Post-Abortion Bleeding: When to Seek Medical Advice

Q: Post-Abortion Bleeding: When to Seek Medical Advice

Hello Ms. <br>Cheng： Your situation is not uncommon among patients taking RU486. <br>Some individuals may appear to be clear for several days, only to experience bleeding again for a few days without any apparent reason. <br>This could be due to the consumption of traditional Chi

Abortion bleeding

On July 11, I took RU486, and on the 13th, I took a contraction-inducing medication and experienced bleeding.
On the 20th, I returned for a follow-up, and the doctor prescribed additional contraction medication and a hemostatic agent.
During my visit on the 25th, the doctor confirmed that everything was clear and there were no issues, and I had not experienced any bleeding during this time.
However, on the 27th, I suddenly had a significant amount of bleeding again.
When I went back to see the doctor, an ultrasound showed that everything was clear and there was no bleeding from the uterus.
The doctor suggested it might be ovulation bleeding, but is it possible for ovulation bleeding to be that heavy? I'm very worried.

Cheng, 20~29 year old female. Ask Date: 2016/07/27

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello Ms.
Cheng: Your situation is not uncommon among patients taking RU486.
Some individuals may appear to be clear for several days, only to experience bleeding again for a few days without any apparent reason.
This could be due to the consumption of traditional Chinese medicine, such as Shenhua Decoction or ginseng; or it may result from consuming too many cold items or pain relievers, which can lead to re-bleeding.
If the ultrasound shows that everything is clear, then it is generally not a concern.
Sometimes, after a few days, as the endometrium heals and regenerates, the bleeding will stop naturally.
Alternatively, a blood test can be done to check the levels of the pregnancy hormone B-HCG to see if they are decreasing rapidly.
In any case, try not to be too anxious or worried; you can wait a few more days to see how things progress.
As for whether it could be ovulation bleeding, that cannot be ruled out, but typically, ovulatory bleeding is not very heavy.

Reply Date: 2016/07/27

More Info

Post-abortion bleeding can be a concerning issue, and it's understandable that you're feeling anxious about the situation. After taking RU486 (mifepristone) and a follow-up medication to induce contractions, it's common to experience some bleeding as part of the process. However, the amount and duration of bleeding can vary significantly from person to person.

In your case, it seems that after the initial bleeding following the medication, you had a period of no bleeding, which is a good sign. The fact that your doctor performed an ultrasound and found that your uterus was clear and there was no ongoing bleeding is reassuring. However, the sudden return of bleeding on the 27th, especially if it was significant, can understandably raise concerns.

It's important to note that while some women may experience ovulation bleeding, it typically does not present as heavy bleeding. Ovulation bleeding is usually light and may be accompanied by mild cramping. If you are experiencing heavy bleeding, it is crucial to monitor the situation closely. Heavy bleeding can be defined as soaking through a pad or tampon in an hour or less, or passing large clots. If you notice these symptoms, you should seek medical attention immediately.

Here are some key points to consider regarding post-abortion bleeding:
1. Normal Bleeding Patterns: After a medical abortion, it is normal to experience bleeding for a few days to weeks. The bleeding may start heavy and then taper off. However, if you experience a sudden increase in bleeding after a period of no bleeding, it is essential to consult your healthcare provider.

2. Signs of Complications: Be aware of signs that may indicate complications, such as:
- Heavy bleeding (soaking through pads/tampons in an hour)
- Severe abdominal pain
- Fever or chills
- Foul-smelling discharge
- Dizziness or fainting
3. Follow-Up Care: Since you have already had follow-up appointments, continue to communicate with your healthcare provider about any changes in your symptoms. If your doctor has ruled out retained products of conception and other complications, they may suggest monitoring your symptoms for a short period.

4. When to Seek Help: If you experience heavy bleeding, severe pain, or any other concerning symptoms, do not hesitate to seek medical attention. It’s better to err on the side of caution, especially after an abortion.

5. Emotional Support: Remember that experiencing anxiety after an abortion is common. It may be helpful to talk to someone about your feelings, whether it’s a friend, family member, or a mental health professional.

In summary, while some bleeding after an abortion can be normal, significant or sudden changes in bleeding patterns warrant further evaluation. Trust your instincts—if you feel something is not right, reach out to your healthcare provider for guidance. Your health and well-being are the top priority, and it's essential to ensure that everything is progressing as it should.

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