In Europe, about half of pregnancies are unwanted. About 40% of unwanted pregnancies end in induced abortion, and 90% of the procedures are performed in the first trimester. In countries where abortion is legal, it is usually safe and complications are rare. Globally, 13% of maternal deaths are secondary to induced abortion, and the vast majority of these deaths occur in countries where abortion is illegal. Pregnancy must be confirmed before an abortion is induced. Gestational age is often established by ultrasound, but sometimes only a well-taken history and physical examination are sufficient. Common methods of inducing abortion are: Instrumental evacuation of the uterus after dilatation of the cervix; Medical induction (medicines to stimulate uterine contractions). The method used depends in part on the gestational age. Instrumental evacuation can be used for most pregnancies. Medicines can be used in some pregnancies that are before 11 years of age or after 15 years of age. A medical abortion performed before 11 years of age can be performed on an outpatient basis. Patients undergoing medical abortion after 11 weeks’ gestation should be observed as heavy bleeding is possible. Usually in pregnancy under 14 years old. dilation and suction curettage is used, usually with a large diameter aspiration cannula inserted into the uterus. At a gestational age of less than 9 weeks, manual vacuum aspiration can be used. These devices are portable, do not require an electrical source, and are quieter than electric vacuum aspiration devices. At a gestational age of 14 to 24 weeks’ gestation, dilation and evacuation are usually used. Progressively increasing sizes of tapered dilators are often used to dilate the cervix prior to the procedure. However, depending on gestational age and parity, other types of dilators may need to be used instead of or in addition to tapered dilators to minimize the damage to the cervix that tapered dilators can cause. Medical induction can be used for pregnancies less than 11 years or more than 15 years. In cases where the patient is severely anemic, medical induction for pregnancies beyond 15 weeks should be performed in a hospital where blood transfusion is easy. available. At less than 10 weeks’ gestation, regimens include a progesterone receptor blocker and a prostaglandin E1 analog. Adverse effects of prostaglandins include nausea, vomiting, diarrhea, hyperthermia, facial flushing, vasovagal symptoms, bronchospasm, and decreased seizure threshold. Complications are rare with legal abortion. As the rate of complications increases with advancing gestational age. Serious early complications include: Perforation of the uterus or, less commonly, of the bowel or other organ by an instrument.Heavy bleeding, which may result from trauma or an atonic uterus. Cervical tears, which are usually superficial tears, but can be more serious and require surgical treatment. General or local anesthesia rarely causes serious complications. The most common late complications include: Bleeding and serious infection. These complications usually occur due to retention of placental fragments. If bleeding occurs or if infection is suspected, a pelvic ultrasound is performed. Retained fragments of the placenta can be seen on an ultrasound scan. Mild inflammation is expected, but if the infection is moderate or severe, it can lead to peritonitis or sepsis. Sterility may result from synechiae in the endometrial cavity (Asherman’s syndrome) or tubal fibrosis due to infection. However, induced abortion does not increase the risks to the fetus or the woman during subsequent pregnancies. Source: https://www.msdmanuals.com/en-sg/professional/gynecology-and-obstetrics/family-planning/induced-abortion