Post-Abortion Bleeding After Medication: When to Seek Help

Issues Related to Bleeding in Medical Abortion

On July 4th, I took the first dose of RU486, and on July 6th, I took the second dose.
A week later, during my follow-up appointment, the doctor said the embryo had been successfully expelled.
At that time, the bleeding was minimal and had significantly decreased.
The color was similar to brown.
However, starting around July 17th, the bleeding gradually increased, and the color turned red.
What could be the issue here? Do I need to schedule another follow-up appointment? I also feel some lower back pain and am particularly fatigued today.

Ding Ding, 30~39 year old female. Ask Date: 2024/07/20

Dr. Liu Fuping reply Obstetrics and Gynecology

Hello, if there is an increase in bleeding volume and discomfort in the lower abdomen, it is recommended to return for a follow-up consultation.
Thank you.

Reply Date: 2024/07/20

More Info

After undergoing a medical abortion using RU486, it is common to experience a range of symptoms, including bleeding and discomfort. Your situation, where you initially had a decrease in bleeding that later increased in volume and changed color, raises some important considerations.

Firstly, it is essential to understand that post-abortion bleeding can vary significantly from person to person. After taking RU486, the body goes through a process of expelling the pregnancy tissue, which can lead to bleeding that resembles a menstrual period. Initially, this bleeding may be light and brownish in color, indicating older blood. However, as the body continues to expel tissue, the bleeding can become heavier and may turn red, which is typically fresher blood.

The increase in bleeding you experienced starting around July 17 could be attributed to several factors:
1. Incomplete Abortion: If some tissue remains in the uterus, it can lead to continued bleeding. This is often accompanied by cramping and discomfort. If the bleeding becomes heavy or is accompanied by severe pain, it is crucial to seek medical attention.

2. Hormonal Changes: After an abortion, your hormone levels can fluctuate significantly, which may affect your menstrual cycle and bleeding patterns. It is not uncommon for women to experience irregular bleeding or changes in their menstrual cycle following an abortion.

3. Infection: Although less common, an infection can occur after an abortion, leading to increased bleeding, fever, and abdominal pain. If you notice any signs of infection, such as a foul-smelling discharge, fever, or severe abdominal pain, you should seek medical help immediately.

Given that you are experiencing increased bleeding and discomfort, it is advisable to contact your healthcare provider for a follow-up appointment. They may recommend an ultrasound to ensure that the uterus is clear of any remaining tissue and to assess the cause of the increased bleeding. Additionally, if you are feeling particularly fatigued or experiencing significant discomfort, these are also valid reasons to seek medical advice.

In summary, while some variation in bleeding is normal after a medical abortion, significant changes in bleeding patterns, especially if accompanied by pain or other concerning symptoms, warrant a medical evaluation. It is always better to err on the side of caution and consult with your healthcare provider to ensure your health and well-being.

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