Q: You’ve been an abortion provider for 11 years now and have treated women from all ages within their reproductive years. If a teen carries a pregnancy to term, what are the possible effects on her general health and her future reproductive fitness?
A: Possible complications include: hypertension, pre-eclampsia and eclampsia with end organ damage to liver, kidneys, brain, heart; birth trauma including tearing of cervix, and perineum-including rectum and anal schincter which can lead to fecal incontinence and/or infections. Also anterior damage resulting in vesico-vaginal fistula (hole between bladder and vagina), causing urine leakage and incontinence until repaired. Also a-traumatic birth can lead to stress incontinence due to weakening of pelvic floor. Also risk of bleeding/hemorrhage. Risk of death due to bleeding, endometritis/sepsis, and amniotic fluid embolism-which is more like an anaphylactic reaction to something we don’t quite totally understand.
Q: And if she has an abortion?
A: First trimester abortion has minimal risk of infection and minor risk of bleeding-rarely enough to lead to transfusion, and exceptionally rare injury to uterus and/or surrounding organs (bladder/bowel) second trimester abortion up to 20 weeks risk of above and injury to uterus is less than giving birth. (Injury to uterus entails, perforation usually not requiring more than antibiotics and monitoring-occasionally requiring repair, and rarely requiring hysterectomy. Injury very rarely includes Asherman’s Syndrome, scarring of endometrium impairing future fertility.)
Q: If a teen chooses to have an abortion (versus a woman who is 20 or older), are there specific concerns or medical issues related to the procedure or recovery that need to be addressed?
A: Medical concerns are more related to the social issues for teens and their developmental state related to their ability to parent if they choose to continue a pregnancy. Prenatal care is usually delayed which can lead to a higher risk of hypertensive urgency (high blood pressures causing physiologic problems) and higher risk of eclampsia (pre-eclampsia is the state of this prior to the seizures), (seizures from placenta releasing chemicals that cause high blood pressure and poor circulation to liver, kidneys, and brain.) Otherwise prenatal care is mostly directed at keeping the fetus healthy. Recovery from abortion is usually the same for teens, 20s, and 30s. Older women are different and so are women with complications during the abortion.
The name of this abortion doctor has been withheld for security reasons. It is a chilling fact that the controversy surrounding abortion sometimes leads to bloodshed as seen with the murder of Dr. George Tiller in 2009.