What are the effects of having multiple abortions?

Dear Inquiring Mind, 

Taking the initiative to find out about the possible risk(s) of multiple abortions makes sense. Fortunately, abortion is a low-risk procedure. In fact, the associated risks are significantly lower than those associated with childbirth. Medically speaking, there isn't a maximum number of abortions a person can have; this is a decision that’s up to a patient and their health care provider. For most people, there’s little to no risk of future pregnancy complications, especially if you had uncomplicated abortions. As for legal restrictions, accessing an abortion depends on the state in which you reside. Following the overruling of Roe v. Wade, regulations regarding abortion are constantly changing. If you’re interested in up-to-date information about your state’s reproductive legislation, the Center for Reproductive Rights offers a map that can be useful in determining what care and resources are available to you. 

Having one or more abortions carries little to no risk of future pregnancy complications such as infertility, ectopic pregnancy, miscarriage, or birth defects for future pregnancies. In extremely rare cases, it's possible that a patient can develop pelvic inflammatory disease (PID) or Asherman’s syndrome—condition where scar tissue builds up inside the uterus, causing decreased fertility—as the result of multiple in-clinic abortions. PID is typically the result of a vaginal infection that travels to the uterus or fallopian tubes and can cause scarring, which can lead to fertility issues. However, it’s far more common for PID to develop following an untreated sexually transmitted infection (STI) rather than an in-clinic abortion. Similarly, Asherman’s syndrome is a treatable condition that’s more commonly associated with repeated surgeries on the uterus rather than abortions. 

You mention that you want to avoid having another abortion; many people who share this feeling use birth control to avoid becoming pregnant. Contraceptive options come in two main forms: hormonal and nonhormonal. Hormonal methods of birth control (such as pills, vaginal rings, skin patches, injections, and intrauterine devices) typically utilize varying combinations of estrogen and progestin to impact ovulation and prevent pregnancy, while non-hormonal methods (such as spermicides, vaginal gels, and condoms) provide contraception without the use of hormones. Keep in mind that only condoms can prevent pregnancies and reduce the risk of contracting a STI. Speaking with a health care provider can help you understand the benefits and risks of each one and learn more about what forms of contraception might be right for you. 

Finally, if you did have sex when a birth control method was not used or failed, you still have a non-abortion birth control option: emergency contraception (EC). EC is most effective if taken within 72 hours of having unprotected or protected sex where the method failed but can be taken up to 120 hours (five days) after sex. If taken within the recommended period of time, EC can only help to prevent a pregnancy. EC won’t terminate an existing pregnancy. That being said, EC isn’t recommended to be used as a routine form of birth control. It also isn’t recommended for those who are allergic to it or that are taking medications that can decrease the effectiveness of it. Though there are several forms of EC, levonorgestrel one-pill formulations of EC are now available on retail shelves at many local pharmacies and drugstores. Following the overruling of Roe v. Wade, some states are beginning to restrict access to EC. To track these changes, the Guttmacher Institute maintains an active record of state regulations on EC. If you live in New York City, EC can be obtained for free, 24 hours a day at any public hospital within the five boroughs. 

Some people find that having an abortion is the right choice in the event of an unwanted pregnancy, even if they’ve already had one or more. Since you mentioned you’d like to avoid having another abortion, it might be good to choose a contraception method that best fits your life.  Ultimately, the most beneficial option will be the one that feels the most comfortable for you and best suits your needs. 

Good luck,