Post-Abortion Bleeding Concerns: Your Symptoms and Care - Obstetrics and Gynecology

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After undergoing a dilation and curettage (D&C) procedure following a missed miscarriage at nine weeks, it's understandable to have concerns about post-abortion bleeding. Your experience of initially having a normal amount of bleeding, followed by an increase around the 12th and 13th days post-procedure, is not uncommon. Here’s a comprehensive understanding of your symptoms and care recommendations.


Understanding Post-Abortion Bleeding
1. Normal Bleeding Patterns: After a D&C, it is typical for women to experience bleeding that resembles a menstrual period. This bleeding can vary in volume and duration. Initially, you may have experienced light bleeding, which is common as the uterus begins to heal. An increase in bleeding after a few days can occur as the body expels any remaining tissue or as the uterus contracts.

2. Color and Consistency of Bleeding: The presence of dark brown discharge is often old blood that is being expelled from the uterus. It is generally not a cause for concern unless it is accompanied by heavy bleeding or significant pain. The occasional red spotting can also be normal, especially as your body adjusts post-procedure.

3. Medications: The medications prescribed (estradiol and provera) are intended to help regulate your menstrual cycle and promote uterine contractions to expel any remaining tissue. It’s important to take these as directed and monitor your symptoms.


When to Seek Medical Attention
While your doctors have indicated that your uterus appears to be healing well, there are specific signs that warrant immediate medical attention:
- Heavy Bleeding: If you soak through a pad in an hour or less for two consecutive hours, this is considered heavy bleeding and requires evaluation.

- Severe Pain: While some cramping is expected, severe abdominal pain that does not improve with over-the-counter pain relief should be assessed.

- Fever: A fever over 100.4°F (38°C) could indicate an infection and should be evaluated promptly.

- Foul Smelling Discharge: This could be a sign of infection and should be reported to your healthcare provider.


Follow-Up Care
1. Monitoring Symptoms: Keep track of your bleeding patterns, noting any changes in color, volume, or accompanying symptoms. This information will be helpful for your healthcare provider during follow-up visits.

2. Rest and Recovery: Ensure you are getting adequate rest and avoiding strenuous activities as your body heals. This will help your recovery process.

3. Hydration and Nutrition: Staying hydrated and maintaining a balanced diet can support your overall health and recovery.

4. Emotional Support: Experiencing a miscarriage can be emotionally taxing. Consider seeking support from friends, family, or professional counseling if you find yourself struggling with your emotions.


Conclusion
It’s understandable to feel anxious about your symptoms following a D&C. While some increase in bleeding can be normal, it’s crucial to remain vigilant for any concerning signs. Continue to follow your healthcare provider's recommendations, and don’t hesitate to reach out if you have any worries. Your health and peace of mind are paramount during this recovery period.