Despite the use of local anesthesia, a full 97% of women having abortions reported experiencing pain during the procedure,  which more than a third described as "intense,"  "severe" or "very severe."  Compared to other pains, researchers have rated the pain from abortion as more painful than a bone fracture, about the same as cancer pain, though not as painful as an amputation. 
Studies also reveal that younger women tend to find abortion more painful than do older adults,  and that patients typically found abortion more painful than their doctors or counselors expected.  The use of more powerful general anesthetics can reduce the pain, but significantly increases the risk of cervical injury or uterine perforation. 
Complications such as these are common, as are bleeding, hemorrhage, laceration of the cervix,  menstrual disturbance,  inflammation of the reproductive organs,  bladder or bowel perforation,  and serious infection. 
Even more harmful long term physical complications from abortion may surface later. For example, overzealous currettage can damage the lining of the uterus and lead to permanent infertility.  Overall, women who have abortions face an increased risk of ectopic (tubal) pregnancy  and a more than doubled risk of future sterility.  Perhaps most important of all, the risk of these sorts of complications, along with risks of future miscarriage, increase with each subsequent abortion. 
The particular type and severity of complications depend a great deal on the experience of the abortionist and the particular abortion method used. Given that most abortions are performed at abortion clinics rather than by a woman's regular ob-gyn,  the doctor performing the abortion is likely to be a stranger of whose skill and experience a woman knows very little.  Such things as an inadequate gynecologic examination prior to the operation, the carelessness of the abortionist, or the retention of fetal and placental tissue can all bring on complications. These kinds of complications can usually be treated and generally subside (though not always),  but few women ever return to the clinics for crucial post-operative examinations. 
There is strong evidence that abortion increases the risk of breast cancer. A study of more than 1,800 women appearing in the Journal of the National Cancer Institute in 1994 found that overall, women having abortions increased their risk of getting breast cancer before age 45 by 50%. For women under 18 with no previous pregnancies, having an abortion after the 8th week increased the risk of breast cancer 800%. Women with a family history of breast cancer fared even worse. All 12 women participating in the study who had abortions before 18 and had a family history of breast cancer themselves got cancer before age 45. 
Of course, death of the mother is the most serious of all complications. Over 200 women have died from legal abortions since 1973.  The risk of death increases according to the duration of pregnancy  and the complexity of the abortion technique employed. 
* In most of the discussions above, the abortions referred to are surgical abortions. Chemical methods being relatively new and rare, most studies over the past twenty or so years usually tracked only complications for surgical methods. Complication rates for chemical techniques may be somewhat different; for example, while there is little risk of perforation and laceration with a chemical method, pain and bleeding will probably exceed that of surgical methods. Chemical methods also bring unique risks of their own.
Clinical research provides a growing body of scientific evidence that having an abortion can cause psychological harm to some women. "Women who report negative after-effects from abortion know exactly what their problem is," observed psychologist Wanda Franz, Ph.D., in a March 1989 congressional hearing on the impact of abortion. "They report horrible nightmares of children calling them from trash cans, of body parts, and blood," Franz told the Congressional panel. "When they are reminded of the abortion," Franz testified, "the women re-experienced it with terrible psychological pain ... They feel worthless and victimized because they failed at the most natural of human activities -- the role of being a mother."
The emergence of chemical abortion methods poses a new possibly more devastating psychological threat. Unlike surgical abortions, in which women rarely see the cut up body parts, women having chemical abortions often do see the complete tiny bodies of their unborn children and are even able to distinguish the child's developing hands, eyes, etc.  So traumatic is this for some women that both patients and researchers involved in these studies have recommended that women unprepared for the experience of seeing their aborted children not take the drugs.  Long-term psychological implications of this experience have not been studied.
Researchers on the after-effects of abortion have identified a pattern of psychological problems known as Post-Abortion Syndrome (PAS). Women suffering PAS may experience drug and alcohol abuse, personal relationship disorders, sexual dysfunction, repeated abortions, communications difficulties, damaged self-esteem, and even attempt suicide. Post-Abortion Syndrome appears to be a type of pattern of denial which may last for five to ten years before emotional difficulties surface. 
Now that some clinicians have established that there is an identifiable patterns to PAS, they face a new challenge. What is still unknown is how widespread psychological problems are among women who have had abortions. A Los Angeles Times survey in 1989 found that 56% of women who had abortions felt guilty about it, and 26% "mostly regretted the abortion." Clinicians' current goal should be to conduct extensive national research studies to obtain data on the psychological after-effects of abortion.
With the growing awareness of Post Abortion Syndrome in scholarly and clinical circles, women with PAS can expect to receive a more sensitive appreciation of the suffering that they endure. Fortunately, a growing network of peer support groups of women who have had abortions offers assistance to women who are experiencing emotional difficulties.
Many post-abortive women have also been speaking out publicly about their own abortion experiences and the healing process they went through.. Women or family members seeking information about this particular outreach can contact American Victims of Abortion, 512 10th St. NW, Washington, D.C., 20004.
82. Nancy Wells, D.N.Sc., R.N., "Pain and Distress During Abortion," Health Care for Women International, Vol 12 (1991), pp. 296-297. Actually, all 35 women participating in Wells' study (100%) reported some degree of pain during the abortion, which 34.4% described as "intense."
83. Stubblefield, et al, cited in note 80, p. 493.
84. Eliane Bélanger, Ronald Melzak, and Pierre Lauzon, "Pain of first-trimester abortion: a study of psychosocial and medical predictors," Pain, Vol. 36 (1989), pp. 343, 345.
85 . Belanger, et al, cited above, p. 345, and Stubblefield, et al, cited in note 80, p. 495.
86 . See Tables VII, VIII, IX, X, and XIII, in Stubblefield, et al, cited in note 80, pp. 493-496.
87 . Kenneth F. Schulz, David A. Grimes, Willard Cates, Jr., "Measures to Prevent Cervical Injury During Suction Curettage Abortion," The Lancet, May 28,1983, p. 1184. See also Steven G. Kaali, M.D., et al, "The frequency and management of uterine perforations duing first-trimester abortions," American Journal of Obstetrics and Gynecology, August 1989, p. 408.
88 . Schulz, et al, cited in note 87, p. 1182.
89. Stubblefield, cited in note 9, pp. 1023-1024, and S. Kaali, cited in note 87 pp. 406-408.
90. Stubblefied, cited in note 9, p. 1023
91. L.H. Roht, et al, "Increased Reporting of Menstrual Symptoms Among Women Who Used Induced Abortion," American Journal of Obstetrics and Gynecology, Vol. 127 (1977), p. 356.
93 . David N. Danforth, Ph.D., M.D., ed., et al, Obstetrics and Gynecology, 5th ed. (Philadelphia: J.B. Lipincott, 1986), pp. 217, 257, 382-383. See also Jack Pritchard, et al, Williams Obstetrics, 17th ed. (Norwalk, CT: Appleton-Century-Crofts, 1985), p. 484.
94. Danforth, cited above, p. 887, and David H. Nichols, M.D., Gynecologic and Obstetric Surgery (St. Louis: Mosby-Year Book Inc., 1993), p. 260, and Leon Speroff, Robert H. Glass, Nathan G. Kase, Clinical Gynecological Endochrinology & Infertility (Baltimore: Williams & Wilkins, 1983), pp. 156-157.
95. A. Levin, et al, "Ectopic Pregnancy and Prior Induced Abortion," American Journal of Public Health, Vol. 72, No. 3 (March 1982), pp. 253-256.
96. Anastasia Tzonou, et al, "Induced abortions, miscarriages, and tobacco smoking as risk factors for secondary infertility," Journal of Epidemiology and Community Health, Vol. 47 (1993), p. 36.
97. A. Levin, et al, "Association of induced abortion with subsequent pregnancy loss," Journal of the American Medical Association, Vol. 243, No. 24 (June 27, 1980), pp. 2495-2496, 2498-2499.
98. In 1992, out of 1,528,930 abortions, only 54,460, or 3.6% were performed in physician's offices. The vast majority were performed in abortion clinics (1,057,500 or 69.2%) or at other clinics (307,020 or 20.1%). The rest were performed in hospitals (109,950 or 7.2%). Figures from Stanley K. Henshaw and Jennifer Van Vort, "Abortion Services in the United States, 1991 and 1992, Family Planning Perspectives, Vol. 26, No. 3 (May/June 1994), p. 101.
99. Pamela Zekman and Pamela Warrick, "Women take chances with 'tryout' doctors," Chicago Sun Times, November 14, 1978, p. 1.
100. Stanislaw Z. Lienbrych, M.D., "Fertility Problems Following Aborted First Pregnancy," New Perspectives on Human Abortion, ed. Hilgers, Horan, and Mall, (Frederick, MD: University Publications of America, 1981), pp. 128, 132.
101. Diane Gianelli, "With RU-486, Will More Physicians Provide Abortions?" American Medical News, April 12, 1993, p. 3, 25, 27.
102. Janet Daling, et al, "Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion," Journal of the National Cancer Institute, Vol. 86, No. 21 (November 2, 1994), pp. 1584-1592.
103. Lawson , H. et al, "Abortion Mortality U.S., 1972-1987," American Journal of Obstetrics and Gynecology, Vol. 171, No. 5 (November 1994), pp. 1365-1352. See also, Morbidity and Mortality Weekly Report (CDC), "Abortion Surveillance - U.S., 1989, Vol. 141, No. 55-5, September 4, 1992.
104. Pritchard, cited in note 92, p. 483.
105. Hern, Abortion Practice, cited note 50, pp. 26-35. See also Centers for Disease Control, Abortion Surveillance, 1978, (November 1980) and Christopher Tieze, et al, "Maternal mortality associated with legal abortion in New York State: July 1, 1970-June 30, 1972," Obstet Gynecol, Vol. 43 (1974), p. 315.
106. Wanda Franz, Ph.D., testimony, U.S. Congress, House, Human Resources and Intergovernmental Relations Subcommittee of the Committee on Government Operations, Hearing on Medical and Psychological Impact of Abortion, 101st Congress, 1st Session, March 16, 1989 (Hereafter referred to as Hearing on the Impact of Abortion, 1989). See also Vincent Rue, Ph.D., testimony, U.S. Congress, Senate Committee on the Judiciary, Constitutional Amendments Relating to Abortion, R.J. Res. 18, S.J. Res. 19 and S.J. Res. 110, 97th Congress, 1st Session, Vol. 1, pp. 3329-378; David C. Reardon, Aborted Women, Silent No More (Chicago: Loyola University Press and Westchester, IL: Crossway Books, 1987); Anne Speckhard, Ph.D., The Psycho-Social Stress Following Abortion (Kansas City, MO: Sheed and Ward, 1987); and David Mall and Walter F. Watts, M.D., eds., Psychological Aspects of Abortion (Frederick, MD: University Publications of America, 1979).
107 . Debra Rosenberg, Michele Ingrassia, and Sharon Begley, "Blood and Tears," Newsweek, September 18, 1995, p. 68; Louise Levanthes, "Listening to RU 486," Health, January/February 1995, p. 88. See also Mary Ann Castle, et al, "Listening and Learning from Women About Mifepristone: Implications for Counseling and Health Education," Women's Health Issues, Vol. 5, No. 3 (Fall 1995), pp. 132-133.
108. Philip J. Hilts, "Clinic Trials of French Abortion Pill Begin in U.S., " New York Times, October 28, 1994, p. A28; also Hausknecht, speaking on Donahue, cited in note 41, p. 6.
109. See note 106. See also Vincent M. Rue, Ph.D., Anne Speckhard, Ph.D., James Rogers, Ph.D., and Wanda Franz, Ph.D., "The Psychological Aftermath of Abortion: A White Paper," presented to C. Everett Koop, M.D., Surgeon General of the U.S., September 15, 1987, enclosure to testimony of Wanda Franz, Ph.D., Hearing on Impact of Abortion, 1989, cited in note 106.
110. George Skelton, "Abortion often causes guilt, poll finds," The Sacramento Bee, March 19, 1989, p. A7.
111. Letter from C. Everett Koop, M.D., Sc.D., U.S. Surgeon General to President Ronald Reagan, January 9, 1989.
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