Medical Abortion: What to Expect and When to Seek Help

Medication abortion

Hello, I took one dose of Misoprostol on September 30th, and there were no reactions on that day or the following day.
On October 2nd at 8 AM, I took three pills (which should induce uterine contractions, right?).
I experienced mild abdominal discomfort, and around noon, I noticed bleeding that continued until 8 PM.
The bleeding only occurred when I used the restroom, and there was only a small amount on the sanitary pad.
Unlike other cases, I did not experience severe abdominal pain or pass any blood clots.
Could this indicate that the gestational sac has not been expelled or that there is an incomplete miscarriage?

Liz, 30~39 year old female. Ask Date: 2016/10/02

Dr. Lin Wenbin reply Obstetrics and Gynecology

Consult a physician for an ultrasound examination, as there may be something that has not been expelled.

Reply Date: 2016/10/02

More Info

Understanding medical abortion can be a complex topic, especially when it comes to the expectations and experiences surrounding the procedure. Based on your description, it seems you have undergone a medical abortion using mifepristone (often referred to by the brand name "保諾錠") and misoprostol (the medication you took subsequently). It’s important to understand the typical process and what signs to look for in terms of effectiveness and potential complications.

In a medical abortion, mifepristone is taken first to block the hormone progesterone, which is necessary for the pregnancy to continue. This is usually followed by misoprostol, which induces contractions to help expel the pregnancy tissue from the uterus. The timing and dosage of these medications can vary, but it is common for patients to experience varying degrees of symptoms.

From your account, it appears that after taking the misoprostol, you experienced some abdominal discomfort and light bleeding. It’s not uncommon for the bleeding to start off light and gradually increase. However, the absence of heavy bleeding, significant cramping, or the passage of large blood clots can raise concerns about whether the abortion was complete.

Here are some key points to consider regarding your situation:
1. Bleeding Patterns: After taking misoprostol, many individuals experience heavier bleeding, which can include passing blood clots. The fact that you are experiencing only light bleeding could suggest that the abortion may not be complete. However, every individual’s experience can differ significantly.

2. Pain Levels: While many report significant cramping and pain during the process, others may have a milder experience. The absence of severe pain does not necessarily indicate a problem, but it can be a sign that the process is not proceeding as expected.

3. Follow-Up Care: It is crucial to have a follow-up appointment with your healthcare provider after a medical abortion. This appointment typically occurs within a week or two after taking the medications to ensure that the abortion was complete and to check for any complications. If you have not yet scheduled this follow-up, I strongly encourage you to do so.

4. Signs of Complications: If you experience severe pain, heavy bleeding (soaking through two or more pads in an hour for two consecutive hours), fever, or foul-smelling discharge, you should seek medical attention immediately. These could be signs of an incomplete abortion or infection.

5. Emotional and Psychological Support: Undergoing a medical abortion can be an emotional experience. It’s important to have support during this time, whether from friends, family, or professional counseling services.

In summary, while your experience may not align with the more typical symptoms of a medical abortion, it does not automatically indicate a failure of the procedure. However, it is essential to consult with your healthcare provider for a thorough evaluation. They may recommend an ultrasound or other assessments to determine if the pregnancy tissue has been fully expelled. Your health and well-being are paramount, and seeking professional guidance is the best course of action.

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