Post-Abortion Symptoms and Concerns: A Guide for Women

Abortion

Hello, doctor.
Due to the gestational sac growth stopping at 6 weeks, I took medication for a medical abortion on October 15 at about 9 weeks.
The next day, I experienced some tissue expulsion.
On October 18, during a follow-up visit, it was confirmed that the gestational sac had been expelled.
From then until October 27, I only had a small amount of fresh blood, requiring only a panty liner.
Starting October 28, the discharge turned brown and decreased further.
On October 30, I suddenly had some flesh-colored tissue expelled along with a small amount of red blood.
That day, I took a home pregnancy test, which still showed two lines.

I would like to ask:
1.
Is it possible that the minimal menstrual bleeding indicates that not everything has been expelled, especially since I usually do not have such light periods?
2.
Given that I still see two lines on the pregnancy test, does this mean that there may still be retained tissue that requires a dilation and curettage (D&C)?
3.
The doctor originally scheduled a follow-up visit on November 7 to check the pregnancy hormone levels through a urine test.
Should I return for an earlier visit, or is it normal for the hormone levels to not drop quickly? Thank you!

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

Dr. Lü Lizheng reply Obstetrics and Gynecology

The home pregnancy test still shows two lines, indicating that there is still a small amount of embryonic tissue present.
Whether surgical curettage is necessary or if medication can suffice should be discussed further during a follow-up appointment with your physician.
Sincerely, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2016/10/30

More Info

After undergoing a medical abortion, it is common for women to experience a range of symptoms and concerns regarding their recovery. In your case, it appears that you have been monitoring your symptoms closely after taking medication for the abortion and have noticed some unusual bleeding patterns. Let’s address your concerns systematically.

1. Bleeding Patterns: It is not uncommon for women to experience light bleeding or spotting after an abortion. The fact that you initially had some bleeding and then transitioned to brown discharge is typical as the body clears out the uterine lining. Brown blood usually indicates older blood that is taking longer to exit the body. However, if you are experiencing very light bleeding that is significantly less than your normal menstrual flow, it is essential to monitor this closely.
2. Incomplete Abortion Concerns: You mentioned that you are concerned about whether the tissue has been expelled completely. If you are experiencing only minimal bleeding and have passed some tissue, it may indicate that the abortion was successful. However, the presence of a positive pregnancy test (two lines) suggests that there may still be some pregnancy hormone (hCG) in your system. This can happen if there is retained tissue or if your body is still processing the hormonal changes.
3. Follow-Up Care: It is crucial to follow up with your healthcare provider, especially since your doctor has scheduled a follow-up appointment for November 7 to check your hCG levels. If you are feeling uncertain or if your symptoms change (such as increased bleeding, severe pain, or fever), it is advisable to contact your healthcare provider sooner than the scheduled appointment. They may want to perform an ultrasound to ensure that the uterus is clear of any remaining tissue.

4. D&C Consideration: If there is retained tissue, your doctor may discuss the option of a dilation and curettage (D&C) procedure to ensure that the uterus is completely empty. This is typically considered if there are signs of complications or if the bleeding does not normalize.

5. Emotional and Physical Recovery: Beyond the physical aspects, it is also important to consider the emotional recovery after an abortion. Many women experience a range of emotions, including relief, sadness, or anxiety. It is perfectly normal to seek support from friends, family, or mental health professionals during this time.

6. Future Contraception: If you are considering future pregnancies, it is advisable to discuss contraception options with your healthcare provider. They can help you understand when it is safe to try for another pregnancy and what methods might be best for you.

In summary, while some light bleeding and changes in discharge can be normal after an abortion, it is essential to stay vigilant about your symptoms. If you have concerns about incomplete abortion or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation. Your health and well-being are paramount, and timely follow-up care is crucial in ensuring a smooth recovery.

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