Weight Changes After Abortion: What You Need to Know About Causes and Recovery

Abortion, the termination of a pregnancy by removing the product of conception from the uterus, can have various physical and emotional effects on a woman's body. While emotional aspects are often discussed, the physical changes, including weight fluctuations, are also important to understand. This article, reviewed by MSc, Dr. Tran Lam Khoa of Vinmec Central Park International Hospital's Department of Obstetrics and Gynecology, explores the causes of weight changes after an abortion and provides guidance on managing physical recovery.

Introduction: Abortion and Its Physical Impacts

Abortion is a process in which pregnancy gets terminated by the removal of the product of conception from the body of the mother. It usually occurs before 28 weeks of pregnancy and when happens without any intervention is known as a miscarriage. Besides psychological issues, abortion also has physical impacts on the body. Weight gain is one of them. Recovering from an abortion requires not only emotional care but also physical nourishment.

Understanding Weight Changes After Abortion

Hormonal changes, emotional distress, and changes in dietary habits can all contribute to weight fluctuations after an abortion. It's essential to understand these factors to manage your health effectively.

Do You Lose Weight After an Abortion?

Normally you don’t lose weight after an abortion. Instead, weight gain is common due to hormonal changes in the body. Women’s bodies experience changes as the foetus grow in her womb and after an abortion, these changes are the reason that you don’t lose weight just after the removal of the foetus from the body.

Weight loss can occur after an abortion. “It’s customary to gain some weight with pregnancy, so after there is no longer a pregnancy, weight loss could be a normal or anticipated result,” explains Alan Lindemann, MD, OB-GYN.

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Of course, this depends on how many weeks pregnant you were when you had the abortion.

It’s also possible, he says, that nausea associated with the continued presence of pregnancy hormones could result in weight loss.

According to Marchand, weight gain after an abortion should not occur due to a physiological response from your body.

“The change from pregnant to non-pregnant state allows the body to store less water,” adds Greg Marchand, MD, OB-GYN. “Therefore, you can expect more urination and your body’s water weight to decrease following abortion.” Any stress you experience can also affect your weight. If you’re concerned about losing too much weight, consult a doctor or other healthcare professional.

However, you can lose weight after an abortion with proper diet and exercise. Counselling by a health care provider may be very helpful in dealing with emotional stress which may be the cause of weight gain after a miscarriage. Weight loss doesn’t happen overnight. You have to strive for it and train your body to help it back to normal shape.

Do You Gain Weight After an Abortion?

After an abortion, weight gain is a very common phenomenon. It might be due to certain reasons:

Depression: Depression is one of the most common causes of weight gain after abortion. It is because women usually overlook their diet in depression and consume extra calories resulting in substantial weight gain
Hormonal changes: Hormonal changes after the abortion affect your body’s metabolism which may be the cause of weight gain and fatigue.
Habitual eating: Habitual eating may continue after abortion which can lead to weight gain. Most women remain stuck in the habit of eating extra calories as they were taking during pregnancy.
Another pregnancy: One rare cause of weight gain after abortion is another pregnancy because ovulation starts again after the abortion.

It is very normal to gain weight after an abortion. The reason behind this gain is the hormonal changes that get started early in the pregnancy and continue to few weeks after the termination of pregnancy whether in the form of abortion or normal vaginal delivery. Fluctuating hormones change your metabolism. You may go into a hypothyroidism state in which weight gain substantially occurs due to sluggish metabolism. Some women start consuming extra calories to balance the nutritional needs of the body which may lead to weight gain. It may also be the side effect of some medications you consume after abortion on the prescription of your doctor.

Physical Recovery After Abortion: Essential Guidelines

After undergoing an abortion procedure, patients may experience mild pain in the initial days and vaginal bleeding resembling menstruation for 3-7 days. It is important to monitor for worsening abdominal pain or abnormal bleeding.

Abstain from Sexual Intercourse for at Least One Month

The foremost and essential guideline is to abstain from sexual activity for at least one month. This helps prevent unintended pregnancies and avoids unnecessary damage to the cervix. The abortion procedure can disrupt hormonal balance, alter menstrual cycles, and negatively impact reproductive health. Hormonal imbalances increase the risk of bacterial infections if hygiene is not maintained, potentially leading to inflammation, infection, or bleeding.

Avoid Heavy Physical Activity

Refrain from strenuous physical activities, maintain adequate rest, and adopt a positive mindset to facilitate faster recovery.

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Pay Attention to Your Diet

You need to ensure adequate nutrition through your diet, and supplement many vitamins and nutrients through food, vegetables, and fruits.

Maintain Proper Personal Hygiene

Clean the genital area according to the doctor's instructions, do not use any cleaning solution other than the doctor's instructions. Have regular check-ups according to the prescribed time. Refrain from vaginal douching or inserting anything into the vagina. Avoid harsh chemical cleaning agents. Always clean the genital area from front to back to prevent infections.

Dietary Recommendations After Abortion

What Should You Avoid Eating After an Abortion?

Limit snacks and fried foods: snacks, fast food, and fried foods with a lot of oil such as french fries,… are favorite foods of many people that seem harmless but they are foods that contain very high calories and fat. Stimulant drinks such as alcohol, beer, coffee, carbonated drinks,…

What Should I Eat After an Abortion?

Supplement protein from nutrient-rich foods: Abortion causes the body to lose blood, and bleeding can last up to a week afterward. Protein is an essential nutrient for blood regeneration. Therefore, you should increase foods rich in protein in your meals such as meat (especially beef), animal liver, beans, eggs, and milk.
Foods rich in vitamins: Supplement with basic vitamins such as vitamin C, B1, B2, and vitamin E. Fresh fruits and green vegetables such as spinach, amaranth, tomatoes, bean sprouts, pumpkin, apples, and grapes contain extremely rich vitamin content, in addition to iron and phosphorus to help aid in blood replenishment. If you feel bored and have difficulty eating, you can replace it by drinking fruit juice or fruit smoothies.
Folic acid: Folic acid is essential for women who have just had an abortion.Folic acid is a B vitamin that helps regenerate red blood cells. Folic acid can be obtained from easily available foods such as animal liver, green vegetables, bread, corn, peas, and mushrooms.
Calcium supplements: Lack of calcium in the body causes insomnia, lethargy, and aching limbs. Therefore, calcium supplementation is extremely necessary for rapid health recovery. Don't forget to supplement calcium from seafood, almonds, dark green vegetables, kiwi, mushrooms, etc.
Easily digestible foods: To facilitate the absorption of nutrients and avoid intestinal diseases, experts advise women to eat easily digestible foods such as sweet potatoes, bananas, avocados, zucchini, and chicken.

In addition to nutrient-rich foods, ensure adequate hydration by drinking at least 2 liters of water daily to boost metabolism. Milk or fruit juices can also be included. Even if your body is tired and does not want to eat, you must not skip meals. You can divide your meals into smaller portions to limit loss of appetite. Abortion can lead to blood loss, which may cause a drop in iron levels. Replenishing iron is vital for preventing anemia and aiding in recovery. Iron-rich foods include red meat, poultry, fish, or spinach. Protein is essential. Including a good source of protein in your meals can help your body recover more quickly. Consider lean meats, eggs, dairy products, beans, and nuts. These are important for maintaining good digestion and preventing constipation, which can be a concern due to the use of pain medications or changes in diet following an abortion. Staying hydrated is essential for overall health and helps in the healing process. Water is best, but you can hydrate with herbal teas and natural fruit juices. Calcium helps rebuild bone strength, especially if you’ve experienced decreased physical activity. These are rich in vitamins, minerals, and fiber, aiding in a speedy recovery.

Potential Complications After Abortion

Throughout the procedure, metal instruments are repeatedly inserted and removed, which may cause uterine trauma or even perforation of the cervix or uterus. Some major complications that may occur include:

Uterine perforation.
Hemorrhage.
Cervical tears during the procedure.
Uterine adhesions, often manifesting as reduced menstrual flow or absence of menstruation.
Retained placental tissue, indicated by prolonged bleeding and a higher risk of infection.
Incomplete abortion, where parts of the fetus or its appendages remain and continue to develop.
Infection of the reproductive organs or uterus due to non-sterile procedure practices or poor post-procedure hygiene.
Menstrual irregularities post-abortion, such as prolonged bleeding.
Blocked fallopian tubes caused by inflammation, which can impact future fertility.

Signs Requiring Immediate Medical Examination

You should return to the medical facility for a re-examination immediately if you have one of the following signs:

Severe pain in the lower abdomen, muscle pain, and abdominal pain when pressed.
Fever or chills.
Heavy bleeding (more than normal menstrual bleeding), lasting more than 10 days.

Follow-Up Check-Ups

At the follow-up visit after the abortion, the patient will have a gynecological examination so that the doctor can check whether the uterus has returned to its normal state, signs of genital tract infections, and persistent vaginal bleeding.

What to Expect in the Days After an Induced Abortion

After a medication abortion, expect some bleeding. Cramping is common after a medication or procedural abortion.

Bleeding After Abortion Varies

How much and how long you bleed can vary after an abortion depending on the type of abortion, how many weeks pregnant you were and your medical and pregnancy history (2, 5). Most people report bleeding on-and-off for anywhere from a few days to six weeks after an abortion. Bleeding can stop and restart after an abortion and does not always follow the typical pattern of a period (heavy to light). People can ovulate as soon as two weeks after an abortion, so period bleeding is typically expected around 4-6 weeks after an abortion (5). Typically, you can expect more bleeding after a medication abortion than a procedural abortion (3). Aftercare instructions from your clinic might discuss “pelvic rest” or not using tampons for 2-4 weeks after abortion, however, there is no medical evidence to support this. I generally advise patients not to use a tampon while the pregnancy is expelling during medication abortion (after taking misoprostol) because the tissue needs to exit the body. Once the pregnancy tissue has passed and the medication abortion process is complete, you can use a tampon again. Unlike tampons, menstrual cups are likely safe to use throughout the medication abortion process. Menstrual cups each hold a specific volume, so keeping track of how many times you have emptied the cup during the medication abortion can help your provider decide if your bleeding is within the expected range. As mentioned earlier, if you soak through four pads within two hours after an abortion, you should contact your healthcare provider or seek medical attention (3). So, how does that translate to a menstrual cup? A soaked heavy flow, super, or ultra pad holds around 15-18 ml of blood, so four soaked pads would be 60-72 ml of blood in two hours. Menstrual cups can vary in volume capacity, from 20-70 ml each. You should check with your individual menstrual product to know how much volume it holds to determine how many times your cup would need to be full to equal about 70 ml in two hours.

Pain After an Abortion Might Feel Like Cramping or Pressure

It is typical to have some cramping, a feeling of pressure, or soreness during or immediately after either type of abortion (3, 6). The cramping afterwards could feel like heavy menstrual cramps or diarrhea cramps (6). Pain and cramping after an abortion typically only lasts a few days (6). Most people can manage the pain after an induced abortion with higher doses of ibuprofen (800 mg every eight hours) coupled with a heating pad. Those with allergies or contraindications to ibuprofen and people with complex pain conditions might require a few tablets of narcotic medications for pain control. Some providers routinely prescribe a few narcotic tablets for pain management with medication abortion or second-trimester procedural abortion, while some do not. If your pain is not controlled with high-dose ibuprofen or the narcotic medications you were prescribed, contact your healthcare provider.

Time off Work and Exercise After an Abortion Depends on You

In a just and equitable world, every person would have access to paid time-off from work for physical and emotional recovery after any pregnancy outcome-abortion, miscarriage, ectopic pregnancy and birth. When you can return to work is unique to you and your recovery. Physical and emotional recovery can vary for each person and each pregnancy. Some people want a procedure in the morning and want to return to work in the evening. Some people want a month to recover emotionally before returning to work. Both are totally fine. If your work involves heavy labor, consider at least one or two days off after your abortion for physical recovery. If your job is work-from-home or you can get accommodations to sit for most of your day, then you can likely return to work the day after an abortion. Don’t return to work the same day after a procedural abortion with sedation medications. With medication abortion, you can return to work after taking mifepristone and before taking misoprostol. You can exercise when you feel ready (7). Immediately after an induced abortion is not the time to start a new exercise program or do heavy weightlifting or high-intensity workouts. If you usually do a workout every day and you feel like doing it after your abortion, listen to your body. Start slow and work back up to your regular pace over the next few days or weeks. If you notice increased bleeding or pain after a particular exercise, back down a little and go slower. Allow your body the unique time you need to recover.

You Can Have Sex After an Abortion When You Feel Ready

You can have vaginal sex after an abortion when you feel ready to have sex (7). Although your aftercare paperwork from your abortion provider may say to wait 2-4 weeks after an abortion before having vaginal sex, this is not an evidence-based recommendation (5). Do not have vaginal sex on the day you take the misoprostol or while you are passing the pregnancy. Do not have vaginal sex if you have overnight cervical dilators in place prior to a second-trimester procedural abortion.

Addressing Post-Abortion Syndrome

Post-Abortion syndrome is a form of post-traumatic stress disorder. The process of making an abortion choice, experiencing the procedure and living with the grief, pain and regret is certainly, at it's very core, traumatic. As with any trauma, individuals often try to "forget" the ordeal and deny or ignore any pain that may result. Many simply don't relate their distress to the abortion experience. At some point, however, memories resurface and the truth of this loss can no longer be denied. The symptoms of post abortion syndrome will not necessarily appear at the same time, nor is likely that any woman will experience the entire list. Some may occur immediately after an abortion and others much later. Below are the symptoms that describe post-abortion syndrome, as described by Dr.:

Guilt: Guilt is what an individual feels when she has violated her own moral code. For the woman who has come to believe, at some point either before or after the abortion, that she consented to the killing of her unborn child, the burden of guilt is relentless. There is little consolation to offer the woman who has transgressed one of nature's strongest instincts: the protection a mother extends to her young.
Anxiety: Anxiety is defined as an unpleasant emotional and physical state of apprehension that may take the form of tension, (inability to relax, irritability, etc.), physical responses (dizziness, pounding heart, upset stomach, headaches, etc.), worry about the future, difficulty concentrating and disturbed sleep. The conflict between a woman's moral standards and her decision to abort generates much of this anxiety. Very often, she will not relate her anxiety to a post-abortion syndrome abortion, and yet she will unconsciously begin to avoid anything having to do with babies.
Psychological "numbing:" Many post-abortive women maintain a secret vow that they will never again allow themselves to be put in such a vulnerable position. As a result, often without conscious thought, they may work hard to keep their emotions in tight check, preventing themselves from feeling the pain of what has happened, but also greatly hampering their ability to form and maintain close relationships.
Depression and thoughts of suicide: Deterioration of self-concept--because she feels wholly deficient in her ability to function as a "normal" woman. Reduced motivation--for the normal activities of life. Disruption in interpersonal relationships--because of the general lack of enthusiasm for all activities. Thoughts of suicide--or preoccupation with death.
Anniversary syndrome.
Re-experiencing the abortion: A very common event described by post-abortive women is the sudden distressing, recurring "flashbacks" of the abortion episode, often occurring during situations that resemble some aspect of the abortion, such as a routine gynecological exam, or even the sound of a vacuum cleaner's suction. "Flashbacks" also occur in the form of recurring nightmares about babies in general or the aborted baby in particular.
Preoccupation with becoming pregnant again: A significant percentage of women who abort become pregnant again within one year, and many others verbalize the desire to conceive again as quickly as possible.
Anxiety over fertility and childbearing issues: A common post abortion syndrome symptom in women is a fear that they will never again become pregnant or be able to carry a pregnancy to term.
Interruption of the bonding process with present and/or future children: Fearing another devastating loss, a post-abortive woman may not allow herself to truly bond with other children. Another common reaction is to atone for her actions toward the aborted child by becoming the world's most perfect mother to her remaining or future children. Likewise, the woman who already had children at the time of her abortion may discover that she is beginning to view them in a different light. At one extreme, she may unconsciously devalue them, thinking things like, "you were the lucky one.
Survival guilt: Most women do not abort for trivial reasons. They are usually in the midst of a heartbreaking situation whereby they stand to lose much if they choose to carry their pregnancies to term.
Development of eating disorders: Some post-abortive women developed anorexia or bulimia. While this phenomenon remains largely unexplored at this time, several factors may contribute to it. First, a substantial weight gain or severe weight loss is associated with unattractiveness, which reduces the odds of becoming pregnant again. Second, becoming unattractive serves as a form of self-punishment and helps perpetuate the belief that the woman is unworthy of anyone's attention. Third, extremes in eating behavior represent a form of control for the woman who feels her life is totally out of control.
Alcohol and drug abuse: Alcohol and drug use often serve initially as a form of self-medication--a way of coping with the pain of the abortion memories. Sadly, the woman who resorts to alcohol and/or drugs eventually finds herself having not only more problems but also fewer resources with which to solve them.
Other self-punishing or self-degrading behaviors.
Brief reactive psychosis: Rarely, a post-abortive woman may experience a brief psychotic episode for two weeks or less after her abortion. The break with reality and subsequent recovery are both extremely rapid, and in most cases the person returns completely to normal when it is over. While this is an unusual reaction to abortion, it bears mentioning only because it is possible for a person to have a brief psychotic reaction to a stressful even without being labeled a psychotic individual. During such and episode, the individual's perception of reality is drastically distorted.

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