258 Abor tion
Fainting or loss of consciousness
Fainting can be a sign of shock after abortion, either
from heavy bleeding, severe injury to the internal organs, or
infection. For signs and treatment of shock, see page 254. If
a woman faints but wakes up very soon afterward and does
not have signs of shock, give her plenty of liquids to drink and
watch her carefully.
Injury inside the body (internal injury)
An internal injury from an abortion is most often caused by
a sharp object that makes a hole in the womb. The object may
also cause damage to other internal organs, such as the tubes,
ovaries, intestines, and bladder.
When a woman has internal injuries she may have severe
bleeding inside her abdomen but almost no bleeding from her
Signs (she will have some or all of these):
• her abdomen feels stiff
and hard with no sounds
or gurgles inside
• very bad pain or
cramps in the
• nausea and vomiting
Listen for gurgles for 2 minutes.
• pain in one or both shoulders
• Immediately take the woman to a hospital or clinic where she
can have surgery. An injury inside the body must be repaired
right away by a surgeon or it can lead to infection, shock, and
• Do not give her anything by mouth—no food, no drink, not
even water—unless it will take more than 12 hours to get to
a health center. Then give water only in small sips. Or let her
suck on a piece of cloth soaked in water.
• If she has signs of shock, treat her for shock (see page 254).
Make sure nothing is blocking her mouth and that she can
• Give her the medicines for infection (see page 257), but
only by injection or IV. If possible, give her a tetanus toxoid
vaccination (see page 515).
Where Women Have No Doctor 2012