The short answer on fertility

Having an abortion does not usually affect your ability to get pregnant in the future or to carry a pregnancy to term. This is the consistent position of the NHS and the RCOG, and it applies both to medical abortion using tablets and to surgical abortion.

The more immediate point catches most people out: fertility returns almost straight away. Ovulation can occur within about two weeks of an abortion, which means you can conceive again before you have had any period at all.

That has a practical consequence in both directions. If you do not want to be pregnant again yet, contraception needs to start immediately rather than waiting for your next period. If you are hoping to conceive, it may happen sooner than you expect.

What the evidence does and does not support

Things that are not the case

It does not cause infertility in the ordinary course of events.
It does not cause breast cancer. This claim circulates widely and is not supported.
It does not mean you will miscarry next time. A straightforward abortion does not raise the risk of miscarriage in a subsequent pregnancy.
One abortion does not "use up" chances.

The genuine, uncommon risks

Every procedure has some risk, and being accurate is more useful than blanket reassurance. The RCOG and NHS identify the following as uncommon but real:

Infection. If untreated, pelvic infection can damage the fallopian tubes, which can affect fertility. This is why any signs of infection afterwards should be treated promptly, and why providers screen for and treat infection around the time of an abortion.
Retained tissue, requiring a further procedure.
Injury to the womb or cervix, which is rare, and rarer still with early procedures.

The consistent theme is that fertility problems after an abortion are almost always the result of an untreated complication rather than the abortion itself. Treated promptly, they usually resolve without lasting effect.

If you want to conceive again

How long to wait

There is no fixed medical requirement to wait a set number of cycles before trying. You will usually be advised to wait until any bleeding has stopped, and to allow at least one period so that dating a subsequent pregnancy is easier. If you had a later abortion, a surgical procedure with complications, or an infection, take individual advice.

Before trying

Start folic acid before conceiving.
Make sure any infection was fully treated, and that a partner was treated too if relevant.
Have a cervical screening test if you are due one.
Let your GP know your history when you book antenatal care — it is relevant clinical information, and clinicians deal with it routinely and without comment.

Your cycle afterwards

Bleeding after an abortion varies and can last a couple of weeks. Your first period usually comes within four to six weeks. Cycles may take two or three months to settle into their usual pattern.

The emotional part

People's feelings after an abortion vary enormously, and there is no correct version. Relief is common. So is sadness, and so is both at once. Feeling grief does not mean you made the wrong decision, and feeling relief does not mean you are cold.

Trying to conceive later can sometimes bring feelings back unexpectedly, particularly around dates, or if conception takes longer than hoped and you find yourself connecting the two. That connection is almost always false — but the worry is real and worth talking about rather than carrying silently.

Post-abortion counselling is available through abortion providers and is usually free, including some time after the event. You do not have to be in crisis to use it.

When to seek medical advice

Urgently, at the time or in the days afterwards: heavy bleeding soaking more than two pads an hour, severe pain not helped by painkillers, a fever, or offensive-smelling discharge. These need same-day assessment.

Later on:

Periods have not returned within about eight weeks.
Periods are much lighter or absent afterwards, or you have cyclical pain without bleeding — this is uncommon but should be investigated.
Persistent pelvic pain, pain during sex, or unusual discharge.
You have been trying to conceive for a year, or six months if you are over 35.

If you are struggling to raise your history with a clinician, you do not have to justify it. It is part of your medical record like anything else, and it helps them help you.

Later abortions and surgical procedures

Most abortions in the UK and Ireland happen early in pregnancy, and early medical abortion has a very low complication rate. Procedures later in pregnancy carry a slightly higher chance of complications, including injury to the cervix, and this is the situation where individual advice about future pregnancies is most worth seeking.

If you had a later abortion, ask specifically whether anything about it should be mentioned at your next antenatal booking. In most cases the answer is that it makes no difference, but having asked is better than wondering.

If you have had more than one

Repeated abortions do not, in themselves, cause infertility. The concerns that exist relate to cumulative risk from any procedures involved rather than to abortion as such. If you have had several and are worried, that is a reasonable thing to raise with a GP directly, and contraception advice tailored to what has not worked for you before is worth asking for at the same time.

Rhesus negative blood

If your blood group is rhesus negative, this is relevant to future pregnancies and you should have been offered anti-D at the time. If you are not sure whether you received it, ask — it is recorded, and knowing matters for subsequent pregnancies.

Telling a future clinician

You are not obliged to disclose an abortion to anyone in your life, but it is genuinely useful information for maternity care, and it is recorded and treated like any other part of your history. Clinicians ask about previous pregnancies because the number and outcome affect your care, not to form a view.

Getting Pregnant After a Termination