Post-Abortion Bleeding and Discharge: What to Expect After 20 Days

It has been 20 days since the abortion, and there is still some bleeding and discharge?

After the abortion procedure on February 1st, I experienced very little bleeding for the first one to two days.
On the third day, there was a slight increase in bleeding, but it was still minimal, only enough to require a panty liner.
After that, I mostly had brown discharge.
During my follow-up appointment three days post-surgery, the doctor performed an ultrasound and confirmed that everything was clear.
I took medication for three days.
By the second week after the procedure, the discharge had significantly decreased, almost to the point of being nonexistent.
However, on the 21st day, the discharge increased again.
This morning, I noticed a sensation of discharge and found a lot of dark red, almost black clots on the toilet paper after wiping.
Following that, there was more brown discharge, and I also felt some in the vaginal area.
When I needed to use the restroom, I felt a bloated sensation in my uterus, similar to menstrual cramps.
I am very concerned about whether there is a problem or if it is just retained blood that hasn't been expelled.
Doctor, what do you think about my symptoms? If I need medical attention, would it be possible to go to another hospital for an examination?

yoyo, 30~39 year old female. Ask Date: 2017/02/21

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I apologize for not being able to provide a diagnosis based on what you've described.
It is advisable to return to your obstetrician-gynecologist for a thorough examination.
Wishing you good health.

Reply Date: 2017/02/21

More Info

After an abortion, it is common for women to experience a range of symptoms, including bleeding and discharge. The timeline and nature of these symptoms can vary significantly from person to person. Based on your description, it seems you are experiencing some typical post-abortion symptoms, but there are also signs that warrant further attention.

1. Post-Abortion Bleeding and Discharge: It is normal to have light bleeding or spotting for a few days after an abortion, which may then transition into brownish discharge as the body expels the remaining tissue. The fact that you had minimal bleeding initially and then experienced a change to more significant discharge on day 21 is not uncommon. However, the presence of dark red or black clots can be concerning. This could indicate retained products of conception or other complications.

2. What to Expect: Generally, after an abortion, the bleeding should gradually decrease over time. The typical timeline for the return to normalcy can vary, but most women see a significant reduction in bleeding within two weeks. If you are experiencing increased bleeding or the return of clots after a period of reduced discharge, it could suggest that not all tissue has been expelled, or there may be another underlying issue.

3. When to Seek Medical Attention: You should seek medical attention if you experience any of the following:
- Heavy bleeding (soaking through a pad in an hour or less).

- Severe abdominal pain that does not improve with over-the-counter pain relief.

- Fever or chills, which could indicate an infection.

- Foul-smelling discharge.

- Any other symptoms that feel unusual or concerning to you.

4. Follow-Up Care: If you are worried about your symptoms, it is advisable to return to your healthcare provider for a follow-up appointment. They may perform an ultrasound to ensure that your uterus is clear of any remaining tissue. If you feel uncomfortable returning to the same facility, you can seek care at another hospital or clinic. It is important to communicate your symptoms clearly to the healthcare provider so they can assess your condition accurately.

5. Future Considerations: After an abortion, it is crucial to monitor your body’s response. If you are planning to conceive again, it is generally recommended to wait until you have had at least one normal menstrual cycle before trying to get pregnant again. This allows your body to heal properly and can help in dating any future pregnancies accurately.

In summary, while some variation in bleeding and discharge is expected after an abortion, significant changes, especially the presence of dark clots and increased pain, should be evaluated by a healthcare professional. It is always better to err on the side of caution when it comes to your health. If you have any doubts or concerns, do not hesitate to seek medical advice. Your health and well-being are paramount, and timely intervention can prevent potential complications.

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