Although the terms may sound similar, miscarriage and abortion refer to two completely different situations. In both cases, a pregnancy ends, but the main difference lies in why it happens and how it is managed.
A miscarriage occurs when a pregnancy ends without the pregnant person taking voluntary action to end it, while an abortion, also known as induced abortion, occurs when someone decides to end a pregnancy using medications or an in-clinic procedure.
Understanding this difference can help you better interpret symptoms, know what type of care may be needed, and distinguish verified information from myths related to pregnancy loss, as we will explain further below.
What Is the Main Difference Between a Miscarriage and an Abortion?
As mentioned above, the fundamental difference is what causes the pregnancy to end.
- A miscarriage is the loss of a pregnancy that occurs naturally before 20 weeks of pregnancy. This type of pregnancy loss is quite common. In fact, approximately 8 out of 10 pregnancy losses occur during the first 20 weeks. The Royal College of Obstetricians and Gynaecologists (RCOG) states that approximately one in five pregnant people may experience an early miscarriage and that, in many cases, no specific cause is identified.
On the other hand, an abortion occurs when a person intentionally decides to end a pregnancy, either by using abortion pills or through an in-clinic procedure. The World Health Organization (WHO) defines abortion as the voluntary termination of a pregnancy through pharmacological or surgical means. It is important to remember that when an abortion method recommended by WHO is used according to the stage of pregnancy and administered by someone with the necessary skills, abortion is a safe healthcare intervention.
How Do Miscarriages and Induced Abortions Happen?
Although both end a pregnancy, the causes and processes involved are completely different.
How Does a Miscarriage Happen?
A miscarriage happens when a pregnancy stops developing and the body expels the pregnancy tissue before 20 weeks. Although it can be difficult to know exactly what causes a miscarriage, some possible reasons include:
- Chromosomal problems that make fetal development impossible
- Serious illnesses, such as uncontrolled diabetes
- Blood clotting disorders
- Infections or serious injuries
- Hormonal problems
Although the characteristics of a miscarriage can vary from person to person, some of the most common symptoms include intense abdominal pain, strong cramps, and moderate to heavy vaginal bleeding. Sometimes, blood clots as large as a lemon may also be expelled.
In some cases, a miscarriage does not completely expel the pregnancy tissue from the uterus. This is known as an incomplete miscarriage. When this happens, the same medications or medical procedures used to manage an induced abortion may be used to help empty the uterus and complete the miscarriage.
What does not cause a miscarriage?
Miscarriages rarely happen because the pregnant person did something wrong, but some myths can make people believe otherwise. Here are some things that do NOT cause miscarriages:
- Having sex
- Exercising
- Experiencing stress or strong emotions
- Taking medications, such as emergency contraception
- Minor accidents, such as tripping
How Does an Induced Abortion Happen?
An induced abortion intentionally ends a pregnancy using medications, which may be a combination of misoprostol and mifepristone or just misoprostol, or through a surgical procedure, such as Manual Vacuum Aspiration (MVA).
This kind of abortion, also called medical abortion, uses abortion pills that cause uterine contractions to expel the pregnancy tissue. Abortion pills can be used at different stages of pregnancy, but the number of pills needed and the type of care recommended may vary depending on how far along the pregnancy is. Up to 13 weeks, abortion can be safely self-managed at home. The pills are 85%–95% effective, making this a highly safe method of abortion.
On the other hand, surgical abortion is a very safe medical procedure for ending a pregnancy by removing the tissue from the uterus, for example, Manual Vacuum Aspiration (MVA).
WHO states that abortion can be safely performed using appropriate medical or surgical methods based on the duration of the pregnancy. During the first 13 weeks, abortion with pills can also be self-managed at home or in a place where the pregnant person feels comfortable, making sure they have access to accurate information, such as the Abortion Protocol from safe2choose.org, quality pills, abortion counseling and support from our team of counselors.
How Do the Physical Experiences of Miscarriage and Abortion Compare?
The experiences of both types of abortion can be very similar, especially during an early pregnancy. During a miscarriage, a person may experience:
- Vaginal bleeding
- Cramps or abdominal pain
- Passing blood clots or tissue
- Fatigue
- Temporary changes in pregnancy symptoms
However, the intensity and duration of symptoms vary from person to person and also depend on how far along the pregnancy is.
Abortion with pills also commonly causes bleeding and cramps, as these are part of the process of expelling the pregnancy tissue. For this reason, it is important to note that symptoms alone cannot always determine whether a pregnancy loss was spontaneous or induced.
If there is any uncertainty about what is happening, especially in the presence of severe pain, heavy bleeding, sharp pains, fever, or other concerning symptoms, it is important to seek medical care immediately.
What Type of Care May Be Needed After a Miscarriage or Abortion?
After either process, post-care can vary depending on the person and the situation. Some people do not need additional treatment, while others may require follow-up.
Generally, after a miscarriage, it can take a while for pregnancy hormones to stabilize. This can last approximately one month. During this period, it is normal to experience light bleeding, fatigue, cramps, breast tenderness or discomfort. Emotionally, people may experience disappointment, despair, guilt, grief, and/or relief. All of these responses are expected and do not require medical follow-up. However, if other warning signs occur, such as fever above 38°C/100.4°F that does not go down after taking ibuprofen, chills, foul-smelling discharge, heavy bleeding soaking 2 or more pads per hour for 2 consecutive hours, or very severe abdominal pain, it is necessary to seek care from a healthcare professional.
After an successful induced abortion, WHO indicates that a routine follow-up visit is not necessary. The safe2choose protocols, based on WHO recommendations, also indicate that a pregnancy test or ultrasound is not required afterward, nor is any surgical intervention.
However, if pregnancy tissue remains inside the uterus, additional treatment may be necessary. In that case, a person may experience fever, nausea or chills, heavy bleeding, strong cramps, and general discomfort. Depending on the situation, medications or surgical procedure may be necessary.
How Do Physical Recovery and Future Fertility Compare?
Physical recovery varies depending on the person, how far along the pregnancy was, and the type of care received. Bleeding, cramps, and general discomfort may continue for some time after either a miscarriage or an induced abortion, although they should gradually decrease over the course of a week or so.
In terms of fertility, a safely performed abortion does not cause infertility. The American College of Obstetricians and Gynecologists (ACOG) states that abortion does not increase the risk of infertility and that it is possible to become pregnant again approximately 10 days after an abortion.
After a miscarriage, most people can also have a successful pregnancy in the future. RCOG indicates that most miscarriages are isolated events and that there is a good chance of having a successful pregnancy afterward.
Fertility can return quickly after either process. Therefore, if a person does not want another pregnancy, it is recommended to use contraceptive methods or emergency contraception after unprotected sex.
How Can Miscarriage and Abortion Affect Emotional Well-Being?
Honestly, there is no specific way a person should feel after a miscarriage or abortion. People may experience relief, confusion, sadness, anxiety, anger, guilt, or a combination of many emotions, and all of this is completely normal. Some people recover emotionally quickly, while others need more time. Social context, place of residence, the circumstances of the pregnancy, available support, and stigma can all influence how each person experiences this.
The important thing is to avoid assuming how someone should feel. If emotions become difficult to manage or interfere with everyday life, seeking psychological support may be a good option, and luckily, safe2choose counselors are always available to provide evidence-based information and support without prejudice.
When Should Someone Seek Urgent Medical Help?
After a miscarriage or abortion, some symptoms require immediate medical attention. Do not wait to seek urgent care if you experience:
- Heavy bleeding
- Severe abdominal pain
- Dizziness, weakness, or fainting
- Fever or acute illness
These symptoms can have different causes, but some may indicate complications that require prompt treatment, including an ectopic pregnancy, infection, or hemorrhage.
