Post-Medication Abortion: What to Expect and When to Worry

Miscarriage and abortion?

Hello Doctor: I took medication for a miscarriage on June 7, and on June 9, I noticed some small tissue passing.
By June 13, there was almost no bleeding (I could use a panty liner).
On June 14, during my follow-up appointment, the doctor said that I had expelled everything and prescribed four more days of medication (three pills and one capsule), stating that I would experience some bleeding, but I did not.
Until June 23, when I noticed a little blood while wiping after using the restroom, I didn't pay much attention to it.
On June 24, the same situation occurred, but it had already stained my underwear (I started using panty liners, which had a little red but not much).
By June 25, the panty liners were no longer sufficient, so I switched to sanitary pads.
Up until now, I still feel some contractions, but they are not painful.
Is this normal, Doctor? I have continued to work without taking any time off, could being too tired be a factor? Thank you, Doctor.

Enen, 20~29 year old female. Ask Date: 2016/06/26

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the success rate of medical abortion is approximately 95%, while the failure rate is about 5%.
After taking the abortion medication, patients must return for follow-up within one to two weeks.
Clinical examination, β-HCG measurement, and ultrasound scanning are necessary to confirm whether the embryo has been completely expelled.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2016/06/26

More Info

Understanding post-medication abortion can be a complex process, and it's essential to be informed about what to expect and when to seek medical attention. Based on your timeline and symptoms, it appears that you are experiencing a typical response to medication-induced abortion, but there are some important considerations to keep in mind.

After taking medication for an abortion, it is common to experience a range of symptoms, including bleeding and cramping. The timeline you provided indicates that you began to see signs of the abortion process shortly after taking the medication, which is a positive sign that the medication is working. The presence of small tissue or "clots" is also expected as the body expels the pregnancy tissue.

1. Bleeding Patterns: It is normal for bleeding to vary in intensity and duration after a medication abortion. Initially, you may experience heavier bleeding, which can taper off to lighter spotting. The fact that you saw some bleeding on June 23 and 24, and that it increased to the point where you needed to switch to sanitary pads, suggests that your body is still in the process of expelling the remaining tissue. This is typically expected and can last for several days to weeks.

2. Cramping: The sensation of cramping is also a normal part of the process as your uterus contracts to expel the tissue. While you mentioned that the cramping is not painful, mild discomfort can still be expected. If the cramping becomes severe or is accompanied by heavy bleeding (soaking through a pad in an hour), it would be advisable to seek medical attention.

3. Follow-Up Care: The follow-up appointment with your doctor is crucial. If your doctor has prescribed additional medication, it is likely to help facilitate the process further. It’s important to follow your doctor’s instructions regarding medication and to attend any scheduled follow-up appointments to ensure that the abortion is complete and that there are no complications.

4. Signs of Complications: While your symptoms seem to align with a typical post-abortion experience, there are certain signs that warrant immediate medical attention. These include:
- Heavy bleeding (soaking through two or more pads in an hour for two consecutive hours)
- Severe abdominal pain that is not relieved by over-the-counter pain medication
- Fever or chills
- Foul-smelling discharge
- Symptoms of an ongoing pregnancy (such as a positive pregnancy test after the procedure)
5. Emotional and Physical Well-Being: It’s also important to consider your emotional and physical well-being during this time. The process can be physically taxing, and if you are feeling fatigued, it may be beneficial to take some time off work to rest and recover. Stress and exhaustion can impact your recovery, so prioritizing self-care is essential.

6. When to Seek Help: If you have any concerns about your symptoms or if you experience any of the warning signs mentioned above, do not hesitate to contact your healthcare provider. They can provide reassurance and guidance based on your specific situation.

In summary, while your current symptoms seem to be within the normal range following a medication abortion, staying vigilant and aware of your body’s signals is crucial. Make sure to follow up with your healthcare provider as recommended, and take care of yourself both physically and emotionally during this time. If you have any further questions or concerns, don’t hesitate to reach out to your doctor for personalized advice.

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