Brown Discharge After Abortion: Causes and Concerns

The issue of brown discharge after an abortion?

Hello, doctor.
(I previously underwent tubal surgery.) On November 21, 2017, I had a surgical abortion (dilation and curettage) at about 7-8 weeks of gestation.
The physician at the clinic advised me not to consume alcohol or ginseng products for two weeks.
However, during the second week, a family member gave me a tea that contained ginseng, which led to some bleeding afterward (about the amount of one panty liner, not much) and the expulsion of small blood clots.
The bleeding lasted for about 7 days, after which I experienced brownish discharge until my follow-up appointment on December 8, 2017.
The doctor prescribed estrogen, a gastric medication, a hemostatic agent, and another anti-inflammatory medication for three days.
After completing the medication, I indeed noticed no brownish discharge on the panty liner.
However, after having intercourse with my boyfriend two days ago and yesterday (with a condom), I noticed brownish discharge again.
Additionally, I have been experiencing a dull pain on the right side (near the pelvis) for the past two days, and the day after intercourse, my lower back felt sore and weak, with persistent dull pain in the right lower abdomen and a sensation of bubbles bursting in my abdomen.
Could this be inflammation? Is there a need for a Pap smear?

San San, 20~29 year old female. Ask Date: 2017/12/13

Dr. Huang Jianzhong reply Obstetrics and Gynecology

(I previously underwent tubal surgery) On November 21, 2017, I had a surgical abortion (dilation and curettage) at approximately 7-8 weeks gestation.
The doctor at the clinic informed me that I should avoid alcohol and ginseng products for two weeks.
However, during the second week, a family member gave me a tea that contained ginseng, which led to some bleeding (about one panty liner's worth, not much) and the passage of small blood clots.
The bleeding lasted for about 7 days, after which I experienced brownish discharge until my follow-up appointment on December 8, 2017.
The doctor prescribed estrogen, a gastric medication, a hemostatic agent, and another anti-inflammatory medication for three days.
After completing the medication, I noticed that the brown discharge had stopped.
However, after having intercourse with my boyfriend two days ago and yesterday (with a condom), I found that there was still brown discharge.
Additionally, I have been experiencing a dull pain on the right side (near the pelvis) for the past two days, and my lower back felt sore and weak the day after intercourse, along with a persistent dull pain in the right lower abdomen and a sensation of bubbles bursting in my abdomen.
Is this inflammation? Do I need to have a Pap smear?
Answer: This situation is not indicative of inflammation.
A Pap smear should be performed once the bleeding has resolved.

Reply Date: 2017/12/13

More Info

Brown discharge after an abortion can be concerning for many women, especially when accompanied by other symptoms such as pelvic pain or discomfort. In your case, it seems that you have experienced a series of events following your abortion, including the consumption of a herbal tea containing ginseng, which could have contributed to your symptoms.
Firstly, it’s important to understand that brown discharge is often old blood that is being expelled from the body. After an abortion, it is not uncommon to experience some bleeding or spotting as the body returns to its normal state. This can include brown discharge, which may occur for several weeks post-procedure. However, the presence of small blood clots and a change in the nature of the discharge can indicate that further evaluation may be necessary.

The fact that you experienced bleeding after consuming ginseng tea is noteworthy. Ginseng is known to have various effects on the body, including potential impacts on blood clotting and hormonal balance. It’s crucial to follow post-abortion care instructions closely, as your healthcare provider advised against alcohol and certain herbal supplements for a reason. These substances can interfere with the healing process and may lead to complications such as increased bleeding or infection.

Regarding your symptoms of pelvic pain, especially on the right side, this could be indicative of several issues. Pain in the pelvic area after an abortion can arise from normal post-procedural healing, but it can also suggest complications such as infection, retained products of conception, or even endometriosis, particularly if the pain is persistent or worsening. The sensation of "bubbles popping" in your abdomen could be related to gas or digestive issues, but it could also be a sign of irritation or inflammation in the pelvic cavity.

Given your symptoms, it would be prudent to seek further evaluation from your healthcare provider. A pelvic examination, including a Pap smear if indicated, may be necessary to rule out any infections or other complications. Additionally, an ultrasound may be warranted to ensure that there are no retained products of conception, which can lead to prolonged bleeding and infection.

In summary, while brown discharge can be a normal part of the recovery process after an abortion, the combination of your symptoms—persistent pelvic pain, the presence of blood clots, and the brown discharge—suggests that you should consult your healthcare provider for a thorough evaluation. They may recommend further tests or treatments to ensure that your recovery is progressing as expected and to address any potential complications. It’s always better to err on the side of caution when it comes to your health, especially after a significant medical procedure like an abortion.

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