 1% in the first trimester and less than 5% in the second trimester [4]. Other potential complications include hemorrhage, uterine and cervical injury, infection, and incomplete abortion. Because of the rarity of such events, many clinicians do not have direct experience managing complications of surgical abortion. This chapter details their management so all surgeons, regardless of training, can understand evidence-based procedural abortion care.