Different Types of Abortion: Procedures, Risks, and Side Effects

If you think that you’re pregnant and it’s not what you planned, you might be researching your abortion options. 

It’s essential to understand the types of abortion procedures, their potential risks and side effects, and when they can be performed. 

It is also crucial to know how far along you are in your pregnancy. Call (931) 526-5525 for a free, limited ultrasound. 

First-Trimester Abortion Procedures  

The first trimester spans from conception (around four weeks after the first day of your last menstrual period) to the end of week 13. During this period, abortion providers typically offer medical abortions and dilation and curettage (D&C) procedures. 

What Is a Medical Abortion?  

A medical abortion, commonly known as the abortion pill, uses two medications: mifepristone and misoprostol. It’s FDA-approved for use up to 10 weeks of pregnancy.[1]  

The first medication, mifepristone, interferes with progesterone receptors and prevents the pregnancy from developing. The second medication, misoprostol, causes the uterus to cramp and expel the pregnancy.[2] Both medications require a prescription from a qualified healthcare provider.

A woman takes mifepristone first, followed by misoprostol 24 to 48 hours later.[3] The bleeding and cramping will begin between 2 and 24 hours after taking misoprostol.[4] Most women expel the pregnancy within that timeframe,[5] and the symptoms can vary from a heavy period to more intense cramping and bleeding. 

What Is Dilation and Curettage (D&C)?  

A dilation and curettage (D&C) is a surgical abortion available up to 13 weeks of pregnancy.[6] It’s often completed in under 30 minutes.  

Hours before the procedure, small instruments or a medication open (dilate) the cervix.[7]

During the procedure, the abortion provider will use a spoon-shaped device called a curette to scrape out pregnancy tissue, which includes the fetus and placenta, from the uterus. They may also use a suction device at the end to remove any remaining pregnancy tissue.[8]  

Second-Trimester Abortion Procedures  

The second trimester is from week 13 to week 27. During this stage, dilation and evacuation (D&E) becomes the standard procedure due to the pregnancy’s advanced development.  

What Is Dilation and Evacuation (D&E)?  

A dilation and evacuation (D&E) is a surgical abortion most often performed in the second trimester.[9] It’s more complex than a D&C due to the fetus’s size.  

Here’s how a dilation and evacuation works:

• Cervix Dilation: The day before, sponge-like sticks (laminaria) are inserted into the cervix to absorb moisture, gradually expanding and opening it. Medication may also be used overnight to soften the cervix.[10  
• Procedure: Forceps remove the fetus, sometimes in pieces, and a cannula suctions out the uterine contents.[11]  

D&E procedures typically take 10-30 minutes and are often done under anesthesia. Cramping and bleeding may continue for up to two weeks, with a follow-up visit to ensure everything is complete. 

Risks and Side Effects of Abortion  

Every abortion type—medical or surgical—carries risks and side effects. Understanding these can help you weigh your options.  

Medical Abortion Side Effects and Risks  

After a medical abortion, vaginal bleeding or spotting can last for 9-16 days, though it can last 30 days or longer in some cases.[12] 

Other common side effects include[13]:

• Abdominal cramping (from misoprostol)  
• Headaches  
• Nausea and vomiting  
• Diarrhea and digestive discomfort  
• Chills or mild fever  

Severe risks to watch for:  

• Hemorrhaging: Bleeding that soaks two full-size pads per hour for two hours or more requires immediate attention.[14]  
• Incomplete Abortion: If pregnancy tissue remains, emergency surgery may be needed to prevent infection.[15]  
• Infection: Persistent fever, nausea, or vomiting beyond 24 hours after misoprostol use may indicate an infection and may require antibiotics or surgery.[16]  

Surgical Abortion Side Effects and Risks  

D&C and D&E procedures carry risks such as:  

• Uterine Perforation: An instrument may accidentally puncture the uterus, possibly needing surgical repair.[17]

• Asherman Syndrome: Scar tissue inside the uterus from repeated procedures can impact future fertility.[18]  
• Pelvic Inflammatory Disease (PID): Bacteria introduced during surgery may cause infection in the reproductive tract.[19]  
• Intense Pain: Studies show second-trimester abortions like D&E can be more painful than expected.[20]  

What are the abortion laws in Tennessee?

Abortions are illegal in Tennessee.[21] Even if you plan on traveling out of state for an abortion, you should first have an ultrasound and know your abortion options. 

Frequently Asked Questions About Types of Abortion

1. How long does bleeding last after the abortion pill?

Vaginal bleeding typically lasts between 9 and 16 days after a medical abortion, though some women may experience bleeding for 30 days or longer. 

2. Can abortion procedures affect future fertility?

Repeated surgical procedures can potentially lead to Asherman's Syndrome, where scar tissue forms inside the uterus and may impact fertility. Additionally, complications like pelvic inflammatory disease or uterine perforation, though rare, could affect reproductive health. Having a follow-up appointment after any abortion procedure helps ensure proper healing and can address any concerns about future fertility.

3. What pain management options are available during abortion procedures?

For medical abortions, abortion providers may recommend over-the-counter pain relievers to manage cramping.

For surgical procedures such as D&C and D&E, anesthesia options are typically available. Research shows that procedures like D&E can be more painful than some women anticipate.

4. What is an incomplete abortion, and how is it treated?

An incomplete abortion occurs when tissue from the pregnancy remains in the uterus after a medical or surgical abortion. This is a serious complication that can lead to infection if left untreated. 

Signs may include prolonged heavy bleeding, severe cramping, or fever. Treatment typically requires emergency surgery to remove the remaining tissue and prevent infection. 

5. How long is the recovery period after different types of abortion?

Recovery time varies by procedure type. After a medical abortion, women typically need rest and may use over-the-counter pain relief, with bleeding lasting two to three weeks. 

Have Questions About Abortion in Cookeville, Tennessee? Get the Facts at Cookeville Pregnancy Clinic.

If you’re exploring abortion, you don’t have to navigate it alone. The caring team at Cookeville Pregnancy Clinic provides free information on all your options. 

Call us at (931) 526-5525 or schedule an appointment online today.  

Please be aware that Cookeville Pregnancy Clinic does not provide or refer for abortion services.

Sources

1. FDA. (2025, February 11). Questions and Answers on Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation?sm_guid=NTU1NzgyfDYzMDE1OTM2fC0xfGppbUBha2ZhbWlseS5vcmd8NTY4OTI4MXx8MHwwfDE5OTYwMDk4OHwxMDg2fDB8MHx8NTQ3NzI2fDA1
2. See source #1.
3. See source #1.
4. U.S. National Library of Medicine. (2024, November 15). Mifepristone (Mifeprex). MedlinePlus. https://medlineplus.gov/druginfo/meds/a600042.html 
5. Mifepristone (oral route). Mayo Clinic. (2025, February 1). https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123 
6. Cleveland Clinic. (2024, February 9). Dilation and Curettage (D & C). https://my.clevelandclinic.org/health/procedures/dilation-and-curettage 
7. Mayo Clinic. (2023, November 7). Dilation and curettage (D&C). https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910
8. See source #7.
9. Understanding Dilation and Evacuation (D&E). Saint Luke’s Health System. (n.d.). https://www.saintlukeskc.org/health-library/understanding-dilation-and-evacuation-de
10. See source #9.
11. See source #9.
12. See source #4.
13. See source #4.
14. Danco Laboratories, LLC & FDA. (2016, March). Mifeprex Label. FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020687s020lbl.pdf
15. Mayo Clinic. (2022, July 29). Medical Abortion. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687
16. See source #4.
17. U.S. National Library of Medicine. (2024, April 5). Abortion - Surgical. MedlinePlus. https://medlineplus.gov/ency/article/002912.htm
18. Mayo Clinic. (2024, July 6). Elective Abortion: Does it Affect Subsequent Pregnancies? https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/expert-answers/abortion/faq-20058551
19. Mayo Clinic. (2022, April 30). Pelvic Inflammatory Disease (PID). https://www.mayoclinic.org/diseases-conditions/pelvic-inflammatory-disease/symptoms-causes/syc-20352594
20. Dzuba, I. G., Chandrasekaran, S., Fix, L., Blanchard, K., & King, E. (2022, May 12). Pain, Side Effects, and Abortion Experience Among People Seeking Abortion Care in the Second Trimester. Women’s Health Reports (New Rochelle, N.Y.). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9148646/
21. Tennessee State Laws as of December 2025.