TLDR: Incomplete and failed abortions are becoming more common due to more prominent use of abortion pills and lax regulations after Covid. Take preventative steps (outlined here) before you get an abortion.

Should I be concerned about an incomplete or a failed abortion?

Amanda* came into our clinic early on in her pregnancy for an ultrasound to see how far along she was because she was interested in taking abortion pills. Because Clarity is not an abortion provider, after her ultrasound, Amanda found abortion pills through another clinic. Amanda bled, cramped, and assumed it was over. Sadly, this clinic did not follow up with Amanda or perform a follow up ultrasound. A few months later, Amanda started feeling movement. Because of her mediocre experience with the second clinic, she reached out to her nurse at Clarity, who brought her in for an ultrasound. There on the screen was a nearly 30 week baby! Amanda was shocked, she thought the abortion had worked.

What’s an incomplete or failed abortion?

According to Mosby’s Medical Dictionary, an Incomplete Abortion is “the termination of pregnancy in which the products of conception are not entirely expelled or removed. It often causes hemorrhage that may require surgical evacuation by curettage, oxytocics, and blood replacement. Infection is also a frequent complication of incomplete abortion.” Basically, the abortion was ineffective and pregnancy continues (failed abortion) or pregnancy tissue does not completely pass (incomplete abortion). Sometimes people use these terms interchangeably. Up to 13% of abortions can be affected. 

While incomplete and failed abortions can happen with any type of abortion, they are more frequent for those who take abortion pills.

What’s the risk?

Incomplete abortion may be of more significant concern to women who take abortion pills. Why?

  1. Taking it too late: Simply put, taking the abortion pill too late in pregnancy – or past the FDA-approved timeframe of up to 10 weeks gestational age – could place a woman at increased risk of incomplete abortion. It’s important to know that only women 10 weeks pregnant or earlier are eligible for chemical abortion abortion. Even 10 weeks has been hotly debated as to its effectiveness.
  2. Your weight: Women with a higher BMI experience decreased effectiveness with the abortion pills. Weight is often not taken into consideration when being dispensed abortion pills, especially if getting from an online provider.
  3. No follow up:  A follow-up appointment is necessary to rule out a failed or incomplete abortion and that your body has stayed safe through the process. At-home abortions bypass this critical step at the cost of your health.

Thankfully, we now offer personalized, professional medical care through a free  ultrasound exam for women considering abortion, that can offset some of these risks.

woman taking pill

Rising use of abortion pills 

Before the pandemic, the medical community’s standard of care required that patients first had to undergo a blood test and an ultrasound so that the provider could determine how far along she was in her pregnancy. However, online abortion pill websites rely only on the dates of the last menstrual period to dispense the abortion pills. Unfortunately this does not accurately determine gestational age- every woman’s body and ovulation is different! So complication rates are rising. Without an ultrasound, there is no way to accurately determine how far along someone is or whether a pregnancy is viable.

Signs of Incomplete and Failed Abortions

It is hard to detect incomplete or failed abortions, because like Amanda*, there is no follow up appointment. Cramping and bleeding can happen with both complete and incomplete abortions. The average bleeding with the abortion pill lasts 9-16 days, but can last more than 30 days. Side effects include large blood clots up to the size of a lemon and can include visible parts of the fetus. You can expect a process similar to a miscarriage, or with even more bleeding, clots, and cramping pending how far along you were. You may also experience nausea, vomiting, diarrhea, feeling dizzy, headaches, or hot flashes. Some signs unique to incomplete abortion to pay attention to are:

  • Fever (which may be a sign of infection that requires immediate intervention)
  • Low heart rate and low blood pressure, possibly from cervical shock
  • Pregnancy symptoms that persist- continued weight gain well after abortion, feeling movement, or beginning to show.

Treatments for incomplete abortion vary in each unique situation. Sometimes, a single additional dose of misoprostol could expel the remaining tissue or fetal remains, resolving the issue. However, more severe cases may require a surgical procedure.

woman making list

Preventing Incomplete Abortion

  1. Ask questions! Do your research- you can use this free checklist to determine if you are safely obtaining abortion services.
  2. Get an ultrasound ASAP! The most important step when considering an abortion is getting an ultrasound. Ultrasounds provide info you need- like gestational, age, viability, and pregnancy location. This also ensures you are not further along in your pregnancy than you think. At Clarity we provide free ultrasounds to help you get answers to all of your questions and get the medical services you need as you process your decision.
  3. Seek follow up. Make sure any abortion provider you are considering (even if it is an online pharmacy) can give you a follow up appointment. If it does provide this follow up, think twice!

Seek Medical Care

If you suspect your abortion may have failed or be incomplete, immediately call your doctor and seek emergency medical care. A delay in receiving treatment for this complication could be dangerous to your health.

If you are in Central Kentucky and considering abortion, make a free appointment at Clarity. We can help!