Post-Abortion Bleeding After Follow-Up: Is It Normal?

After the abortion procedure, bleeding started after the follow-up visit and disinfection?

Hello, I underwent a dilation and curettage (D&C) procedure on May 8 when I was five weeks pregnant.
After the procedure, the doctor informed me that I had cervical erosion and advised me to return for a follow-up appointment.
He prescribed Cephalexin, Acetaminophen, and a gastrointestinal medication.
I returned for a follow-up on May 22, two weeks post-operation, when I had no bleeding.
During that visit, I also had an HPV test and Pap smear.
The doctor performed a pelvic examination and noted that my uterus was healing well and that I did not need further medication.
However, there was still some blood inside, so he took a sample and applied some medication for disinfection.
After the appointment, I returned home and started bleeding again, similar to the bleeding I experienced in the two weeks following the D&C.
The bleeding consists of bright red and dark blood, but it is not heavy—more like the last few days of a menstrual period.
I would like to ask if this bleeding is normal.
Additionally, does bleeding affect ovulation? Is it possible for me to be ovulating while I am currently bleeding?

Xiao Han, 20~29 year old female. Ask Date: 2017/05/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I underwent an abortion on May 8, when I was five weeks pregnant.
After the procedure, the doctor informed me that I had cervical erosion and scheduled a follow-up appointment, prescribing Cephalexin/Acetaminophen and a gastric medication.
I returned for my follow-up on May 22, two weeks post-operation, as I had not experienced any bleeding.
During this visit, I also had an HPV test and a Pap smear.
The doctor performed a pelvic examination and noted that my uterus was healing well and that I did not need any further medication.
However, there was still some retained blood, so the doctor took a sample and applied some medication for disinfection.
After returning home, I started bleeding again, similar to the bleeding I experienced in the two weeks following the abortion, with bright red and dark blood, but the amount was not significant—similar to the last few days of a menstrual period.
I would like to ask if this bleeding is normal.
Could this bleeding affect my ovulation? Is it possible that I am currently bleeding and also ovulating?
Answer: The current bleeding could potentially be related to ovulation, but an ultrasound would be needed to confirm this.

Reply Date: 2017/05/23

More Info

Post-abortion bleeding can be a concerning issue for many women, and it's important to understand what is considered normal and when to seek further medical advice. After an abortion, whether it is a medical or surgical procedure, it is common for women to experience some degree of bleeding. This bleeding can vary in amount and duration, and it is typically similar to a menstrual period.
In your case, you had a surgical abortion at five weeks gestation on May 8th, and you experienced a period of no bleeding for two weeks before returning for a follow-up appointment. The fact that your doctor noted some residual blood in the uterus during your follow-up examination is not unusual. It is common for some blood to remain, and it may take time for the uterus to completely clear out any remaining tissue or blood.
The subsequent bleeding you experienced after your follow-up visit, which resembles the end of a menstrual period, can be considered normal. This type of bleeding can occur as the uterus continues to expel any remaining contents and return to its pre-pregnancy state. It is also possible that the bleeding is related to the healing process of the uterine lining, especially if there was any irritation during the examination or if the cervix was manipulated.

Regarding your question about ovulation, it is important to note that bleeding can sometimes coincide with ovulation, but it is not typical. Ovulation usually occurs about 14 days before the start of your next menstrual period, and while some women may experience light spotting during ovulation, it is generally not associated with post-abortion bleeding. If you are currently experiencing bleeding, it may be difficult to determine if you are ovulating at this time.
In general, if the bleeding is light, similar to a menstrual period, and does not include large clots or an unpleasant odor, it is likely within the normal range. However, you should monitor the situation closely. If you experience heavy bleeding (soaking through a pad in an hour), severe pain, or any signs of infection (such as fever or foul-smelling discharge), it is crucial to contact your healthcare provider immediately.

In summary, post-abortion bleeding can vary widely among individuals, and what you are experiencing may be normal as your body adjusts after the procedure. It is always best to keep an open line of communication with your healthcare provider, especially if you have concerns about your symptoms or if they change in nature. Regular follow-ups and monitoring your body’s responses are key to ensuring your health and well-being during this recovery period.

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