How Long Should Bleeding Last After Medical Abortion?

How long does a medical abortion typically last?

Hello doctor, I have a habit of smoking and drinking.
This is my first abortion, and I chose the medical abortion method.
I started taking the first dose on May 3, 2017, taking three pills at once.
On May 5, I took the second dose, also three pills at once.
I began to pass blood clots, and the contractions were not as painful as described online; on a scale of ten, the pain was only about three or four.
I just felt a lot of heat and soreness in my lower back.
After about two hours, I started to pass a large amount of blood clots.
On May 6, I took the third dose, which was for incomplete abortion, and I took it for three days.
On May 11, I returned for a check-up, and the doctor said there was no embryo left.
At that time, the bleeding was less, and the doctor prescribed medication for uterine atony.
On May 18, during my follow-up, the doctor said there was still a little bit left in the uterus that hadn't been expelled.
However, the doctor advised me to observe for a while, and if my period didn't come by mid-June, I should return for a check-up.
No medication was prescribed, and there was no mention of a follow-up appointment.
To expedite the bleeding, I have been drinking herbal soup for the past two days.
Now it is May 23, and I am still bleeding, approximately the same amount as on the fourth or fifth day—not much.
I have been bleeding for almost 20 days now; is this normal? I really do not want to undergo surgery that could harm my uterus.
Could you please advise me on how many days of bleeding after a medical abortion is considered normal? Thank you for your guidance, doctor.

Huo Er, 30~39 year old female. Ask Date: 2017/05/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have a habit of smoking and drinking alcohol.
This is my first abortion, and I opted for a medical abortion.
I started taking the first dose on May 3, 2017, taking three pills at once.
On May 5, I took the second dose, also three pills at once.
I began to expel blood clots, and the contractions were not as painful as described online; on a scale of ten, the pain was only about three or four.
I just felt a lot of heat and soreness in my lower back.
After about two hours, I started to expel a large amount of blood clots.
On May 6, I took the third dose, which was for incomplete abortion, and I took it for three days.
On May 11, I returned for a follow-up, and the doctor said there was no embryo left.
At that time, the bleeding was less, and I was prescribed medication for uterine atony.
On May 18, during my follow-up, the doctor said there was still a little bit left in the uterus that hadn't been expelled.
However, the doctor advised me to observe for a while, and if my period didn't come by mid-June, I should return for another check-up.
No medication was prescribed, and I wasn't told to return for a follow-up.
To expedite the bleeding, I have been drinking herbal soup for the past two days.
Now, on May 23, I am still bleeding, which seems to be about the same amount as on the fourth or fifth day—not much.
I am unsure if it is normal to bleed for nearly 20 days.
I really don't want to undergo surgery that could harm my uterus.
Could you please advise me on how long bleeding after a medical abortion is considered normal? Thank you for your guidance.

Answer: Bleeding for more than a month is considered prolonged.
It is advised not to consume herbal soup, as it is generally believed to affect uterine contractions.

Reply Date: 2017/05/23

More Info

After a medical abortion, it is common for individuals to experience bleeding, which can vary in duration and intensity. Generally, bleeding after a medical abortion can last anywhere from a few days to a few weeks. Most women will notice that the heaviest bleeding occurs within the first few days following the procedure, and it typically tapers off over time.
In your case, since you mentioned that you have been experiencing bleeding for about 20 days, it is important to consider a few factors. First, the duration of bleeding can be influenced by several variables, including the individual's hormonal levels, the timing of the abortion in relation to their menstrual cycle, and any underlying health conditions. It is not uncommon for some women to experience prolonged bleeding, especially if the abortion was performed early in the pregnancy or if there were complications such as retained products of conception.

The presence of blood clots, as you described, is also a normal part of the process. Blood clots can occur as the uterus contracts and expels tissue. However, if you are experiencing large clots or if the bleeding is heavy enough to soak through a pad in an hour or less, this could be a sign of a complication, such as incomplete abortion or infection, and you should seek medical attention promptly.

It is also worth noting that the use of herbal remedies, such as "生化湯" (a traditional Chinese herbal soup), to expedite the process of bleeding may not be advisable without consulting a healthcare provider. While some individuals may seek alternative methods to manage their recovery, it is crucial to prioritize safety and ensure that any approach taken does not interfere with the body's natural healing process.

Given that you have been bleeding for an extended period, it is advisable to follow up with your healthcare provider. They may recommend an ultrasound to check for any retained tissue in the uterus, which could be contributing to the prolonged bleeding. Additionally, they can assess your overall health and provide guidance on managing any discomfort or complications.

In summary, while some bleeding after a medical abortion is normal, prolonged bleeding lasting more than two weeks warrants further evaluation. It is essential to communicate openly with your healthcare provider about your symptoms and any concerns you may have. They can offer the most accurate advice tailored to your specific situation and ensure that you receive appropriate care.

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