Post-Medication Abortion Bleeding: What to Expect - Obstetrics and Gynecology

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After undergoing a medication abortion, it is common to have questions and concerns about the bleeding that follows. Based on your description, it seems you have experienced a range of symptoms and changes in bleeding patterns after taking the medication. Let's break down what you might expect after a medication abortion and address your concerns.

Firstly, it is important to understand that a medication abortion typically involves two main medications: mifepristone (often referred to as RU486) and misoprostol. The first medication is taken at a healthcare provider's office, and the second is usually taken at home within a few days. The process is designed to induce a miscarriage, and the body will expel the pregnancy tissue, which can result in bleeding similar to a heavy menstrual period.

In the days following the administration of these medications, it is normal to experience bleeding that can vary in amount and duration. Initially, you may notice light spotting, which can progress to heavier bleeding with clots as the body expels the pregnancy tissue. The bleeding can last for several days to weeks, and it is not uncommon for it to fluctuate in intensity.
From your account, it appears that you initially experienced light bleeding, which is typical after taking the first dose of the medication. After your follow-up appointment on December 23, where the doctor indicated that you had expelled the tissue, you began taking uterotonics (medications to help the uterus contract). However, the sudden onset of bright red bleeding on December 28, requiring the use of sanitary pads, raises some questions.

Bright red bleeding can indicate fresh blood, which may be a normal part of the process as your body continues to expel any remaining tissue. However, if the bleeding becomes heavy (soaking through a pad in an hour or less), is accompanied by severe pain, or if you pass large clots, it is essential to seek medical attention. These could be signs of incomplete abortion or other complications that may require further evaluation.

It is also important to note that every individual's experience with medication abortion can differ significantly. Some may have more prolonged bleeding, while others may have a shorter duration. The presence of clots is also common, as the body sheds the uterine lining and any remaining tissue.

In your case, since you have already been in contact with your healthcare provider, it is advisable to continue following their guidance. If you have concerns about the amount of bleeding or any other symptoms, do not hesitate to reach out to them for further advice. They may recommend a follow-up ultrasound or additional blood tests to ensure that the abortion was complete and that there are no complications.

In summary, while some bleeding after a medication abortion is expected, sudden changes in the bleeding pattern should be monitored closely. Trust your instincts and communicate openly with your healthcare provider about any concerns you may have. They are there to support you through this process and ensure your health and well-being.