What are patients seeing on social media?
Patients may see mis/disinformation that procedural abortion is high-risk, commonly causing infertility, uterine damage, or death, and that providers intentionally withhold information about risks during counseling. Specific claims that circulate include: “they don’t tell you what this does to your uterus,” “D&C causes permanent scarring and you’ll never be able to get pregnant again,” and “women are dying from these procedures and no one is reporting it.” Some content intentionally blurs safe, evidence-based procedural abortion care with outdated or unsafe practices, making it harder for patients to evaluate what they see online. For procedural abortion in particular, the “dangerous surgery” frame taps into broader anxieties about medical procedures and anesthesia in addition to abortion stigma.
What’s the evidence?
- Procedural abortion is one of the safest procedures in outpatient care. Serious adverse events are rare, and mortality risk is significantly lower than childbirth. Restrictions on abortion care, including waiting periods, that intentionally delay access increase risks associated with procedural abortion, and on a population level, increase maternal mortality.
- Evidence-based approaches to procedural abortion, including uterine aspiration, D&E, and other methods safely used across gestational durations in the US, are safe and effective and not associated with long-term physical or mental health harms in the ways commonly claimed online. Research shows that being denied a wanted abortion increases anxiety and lowers self-esteem immediately after denial.
- Procedural abortion, including vacuum aspiration and D&E, is an established, guideline-supported approach with decades of safety data. Trained providers using appropriate techniques safely and effectively offer person-centered procedural abortion care across gestational durations.
- Pain experiences are real and variable, and offering pain management is not optional. Social media content often conflates pain with danger and procedural abortion risk. Providers can address both separately by validating pain management as standard practice, while clarifying that pain during procedural abortion does not indicate that the procedure is unsafe.
Citations
- Biggs MA, Upadhyay UD, McCulloch CE, Foster DG. Women’s mental health and well-being 5 years after receiving or being denied an abortion: a prospective, longitudinal cohort study. JAMA Psychiatry. 2017;74(2):169–178. doi: 10.1001/jamapsychiatry.2016.3478.
- Raymond EG, Grimes DA. The comparative safety of legal induced abortion and childbirth in the United States. Obstet Gynecol. 2012;119(2 Pt 1):215–219. doi: 10.1097/AOG.0b013e31823fe923. PMID: 22270271.
- Upadhyay UD, Desai S, Zlidar V, Weitz TA, Grossman D, Anderson P, Taylor D. Incidence of emergency department visits and complications after abortion. Obstet Gynecol. 2015;125(1):175–183. doi: 10.1097/AOG.0000000000000603.
- Zori G, Case S, Pyche C, Beckman L. The relationship between state-level abortion policy and maternal mortality in the United States: a scoping review. Health Aff Sch. 2025;3(8):qxaf146. doi: 10.1093/haschl/qxaf146.
- National Academies of Sciences, Engineering, and Medicine. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press; 2018. Available at: nap.nationalacademies.org
- World Health Organization. Abortion Care Guideline. Geneva: WHO; 2022. Available at: who.int
- Society of Family Planning. Clinical Guidance Library — Procedural Abortion. Available at: societyfp.org/clinical/clinical-guidance-library
Talking with patients about procedural abortion safety
Get curious:
It’s understandable to be worried. Can you tell me more about what you’re concerned about? Are you worried about feeling pain, the abortion procedure itself, or something else? It’s also okay to feel nervous in general.
Would you like me to walk you through what to expect with procedural abortion, along with the potential risks and benefits?
Acknowledge concerns & normalize:
It makes sense to have questions about procedural abortion. People tend to share the worst experiences online, not the usual ones.
If a patient has encountered specific claims about risks associated with procedural abortion, name them directly rather than giving general reassurance. Patients who feel their specific concern was heard are more likely to trust the clinical information that follows.
Clarify with evidence and empathy
Procedural abortion is very safe. Serious complications are rare, and we follow clear protocols developed from decades of peer-reviewed research to prevent and treat issues like infection or heavy bleeding.
Pain with procedural abortion is real; what you will feel varies, but we will make a plan together to make sure we can manage your pain.
Key takeaways
- Procedural abortion is highly safe; complications are uncommon, and serious adverse outcomes are rare.
- Decades of safety data support clinical guidelines and practice standards for procedural abortion approaches across gestational durations.
- Pain experiences are real and vary, but making a plan for pain management is essential for providing person-centered care.
- Providers should listen with curiosity to concerns about procedural abortion and respond directly and specifically with evidence rather than general reassurance.
- Abortion restrictions and limits on safe, effective, and evidence-based approaches to procedural abortion care increase risk and cause harm to people seeking abortion care.