Abortion

It is 22:00 in emergency. A 25-year-old re-presents four days after a medical abortion done elsewhere: fever, foul discharge, and bleeding that has soaked three pads in an hour. Her pulse is 118, her blood pressure 96/58, and she looks ill. This is the post-abortion complication drill — retained tissue seeding sepsis, the uterus still bleeding, and a window of minutes before she decompensates. This topic covers that drill, and the counselling and legal framework that surround every abortion encounter.^[1][2]

Overview and definition

Induced abortion ends a pregnancy deliberately; in ANZ it is legal, regulated as health care rather than crime, and performed within a gestational framework set by each jurisdiction. ^[1][7]

This topic takes abortion as a complications-and-law subject — the regimens themselves live in the companion abortion-care topic. Four complications dominate the post-abortion presentation, and the incidence rises with gestational age. The White systematic review (Contraception 2015) set the benchmark for first-trimester aspiration abortion: 3 percent or fewer of procedures needed repeat aspiration, haemorrhage not requiring transfusion occurred in up to 4.7 percent but at or below 1 percent in most studies, and major complications — transfusion-requiring haemorrhage or perforation needing repair — occurred in 0.1 percent or fewer.^[1][2]

References19ShowHide

1. [1]Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Clinical Guideline for Abortion Care (version 1.4) RANZCOG, Melbourne, 2026.Source
2. [2]White K, Carroll E, Grossman D Complications from first-trimester aspiration abortion: a systematic review of the literature Contraception, 2015.PMID 26238336
3. [3]Cheng T, Kumar N, Laursen L, et al. Society of Family Planning Clinical Recommendation: Prevention of infection after abortion and pregnancy loss Contraception, 2025.PMID 40154660
4. [4]Atrio JM, Sonalkar S, Kopp Kallner H, et al. Surgical versus medical methods for second-trimester induced abortion Cochrane Database Syst Rev, 2025.PMID 40626417
5. [5]Farrington E, Huguenin A, Moore P, et al. Second-Trimester Surgical Abortion Is Safe: Audit of Complication Rates at an Australian Tertiary Hospital Aust N Z J Obstet Gynaecol, 2026.PMID 40734334
6. [6]Gemzell-Danielsson K, Cameron S, Bombas T, et al. Rhesus testing and anti-D prophylaxis in RhD-negative women undergoing first-trimester abortion-Systematic Review and Opinion Int J Gynaecol Obstet, 2026.PMID 40728267
7. [7]Snelling JM Beyond Criminalisation: Abortion Law Reform in Aotearoa New Zealand Med Law Rev, 2022.PMID 35092284
8. [8]Bellamak T, Paterson H Reconsidering post 20-week abortion in Aotearoa New Zealand Aust N Z J Obstet Gynaecol, 2023.PMID 37872722
9. [9]Drew AC A comparative analysis of abortion care and outcomes post-decriminalisation in a public sexual health clinic in Queensland, Australia Sex Health, 2025.PMID 40354510
10. [10]Merner B, Haining CM, Willmott L, et al. How Are Healthcare Providers Conscientiously Objecting to Abortion in Australia? A Qualitative Study Perspect Sex Reprod Health, 2026.PMID 41673524
11. [11]Edmondson K, De Costa C, A Grimes H, et al. Experiences and Perceptions of Doctors, Nurses, and Midwives Providing Abortion Care in Australia: A Scoping Review Aust N Z J Obstet Gynaecol, 2026.PMID 42087560
12. [12]Saldanha S, Botfield J, Mazza D Recognising and responding to reproductive coercion in general practice: a qualitative study BMJ Sex Reprod Health, 2026.PMID 41052903
13. [13]Patil R, Dethier D, Fleming M, et al. Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 2 - Abortion Contraception, 2025.PMID 40073954
14. [14]Bearak J, Popinchalk A, Ganatra B, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019 Lancet Glob Health, 2020.PMID 32710833
15. [15]Kim CR, Lavelanet A, Ganatra B; Abortion Care Guideline Development Group Enabling access to quality abortion care: WHO's Abortion Care guideline Lancet Glob Health, 2022.PMID 35303448
16. [16]Cameron ST Early medical abortion Best Pract Res Clin Obstet Gynaecol, 2025.PMID 40015183
17. [17]Zhang J, Zhou K, Shan D, et al. Medical methods for first trimester abortion Cochrane Database Syst Rev, 2022.PMID 35608608
18. [18]Nippita S, Cansino C, Goldberg AB, et al. Society of Family Planning Clinical Recommendation: Management of undesired pregnancy of unknown location and abortion at less than 42 days of gestation Contraception, 2025.PMID 40122324
19. [19]Skahill G, Shankar M Factors that affect the provision of medical abortion services in Australian primary care: a mixed methods systematic review Med J Aust, 2025.PMID 40528569