Post-Medication Abortion Bleeding: What to Expect

The duration of postpartum lochia after a medical abortion?

Hello Doctor: I underwent a medical abortion on March 18, and the embryo was expelled by March 20.
I returned for a follow-up appointment on March 22, where an ultrasound confirmed that the embryo had been expelled.
On that day, the doctor prescribed a three-day supply of pain medication and antibiotics, advising me to return for follow-up on March 29 if I continued to experience bleeding.
Today, March 28, I returned for follow-up due to ongoing bleeding.
The physician prescribed another three days of pain medication and uterotonics, informing me that if bleeding persists until April 4, a surgical procedure may be necessary.
I would like to ask: 1.
Regarding the progression of lochia from March 20 to March 23: I experienced a large amount of bright red bleeding (using overnight pads), but in the last two days (March 26 to March 28), the bleeding has reduced to about half of what it was, with the color changing from light red to dark red.
Is this progression of lochia normal at this stage? 2.
How long does it typically take for the lochia to be completely expelled after a medical abortion? 3.
If I still have bleeding by April 4 (regardless of the amount), will surgery truly be necessary? 4.
What specific symptoms or abnormalities should prompt immediate medical attention? 5.
If I return for another appointment, should I request the doctor to arrange for any additional tests or blood work?

Nìmíng, 20~29 year old female. Ask Date: 2016/03/28

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
The amount of lochia should gradually decrease, with the color changing from bright red to darker red.

2.
It typically takes three weeks, although a small number of individuals may require four weeks, to completely clear out.

3.
If there is still bleeding on day 4 (regardless of the amount), is surgery really necessary? Not necessarily.

4.
If the amount of lochia is significant, accompanied by increasing abdominal pain, fever, etc., further medical evaluation is needed.

5.
If the amount of lochia is decreasing and the color is changing from bright red to darker red, it usually indicates improvement.
The physician can also perform an ultrasound for assessment.
If there is very little bleeding, one can use a home pregnancy test; if the pregnancy response is faint or absent, it indicates improvement.

Respectfully, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2016/03/28

More Info

After undergoing a medical abortion, it is common to have questions and concerns regarding the bleeding and overall recovery process. Based on your description, let’s address your concerns systematically.

1. Progress of Bleeding: It is typical for the bleeding (lochia) following a medical abortion to vary in volume and color. Initially, you may experience heavy bleeding with bright red blood, which is similar to a menstrual period. As you noted, the transition to a lighter flow and darker color is a normal part of the healing process. The fact that your bleeding has decreased to about half of what it was and has changed from bright red to a darker shade indicates that your body is likely expelling the remaining tissue and returning to its baseline state. However, if you experience any sudden increase in bleeding or passage of large clots, it is essential to seek medical attention.

2. Duration of Lochia: The duration of bleeding after a medical abortion can vary significantly among individuals. Generally, it can last anywhere from a few days to several weeks. Most women will notice a gradual decrease in bleeding over time. It is not uncommon for some to experience light spotting for up to four weeks or longer. If you find that the bleeding persists beyond this timeframe or becomes heavier, it is advisable to consult your healthcare provider.

3. Need for Surgical Intervention: If you continue to experience bleeding beyond the expected timeframe (in your case, past April 4), it may be necessary to evaluate the situation further. Surgical intervention, such as a dilation and curettage (D&C), may be recommended if there is a concern about retained products of conception or if the bleeding is excessive. Your healthcare provider will assess your symptoms, including the amount of bleeding and any accompanying pain, to determine the best course of action.

4. When to Seek Immediate Medical Attention: You should seek immediate medical attention if you experience any of the following:
- Heavy bleeding (soaking through one or more pads in an hour for two consecutive hours).

- Severe abdominal pain that is not relieved by over-the-counter pain medications.

- Fever or chills, which may indicate an infection.

- Foul-smelling discharge.

- Any other unusual symptoms that cause you concern.

5. Further Testing and Follow-Up: If you return for a follow-up appointment, your doctor may recommend additional tests, such as a pelvic ultrasound or blood tests, to assess your hormone levels and ensure that the abortion was complete. It is essential to communicate any ongoing symptoms or concerns during your follow-up visits, as this will help your healthcare provider make informed decisions about your care.

In conclusion, while the changes in your bleeding pattern seem to align with typical post-abortion experiences, it is crucial to stay vigilant and proactive about your health. Always feel empowered to reach out to your healthcare provider with any concerns, as they are best equipped to guide you through this process. Your well-being is paramount, and ensuring that you receive the appropriate care and support is essential for your recovery.

Similar Q&A

Understanding Post-Medication Abortion Bleeding: What to Expect

Hello, I would like to ask about my situation. On December 18, I took the second dose of medication for a medical abortion. I had already experienced light bleeding (only needed a panty liner). On December 23, I had a follow-up appointment, and the doctor said that I had expelled...

Dr. Zhang Kunmin reply Obstetrics and Gynecology
Hello, the patient must return for a follow-up appointment one to two weeks after taking the abortion medication. Clinical examination, β-HCG testing, and ultrasound scanning should be performed to confirm whether the embryo has been completely expelled. If there is ongoing bleed...

Understanding Post-Abortion Bleeding After Medication Abortion

Hello Doctor: I took the first and second doses of medication for a medical abortion on February 3rd and 4th, and everything seemed normal at that time. I won't elaborate on that. During my follow-up appointment on February 8th, the doctor performed an ultrasound and mention...

Dr. Huang Jianzhong reply Obstetrics and Gynecology
I took the first and second doses of medication for a medical abortion on February 3 and February 4, and everything seemed normal up until that point. I won't elaborate on the details, but during my follow-up appointment on February 8, the doctor performed an ultrasound and ...

Post-Medication Abortion Concerns: Understanding Bleeding and Treatment Options

Hello, Doctor: About a month and a half after a medical abortion, I started experiencing bleeding similar to a menstrual period, which lasted for three weeks. I visited the doctor three times during this period. During the first visit, the doctor performed an ultrasound but did n...

Dr. Huang Jianzhong reply Obstetrics and Gynecology
About a month and a half after a medical abortion, I started experiencing bleeding similar to a menstrual period, which lasted for three weeks. I visited the doctor three times during this period. During the first visit, the doctor performed an ultrasound but did not clearly indi...

Understanding Post-Medication Abortion Bleeding Patterns: What to Expect

Hello, doctor. On March 4th, I took the first pill at the clinic, and two days later, I took three pills, but I was ten minutes late. Shortly after, I started experiencing abdominal pain and nausea. Around 6 PM, I began to bleed, and the amount was similar to my usual menstrual f...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, you should still follow your doctor's instructions and return to the hospital for a follow-up to see if the miscarriage has been completed. Wishing you good health.