Medication Abortion: What to Expect and When to Seek Help

Medication-induced abortion

I am currently in Australia and, after discovering my pregnancy, I have decided not to continue with it.
I underwent a blood test and scheduled an ultrasound.
After nearly three weeks of various arrangements, I finally took the first dose of medication for a medical abortion on Monday (at eight weeks pregnant) in front of the doctor.
The next day, Tuesday (24 hours later), I used four suppositories at home.
About an hour later, I experienced severe abdominal pain, vomiting, diarrhea, and chills.
I took the pain medication prescribed by the doctor, but it was not effective because I vomited it out.
Later, I had diarrhea along with some light bleeding, but it was not heavy.
After two hours, my body calmed down, and the severe pain subsided, so I lay down to rest.

On Wednesday, I checked my sanitary pad and found no blood, but only noticed some blood when urinating.
In the afternoon, I passed two thin, blood-like substances in the toilet that did not resemble blood clots; they felt like the remnants of a burst balloon.
Could this be embryonic tissue? However, that was the only time I passed that substance.
Up until now, my bleeding has been minimal, only some blood when I urinate.
Is this situation normal? Although I called the hospital on Thursday, they said that everyone's situation is different and that I do not need to take any additional medication.
When I asked how to confirm that everything has been expelled, they said that if I have no bleeding after two weeks, it should be fine, and that I should take a pregnancy test four weeks later.
If I am not pregnant, then everything is okay, and there is no need for further ultrasounds or follow-ups.
This seems completely different from what I read online.
Is this how medical treatment works in Australia? Should I continue to follow the doctor's instructions, or what should I do? Overall, I am very worried that everything has not been completely expelled.

Kai'er, 30~39 year old female. Ask Date: 2015/09/18

Dr. Lü Lizheng reply Obstetrics and Gynecology

Based on your description, the bleeding you are experiencing is more than a menstrual period, which may indicate medication failure and an incomplete miscarriage.
It is advisable to seek medical attention early for confirmation.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/09/18

More Info

Understanding medication abortion can be a complex and sometimes confusing process, especially when navigating the physical and emotional aspects of it. Based on your description, it seems you have already taken significant steps in the process, including taking the first dose of medication and using the vaginal suppositories as directed. It's important to remember that experiences with medication abortion can vary widely from person to person, and what you are experiencing may be within the range of normal.

After taking the first dose of mifepristone (the first medication), and then using misoprostol (the second medication) 24 hours later, it is common to experience a range of symptoms. These can include abdominal pain, cramping, nausea, vomiting, diarrhea, and bleeding. The intensity of these symptoms can vary, and while some individuals may have a more intense experience, others may have milder symptoms.
The abdominal pain and gastrointestinal symptoms you experienced, such as vomiting and diarrhea, are not uncommon. The cramping can be quite severe as the body begins to expel the pregnancy tissue. The fact that you experienced some bleeding, albeit not heavy, is also typical. It is important to monitor the bleeding; light bleeding or spotting can continue for several days to weeks after the procedure.

Regarding the "two thin blood-like things" you mentioned, it is possible that these could be tissue that has been expelled. During a medication abortion, the body may pass clots or tissue that can resemble what you described. However, without a medical professional examining the tissue, it is difficult to determine exactly what it is.
The guidance you received from the hospital is generally consistent with standard practice in medication abortion. It is common for healthcare providers to advise that if you are not experiencing heavy bleeding (soaking through two pads in an hour for two consecutive hours), and if you are not experiencing severe pain that is not relieved by over-the-counter pain medication, then you are likely managing well. The recommendation to follow up with a pregnancy test in four weeks is standard to confirm that the abortion was complete.

If you continue to have concerns about whether the abortion was complete or if you experience any new symptoms, such as heavy bleeding, severe pain, fever, or foul-smelling discharge, it is important to seek medical attention. You can also reach out to your healthcare provider for reassurance or further evaluation if you feel uncertain about your symptoms.

In Australia, the approach to medication abortion is generally patient-centered, and healthcare providers aim to ensure that you feel supported throughout the process. If you feel that your concerns are not being adequately addressed, consider seeking a second opinion or consulting with a healthcare provider who specializes in reproductive health.

In summary, while your experience may feel concerning, it seems to align with what many individuals experience during a medication abortion. Continue to follow your doctor's advice, monitor your symptoms, and do not hesitate to reach out for help if you feel something is not right. Your health and well-being are the top priority, and you deserve to feel supported and informed throughout this process.

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