Minimal Bleeding and No Pain After Medication Abortion: Is It Successful? - Obstetrics and Gynecology

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After a medical abortion, there is very little bleeding and no pain?


On March 25, I took the first dose of 2 pills, and on March 27, I took the second dose of 3 pills.
I waited at the clinic for an hour and a half without feeling anything or seeing any bleeding.
The doctor prescribed two more pills, and after waiting another hour, I still felt nothing and had no bleeding, just some stomach pain.
The doctor performed a transvaginal ultrasound and said that no embryo was visible.
After the transvaginal ultrasound, there was a little bit of bleeding.
The doctor then performed a pelvic examination and used a cotton swab, stating that something was stuck there.
Later, I was shown a flesh-colored piece about 1 centimeter in size.
After returning home, I felt a slight heaviness in my abdomen but had no significant bleeding.
Does this indicate that the procedure was successful? Thank you, doctor.

jiā tíng zhǔ fù, 40~49 year old female. Ask Date: 2023/03/28

Dr. Cao Guotao reply Obstetrics and Gynecology


Hello, you currently look good.
As for whether everything has cleared up, please continue to follow up at the original clinic.
Wishing you good health.

Reply Date: 2023/03/28

More Info


Based on your description, it seems you have undergone a medication abortion and are experiencing minimal bleeding and no pain afterward. This situation can be concerning, especially when trying to determine whether the abortion was successful.

In a medication abortion, two types of medications are typically used: mifepristone (often referred to as RU486) and misoprostol (which may be the medication you referred to as "喜克潰"). The first medication is taken to block the hormone progesterone, which is necessary for the pregnancy to continue. The second medication is taken 24 to 48 hours later to induce contractions and help expel the pregnancy tissue.

It is not uncommon for some individuals to experience minimal bleeding and cramping after taking these medications, especially if the abortion is successful. However, the absence of significant bleeding or pain can also raise concerns about whether the abortion was complete. In your case, the ultrasound indicated that the embryo was not visible, which is a positive sign that the medication may have worked. However, the presence of tissue during the internal examination suggests that there may still be some remnants.

The fact that you experienced a small amount of bleeding after the internal examination could indicate that some tissue was expelled. However, it's essential to monitor your symptoms closely. If you continue to have minimal bleeding and no pain, it may be a sign that the abortion was successful, but it is crucial to follow up with your healthcare provider for further evaluation.

In general, after a medication abortion, healthcare providers recommend a follow-up appointment within one to two weeks to ensure that the abortion was complete. This follow-up may include a physical examination, blood tests to check hormone levels (specifically β-HCG), and possibly another ultrasound to confirm that there is no remaining tissue in the uterus.

If you are still concerned about whether the abortion was successful, or if you experience any new symptoms such as heavy bleeding (soaking through a pad in an hour), severe pain, fever, or foul-smelling discharge, you should seek medical attention immediately. These could be signs of complications, such as an incomplete abortion or infection.

In summary, while minimal bleeding and no pain can be normal after a medication abortion, it is essential to have a follow-up appointment to confirm that the abortion was complete. Trust your healthcare provider's guidance, and do not hesitate to reach out to them with any concerns or questions you may have about your recovery process. Your health and well-being are the top priority, and open communication with your healthcare team is vital during this time.

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